On the Pill: A Social History of Oral Contraceptives, 1950-1970

by Elizabeth Siegel Watkins

"In 1968, a popular writer ranked the pill's importance with the discovery of fire and the developments of tool-making, hunting, agriculture, urbanism, scientific medicine, and nuclear energy. Twenty-five years later, the leading British weekly, the Economist, listed the pill as one of the seven wonders of the modern world. The image of the oral contraceptive as revolutionary persists in popular culture, yet the nature of the changes it supposedly brought about has not been fully investigated. After more than thirty-five years on the market, the role of the pill is due for a thorough examination." -- from the Introduction In this fresh look at the pill's cultural and medical history, Elizabeth Siegel Watkins re-examines the scientific and ideological forces that led to its development, the part women played in debates over its application, and the role of the media, medical profession, and pharmaceutical industry in deciding issues of its safety and meaning. Her study helps us not only to understand the contraceptive revolution as such but also to appreciate the misinterpretations that surround it.

Genres: History, Sexuality, Nonfiction, Feminism, Gender Studies, Medicine, Gender and Sexuality

208 pages, Hardcover

First published October 14, 1998

Reviews

[CJ]

A deeply researched case study in how the interests of the medical field, the pharmaceutical industry, the government and the women's movement intersected and divulged in the creation and implementation of the birth control pill. Arguably the biggest development in the movement for women's liberation, hormonal birth control also has a complicated history as a major profit driver for big pharma and a drug who's side effects are still frustratingly understudied. This book shows how different eras of feminists responded to those contradictions, being in many cases strongly supportive of the pill while also at times critical of the male-dominated industries promoting it. Watkins also points out that the implementation of the pill -- which is not a 'medication' in that it doesn't treat an illness, but still requires a prescription from a doctor -- shifted the balance of power between patients and their doctors as one of the first drugs patients proactively sought out. Similar to abortion and other controversial procedures, the medical field has maintained a strong grip on the prescription of birth control, but it's unclear whether this is either necessary or in the best interests of women (as Watkins quoted one person saying, it would be safer to sell birth control over the counter and to keep cigarettes behind a counter). We appear to be in an era where being critical of either medical authority or birth control itself is looked down upon, and while there are understandable reasons for this (the demise of Roe v. Wade and increasing criminalization of birth control, criticism of doctors being coded as right wing post-COVID), I think women would be better served by a return to increased skepticism and begin to demand better of those who profit off of our fertility.

[Katie · Rating 3 out of 5]

Re-evaluating popular perceptions around the social impact of the birth control pill in middle-class America, in this text, Siegel Watkins sets out to explore changing views around the pill in the 1950s and 1960s and the ways technology, medical science, and social ideas around sex and feminism influenced the acceptance and mass popularity of the pill. Developed when medical science was at its height of postwar popularity and authority, Siegel Waktins argues the pill represented both technological advances and the means by which women's health care was increasingly "medicalized" in mid-century America. Through the influence of doctors (who readily embraced the pill because it allowed them to assert their authority around family planning and say the prescription-based model as profitable), mass media, and, of course, birth control advocates who tapped into concerns around population size, the pill was readily embraced. However, as Siegel Watkins demonstrates, in this assertion of authority, the medical profession failed to properly convey the level of risk involved with the pill to female patients. In the second half of the book, Siegel Watkins traces debates around the purpose of medical therapies and the limitations around when interventions should occur. Prompted by concerns around the pill, along with influences from the consumer rights movement and the larger feminist movement, women pushed doctors, government, and industrial officials to fully disclose the risks with birth control.

Concluding in 1970 with the U.S. hearings around birth control, Siegel Watkins' texts demonstrates the ways medical bodies, pharmaceutical companies, birth control advocates, and government officials viewed the pill. As a social history, I would have preferred to hear more of women's voices and everyday experiences with the pill. I would have also liked to have seen the mass media side of the debates explored further - why did magazines publish so much about birth control? What influenced them to give space for this topic and not other issues? Did medical professionals and/or pharma executives influence these magazines?

[Sara Watson · Rating 4 out of 5]

On the Pill complicates (and debunks) the causal relationship between a technology and a socio-cultural revolution. It also explores the tensions in the widespread adoption of a technological fix for socio-econimc problems (namely overpopulation concerns).

It is particularly interesting, though perhaps not surprising given the large percentage of the population concerned, that the Pill initiated an important shift in patient-doctor information relationships, introducing the patient package insert we are so familiar with now. Watkins handles the delicate balance in the subjectivity of patient risk-benefit calculations well. I also particularly enjoyed the treatment of journalists and the media's role in the adoption of the pill.

My only lament is that this history stops at 1970, as I'd love to know more about how these controversies continue with the introduction of new technologies (rings), and as alternatives to the pill are explored (a renewed interest in IUDs).

[saizine · Rating 3 out of 5]

A perfectly serviceable history of the development of the pill, although not one that is not otherwise accessible elsewhere. Of particular interest in this publication, however, is the emphasis on the development of the patient package insert and the (often lopsided) relationship between doctor and patient (as well as pharmaceutical companies/development and doctors and patients). As always, I am interested in how risk-benefit analyses are carried out and by whom, and this book addressed this complication in adoption of the pill very well. Certainly a book to pick up if you’re looking to explore the pill in many facets (not only medical but also through the lenses of technological development, risk calculation, media coverage etc), but perhaps not the seminal work on the subject.

[Jess · Rating 3 out of 5]

This was an important book to read in terms of learning the history of the pill. However, there were some sections that were geared more towards medical professionals that I did not completely understand. But the parts about the social history were a lot more interesting.

[Beth · Rating 3 out of 5]

Nice overview of the history of the birth control pill and it's larger historical and social meanings. Would have liked to have seen more detail but is a nice addition to the literature on prescription drugs.