The Dark Side of the Contraceptive Pill

Valentina Pérez Sánchez

A cornerstone for women’s sexual freedom in modern history, this type of birth control is the most used method to date, but do we know at what cost it was invented? Why don’t we have a version for the male population yet? Its roots are covered in racism and controversy, let’s discover why.

We’ll draw a setting first: the island of Puerto Rico in the mid-’50s was an area with no laws on birth control and was unfairly perceived as an overpopulated area. Before the invention of the pill, the only method for preventing pregnancy was complete sterilization, popularly called “la operación”, which was heavily sponsored by the government. Let’s not forget that contraception was illegal for single women in the States, and as for the rest of the world, let’s say it wasn’t very present.

Now it’s hard to pinpoint why this territory was specifically chosen for these trials, as there are numerous reasons. Firstly, it was very close to the United States and easily reached by plane, secondly, sterilization made the pill look like a miracle option, and thirdly, clinical trials had been already attempted in the US, but they couldn’t continue as it was against the law.

With the considerable demographic boost in the first half of the twentieth century, there was a surge of the eugenic movement, mostly in the medical field and in high levels of society. This meant selectively mating people with desirable traits for an improvement of the human race, aiming to breed out disease, disabilities, and undesirable characteristics.

Let’s talk about the team of people that were behind all of this. With a clear eugenics background, we have activist and sex educator Margaret Sanger, millionaire heiress, suffragette Katherine McCormick, biologist Gregory Pincus, and Catholic physician and gynecologist John Rock. They weren’t shy about stating why they wanted to create the pill: it was to prevent overpopulation and to breed out poor, uneducated, and mentally ill people. They had the money, the clinics, and the experience. They had done that already before in 1939 with the “Negro Project”, a family planning project that had a very controversial foundation.

They targeted Puerto Rican women who were from low-income zones, and most of the time these women were illiterate and already had children. It’s important to say that they weren’t even told that it was a trial and of its consequences, so the true intentions were hidden right from the start. They also took advantage of the fact that these women didn’t have access to health care, so the regular doctor check-ups offered were something they couldn’t say no to.

To make things worse, the first versions of the pill had tremendous amounts of hormones, so 17-22% of the participants dropped out because of its side effects. But these were ignored by the doctors monitoring the trial, saying that the women were simply imagining them. After all, their main target was to prove its efficacy in humans so they could start selling it. 

From that moment on, it was trial after trial, more side-effects, and even three known casualties (but researchers never bothered to perform any autopsy) until the pill was commercialized in 1957. The clinical trials in Puerto Rico went on until 1964, and so did the sterilizations as well. One-third of Puerto Rican women from 15 to 49 were sterilized during this time. Many of them involuntarily and as part of the government-mandated procedure after the birth of their second child. 

Called by many as the greatest invention of the twentieth century, we can’t help but wonder, (especially after knowing its shady background) how this type of drug really impacts women’s bodies and why a masculine alternative hasn’t been commercialized yet. It doesn’t seem fair, does it?

Let's be clear: yes, the pill has been a power-move since its invention and unfortunately the only working solution to many poorly investigated diseases like endometriosis, but are all its side-effects worth its intake? From a headache, it can go to blood clots, strokes, and even depression or cancer. And yes, there is direct evidence of this after a huge study in Denmark in 2016 proved the link to depression, especially amongst teenagers. The same goes for other contraceptive varieties like the vaginal ring and the hormonal IUD.

Do we know if it’s safe to take long term? And has there been enough research done on it? The thing is, there hasn’t. Furthermore, we can’t forget that this is a synthetic hormone-based drug, just like steroids, which are very frowned upon in society and even banned in sports competitions. 

In 2021 there are still no male pills or other contraceptive options. Although there have been many clinical trials, none have been proved satisfactory enough to hit the market, mostly due to side effects. These are already present in the female pill, like headaches, acne, tiredness, weight gain up to 2 kg, and reduced sex drive. Moreover, the fact that there has been little interest by pharmaceutical companies to bring it to commercialization doesn’t help at all.


Throughout history, much of the responsibility for contraception and birth control has fallen on women’s backs. But considering that pregnancy lasts an average of nine months and that men can impregnate a different woman every day if they wanted to, aren’t we placing the burden on the wrong people? 

Illustrated by Carolina Diaz

artil / The Dark Side of the Contraceptive Pill

Valentina Pérez Sánchez

"I joined artil mainly to channel my discontent and frustration with today’s world. Through my words, I expect to advocate equality for people of all genders, to fight for a greener environment, and to challenge the current capitalistic system from which most of our problems as a society come. Let’s change the current narrative and live in a fairer place!"

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