Elizabeth Siegel Watkins. On the Pill: A Social History of Contraceptives, 1950-1970. Baltimore and London: Johns Hopkins University Press, 1998. viii + 183 pp. $25.95 (cloth), ISBN 978-0-8018-5876-5.
Reviewed by Susan L. Smith (Department of History and Classics, University of Alberta, Canada)
Published on H-Women (June, 1999)
The history of reproduction is an endlessly fascinating topic for women's historians. However, few historians of birth control have ventured into the post-World War II era. In On the Pill: A Social History of Contraceptives, 1950-1970, Elizabeth Siegel Watkins provides an excellent overview of the development of oral contraceptives and the subsequent debate over issues of safety. In the process of detailing the history of the modern era's new method of birth control, Watkins reveals much about reproductive politics in the United States during the 1950s and 1960s.
Watkins analyses the birth control pill, which went on the market in 1960, as a form of medical technology. She describes who conducted, and who paid for, the research that led to the development of an oral hormonal contraceptive. She shows how Planned Parenthood, which brought together the goals of the birth control movement and the population control movement, promoted the pill's development. As Watkins points out, "the climate of the 1950s favored scientific and technological solutions to social problems" (p. 19). She also discusses briefly how the large-scale field trials of the oral contraceptive were conducted on women in Puerto Rico where American interest in promoting birth control and population control meshed.
Watkins also looks at some of the consequences of the pill, including its use as an icon of the sexual revolution of the 1960s. Her research dismantles the popular assumption that the pill caused the sexual revolution. In the 1960s demographers studied the birth control practices of married women and sociologists studied the sexual behavior of unmarried people. Despite the fact that these scholars were studying different populations, journalists erroneously identified a correlation between the development of the pill and changes in sexual practices. As Watkins states, "the pill did indeed revolutionize birth control, and radical changes in sexual attitudes and conduct did take place, particularly among young people, but no one ever established a connection between these two phenomenon" (p. 55).
Another consequence she examines is how the pill affected the relationship between women and their doctors. According to Watkins, "by 1990, 80 percent of all American women born since 1945 had used the pill at some time in their lives" (p. 132). Given that the pill was only available under a doctor's prescription, she suggests that the oral contraceptive contributed to increased medical control over the lives of many women.
One of the most interesting themes developed in the book is the irony that the same oral contraceptive that was celebrated by one generation of feminists ended up criticized by the next. Watkins helps us to understand how that transformation of meaning came about. In the 1950s, feminists like Margaret Sanger and Katherine McCormick lobbied hard for an oral contraceptive, with McCormick contributing hundreds of thousands of dollars to its development. They saw the creation of the pill "as a scientific triumph for women in their efforts to gain control over their reproductive lives" (p. 5). For example, Planned Parenthood eagerly endorsed the pill and provided it at low cost in its clinics.
However, questions about side effects and safety altered feminist responses to the pill. As early as 1964, researchers began to examine some of the health effects. As Watkins notes, unlike other pills, "perfectly healthy women took it for long periods of time" (p. 88) even though little was known about the long-term health hazards. By the 1970s, even as Planned Parenthood retained its strong support for the pill, at least some feminists came to see it "as an ill-conceived, poorly tested contraceptive foisted on women through the collusion of the drug industry and the medical profession" (p. 5). According to Watkins, the new women's health movement was created, at least in part, out of the controversy over the pill.
The history of the birth control pill is a fascinating topic. However, at times On the Pill reads more like a dry, institutional report than a lively historical analysis. Although Watkins draws on scientific and medical sources, she presents little of women's voices, opinions, and experiences, especially as consumers. Unfortunately, I would not recommend this book for classroom use. Nonetheless, there is much of value here to scholars.
In the end, what struck me as most important in Watkins's research was her emphasis on the central role that the media played in the dissemination of information about the pill. The popular press helped to shape perceptions of the pill, from the initial enthusiasm in the early 1960s to the safety concerns of the late 1960s. This book is a powerful reminder that the media has had a tremendous influence as the translator of scientific and medical research to the general public, and even to practicing physicians.
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Susan L. Smith. Review of Watkins, Elizabeth Siegel, On the Pill: A Social History of Contraceptives, 1950-1970.
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