From The New England Journal of Medicine
The subtitle calls this book "a social history of oral contraceptives, 1950-1970," but since women could only get "on the Pill" beginning in 1961, it really describes use of the Pill only during a nine-year period ending in 1970. But which Pill?
As a chemist with a long interest in oral steroid contraceptives, I found this book useful. Whether readers of the Journal, notably medical practitioners, will find it so is an open question. For all practical purposes, Watkins considers the Pill to be synonymous with norethynodrel (Enovid), which was introduced as a contraceptive agent in 1961 by the G.D. Searle company and has since been withdrawn. But the mid-1960s -- that is, halfway through Watkins's book -- sales of norethynodrel were already far surpassed by those of norethindrone; by 1970, norgestrel had become a third key player.
A social historian's assumption that the Pill is the Pill is the Pill does not read right to a chemist, nor should it to a physician, who surely would not equate a pill containing 10 mg of norethynodrel from 1961 with the 2.5-to-1.0-mg formulations used by the end of that decade, let alone the pills of today, containing much lower doses.
Moreover, though the arbitrarily selected cutoff date of 1970 might make sense for a simple history, a social history of the 1960s cannot be considered without examining the effects of the events of that decade on the 1970s, 1980s, and 1990s. It is no wonder that Watkins has to trespass more than once on her self-imposed boundary. One of her broader overviews -- dealing with the contentious issue of package inserts, which affected far more than just the Pill -- is also the most successful one of the book. But how much more useful this book would have been if the arbitrary cutoff date had been extended, say, into the mid-1980s, up to the advent of AIDS. It behooves a social historian to analyze the phenomenon that, in spite of the fact that the Pill does not protect against sexually transmitted diseases, the number of women using oral contraceptives in the United States is now at an all-time high.
Except for a single sentence on page 125 ("... by 1970 more than a hundred lawsuits had been filed against birth control pill manufacturers"), Watkins fails to elaborate on the enormous effect that litigation concerning the Pill had on the withdrawal of the pharmaceutical industry from research and development with respect to contraceptives during the early 1970s. I was also surprised that the 1978 oral-history project of the American Academy of Arts and Sciences, "Historical Perspectives on the Scientific Study of Fertility," seems to have been left out altogether. Its unedited transcripts of unvarnished personal debates are extremely relevant to the study of the 1960s.
I feel that a historian, especially one so interested in a woman's perspective, would have found this oral-history project germane to one of the longest chapters in her book. The Nelson hearings held by the U.S. Senate, which heard testimony on the safety of oral contraceptives, is extensively covered by Watkins. Missing, however, is adequate attention to the extraordinary bias of almost all the participants. For instance, one of the most virulent critics of the Pill, Dr. Hugh Davis of Johns Hopkins University, considered the Pill's side effects so great that, according to Watkins, he would have ordered it taken off the market had it been a food product. Watkins neglects to mention that Davis, the developer of the Dalkon shield, was simultaneously touting the complete safety of his contraceptive device.
One of the blurbs on the jacket of the book calls this "the first well-documented and thorough historical analysis of [the Pill]." On the Pill is a concise collection of material from many sources, and to that extent it is useful. But "first" or "thorough" it is not.
Reviewed by Carl Djerassi, Ph.D.
--This text refers to an out of print or unavailable edition of this title.
Review
This is an exemplary study of how the nation which first had access to oral contraceptives first came to terms with their advantages, and their drawbacks.
(Jon Turney
Times Literary Supplement )
Intelligent and well-structured... An admirable exercise in social history.
(Richard Davenport-Hines
Nature )
A particularly fascinating issue, trim and focused, sophisticated and helpful, fresh and very interesting.
(Rickie Solinger
American Historical Review )
In every carefully organized, lucidly written chapter Watkins provides surprising corrections to conventional thinking about the new birth control method... One especially noteworthy theme is the book's exploration of the politics of the pill, including Planned Parenthood [Federation] of America's concerted efforts to rebut critics, federal officials' dramatically shifting positions from the 1950s to the 1970s on birth control, population control and family planning, and pill-induced tensions among feminists.
(Janet Farrell Brodie
Journal of American History )
Any study of the development of the birth-control pill will be centrally concerned with the expansion of women's reproductive choices. But, as this book so clearly demonstrates, it involves other questions too. In part, it is about the risks that come with the ingestion of oral contraception. It is about the relationship between women and doctors, between women and their partners and betwen science, medicine and the media. Not least, it is about how women have responded differently to this intervention into their bodies. Underpinned by some excellent archival material, interviews with key individuals and an extensive use of the newspapers, magazines and medical journals of the time, this study is particularly strong in its discussion of concerns over the safety of the Pill... This is not the only area of interest within this valuable book. Anyone concerned with the debate over scientific advance and medical authority will find this a highly stimulating study... For her, the Pill brought the possibility of voluntary pregnancy, and feminist (and other) critics of its medical effects and social repercussions will need to engage carefully with her arguments if this important debate is to be taken to a new level.
(Martin Durham
Journal of American Studies )
