Relevant to Pincus and Rock’s decision to use Puerto Rico as the pill’s testing ground is the fact that between the 1930s and 1970s, Puerto Rican women were sterilized in droves—many against their will. This was made possible by U.S. colonialism, which since the 1898 Spanish-American War invasion has dispossessed the majority of Puerto Ricans of their land, resulting in widespread poverty.

