America and the Pill: A History of Promise, Peril, and Liberation (review)

Elaine Tyler May’s America and the Pill is a clearly and succinctly written history of the research and development of the contraceptive pill, its imagined and real impacts on people and populations, and its place in the lives of English-speaking women and men in the present. May draws on her personal history of the pill (her father was a physician involved in its FDA approval process and she used it herself), primary sources, and an online survey of pill users (and some partners of pill users) to argue for the technology’s impact across American and world history.

May convincingly argues that while many individuals involved in and studying the pill’s development thought that it would be most effective in supporting broad cold war goals such as population control and promoting capitalism, instead the pill had the most impact on women’s personal lives: their sense of control over their bodies; relationships to families, partners, and religious institutions; political agency; emergent feminist ideals; and sexual agency. America and the Pill joins broader histories of birth control in America such as Linda Gordon’s Woman’s Body, Woman’s Right (2000) and Leslie Woodcock Tentler’s Catholics and Contraception (2009), and histories of cold war families, gender, and reproduction, such as Laura McEnaney’s Civil Defense Begins at Home (2000) and Stephanie Coontz’s The Way We Never Were (1988) offering a concise analysis of the pill’s past and present-day effects on politics, culture, and individual lives.

May traces the history of the pill’s creation and testing and does not minimize the ethically questionable processes of testing high dosages of progesterone on mental hospital patients and later on impoverished Puerto Rican women in the 1950s. As the pill gradually became available worldwide and eventually in much less harmful lower doses, it became an instrument of countless women’s feelings of agency over their bodies, minds, and futures. As May put it in discussing the pill’s impact on women in the developing world, “the most important factor in lowering the birth rate was the education of women. As women gained more rights, opportunities, and access to education they were able to assert themselves more fully in their families and society and to take more control over their lives” (p. 52). The same was true of women in the developed world. Access to the pill, as many of the online survey-takers narrate, gave women courage to challenge religious teachings on premarital sex and virginity, to advocate for a pill that men would take as well, and to plan pregnancies with their male partners.

May uses internet survey interviews to gather today’s men’s and women’s experiences with and perceptions of the pill throughout the text but concentrates quotations from them at the end of the book to show how individuals wrestle with its effects on their behavior, sense of themselves, and medical decisionmaking. Whether they loved or hated using the pill, survey respondents saw easy, inexpensive access to the pill and to birth control generally as signal achievements of medical technology and feminist activism. Using an internet survey for first-person testimonies, however, does not give May a diverse socioeconomic sample of respondents. Those quoted tended to have no problems accessing or paying for birth control, and the analysis of the pill’s current place in women’s lives would have been strengthened with in-person interviews of women who faced obstacles to obtaining any form of the pill for reasons of economics, distance, or family or partner interference.

America and the Pill would be an excellent addition to upper-level undergraduate or graduate courses on women’s and gender history, the history of sexuality, and post-1945 American history. It will take its place alongside May’s Homeward Bound (1988) as a classic of post–World War II American sociocultural history.