America and the Pill: A History of Promise, Peril, and Liberation by Elaine Tyler May (review)

An accomplished historian and author, Elaine Tyler May capitalizes on the fiftieth anniversary of the US Food and Drug Administration’s approval of the first birth control pill in the spring of 1960 with her America and the Pill. May asserts that while the pill has global implications, its story is an American one because of the involvement of American women who initiated research on the pill, American scientists who developed the hormonally based compound, and the vast numbers of American women who continue to swallow it.

The book synthesizes a wealth of admirable scholarship about American birth control history in an entertaining fashion. May begins by highlighting women’s participation in the development of the pill, crediting birth control crusader Margaret Sanger for wanting a contraceptive under women’s control; Katherine McCormick for funding the research of Dr. Gregory Pincus and his associates; and Drs. Edris Rice-Wray and Adaline Satterthwaite for testing it. May goes on to echo three well-known arguments: the fear of overpopulation spurred the development of the pill; the sexual revolution and the pill were uneasy allies; and the introduction of the pill disrupted gender relationships on many levels.

Given the long-standing eugenic underpinnings of the American birth control movement, it should come as no surprise that during the Cold War era Sanger, McCormick, and Pincus were motivated by the putative threat of a population explosion in the developing world. The timing led many in the United States to suggest that the pill could curtail overpopulation, thereby reducing the possibility that poverty-stricken masses would turn to Communism as a solution to their woes. Significantly, the pill was tested on women in Puerto Rico, one of the most densely populated parts of the world. There also was considerable support for using the pill domestically against minorities. The high birthrate of African Americans, especially in the southern states, led to simplistic claims that the pill could curb their fertility as a way to escape poverty. Some male leaders in the Black Power movement denounced the pill as a genocidal weapon against Americans, while some African American women saw it as a conduit to reproductive freedom.

Efficacious and easy to consume, the pill is often associated with the sexual revolution. This growing acceptance of premarital sex was fueled by sensationalized media reports about the presumed impact of this contraceptive on single women. However, single women were engaging in sexual intercourse regardless of the availability of the pill. Other kinds of contraceptive devices such as the condom and the diaphragm were already in use. Moreover, as the pill was a prescription drug, single women were dependent upon a doctor’s willingness to prescribe it to them in the face of moral and legal sanctions. As May notes, the pill may have had its greatest impact on married women, permitting them to space the births of their children and, therefore, benefit from educational and professional opportunities.

Despite recurring concerns over its safety, single and married women continued to use the pill, upending the authority of the Catholic Church over women’s sexual and reproductive autonomy and challenging the medical profession’s control over women’s sexual and reproductive health care. May’s assessment of the current status of the pill comes from the results of an Internet survey she administered, though the methodological design appears hazy. She finds that women’s ongoing embrace of the pill has initiated major changes in intimate encounters between men and women. The pill gives women complete contraceptive control. In the absence of a comparable male contraceptive, the burden of an unwanted pregnancy falls squarely upon a woman’s shoulders. Still, the pill can be held responsible for more open communication among women and between women and men about sexuality and sexual pleasure. More recently, women are using the pill for noncontraceptive purposes such as clearing up acne.

One of the most interesting details in...