Revisiting the Dark History of Birth Control Testing in Puerto Rico

Lead Photo: Photo: Getty Images
Photo: Getty Images
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If you’ve scanned your Facebook or Twitter accounts in the last few days, you’ve likely read that the male birth-control shot hit a snag because men couldn’t deal with the side effects that women who take contraceptive pills regularly feel. While that’s not exactly true – the injection also needs an adjustment in hormonal levels before it’s ready to reach market – the frustration is understandable. Women have always unequally carried the burden of birth control. And given that these men knew they were participating in a clinical trial and had their concerns taken seriously is a reminder of the ugly history behind the birth control pill. Though often touted as one of the 20th century’s most important inventions, the pill came at the expense of women of color.

After doctors John Rock and Gregory Pincus successfully tested the pill in Boston between 1954 and 1955, they knew they had to move on to large-scale human trials before getting their new product onto the market. A 1955 visit to Puerto Rico convinced Pincus that the island was the perfect place to conduct these experiments. The lack of anti-birth control laws and a stationary population made Puerto Rico appealing to the doctors.

Targeting the most disenfranchised women, they began in Rio Piedras. PBS reports that Pincus “hoped that by showing Puerto Rican women could successfully use oral contraceptives, he could quiet critics’ concerns that oral contraceptives would be too ‘complicated’ for women in developing nations and American inner cities to use.”

In April 1956, the trials began, and so many women signed up that the doctors ended up expanding the experiment to different parts of the island. Despite living in a staunchly Catholic country, Puerto Rican women embraced birth control, as did officials. The government saw it as a form of population control, and because women previously turned to sterilization or abortions to avoid pregnancies, they saw the birth control pill as a liberating choice.

Nearly fifty years after participating in the experiments, Delia Mestre could still remember the hospital social worker who visited families in her neighborhood and offered them a simple way to avoid pregnancy. “We all jumped on it quickly and didn’t look back,” a 60-year-old Mestre told the Orlando Sentinel in 2004. “Women were told this was medicine that would keep them from having children they couldn’t support.”

What they women didn’t know was that they were serving as guinea pigs, as doctors monitored the effects of the experimental drug. The pill also had three times as much hormones as the modern-day pill, which brought a host of side effects that went unaddressed. From the mid-1950s to about 1964, the poor and uneducated women received free birth control, testing several different versions.

Doctors dismissed complaints about negative reactions, calling them psychosomatic because women in Boston didn’t experience as many side effects. But even after three women died, the doctors did nothing. No one performed an autopsy to determine if the death was drug related. Experiments in other parts of the United States stopped because of the side effects, but they continued for years in Puerto Rico. By 1960, the FDA approved the pills – marketed to white women “as a symbol of independence.”

Even half a century later, the unwitting participants felt the pain of this deception. “The experiments were both good and bad,” Mestre said, as she began to tear up. “Why didn’t anyone let us make some decisions for ourselves? I have difficulty explaining that time to my own grown children. I have very mixed feelings about the entire thing.”

According to PBS, the doctors ended up tarnishing their reputations, with people accusing them of colonialism and exploitation of poor Puerto Rican women. In that time, participants of human trials didn’t have as many protections in place. The rules were less rigid. Because of Pincus and Rock’s trials, stronger rules and guidelines for future clinical trials were put into place.