Devices and Desires A History of Contraceptive in America By Andrea Tone

1. Devices and DesiresA History of Contraceptive in AmericaBy Andrea Tone Christel McCarty Final Project FHS 2450

2. Anthony Comstock The Comstock act was voted into law on March 3, 1873. This law defined contraceptives as obscene and inaugurated a century of indignities associated with birth controls illicit status. So, who was Anthony Comstock. Anthony was born in 1844 in the country side of New Canaan, Connecticut. He was a zealous devotee of the church and he served a short stint in the Union Army. During this one and a half years in service he did not witness battle, he put his efforts into something he felt more productive. He started his own battle against tobacco, alcohol, gambling, and atheism. After leaving the military in 1865 Anthony moved to New York and was exposed to a whole new world. Being exposed to all seeing the way that contraceptives sold, abortion services, and erotica thrived disgusted Anthony. His reaction to the sexualized economy influenced his anti vice campaign. Weeding it out was the only way to destroy this industry. So he found an organization that would help back this cause, the NYSSV. Comstock Bill; No obscene , lewd, or lascivious book, pamphlet, picture, paper, print, or other publication of an indecent character, or nay article or thing designed or intended for the prevention of conception or producing of abortion, nor any article or thing intended or adapted for any indecent or immoral use of nature, nor any written or printed card, circular, book, pamphlet, advertisement, or notice of any kind giving information, directly or indirectly, where, or how, or of whom, or by what means either of the things mentioned may be obtained or made…shall be carried in the mail; and any person who shall knowingly deposit, or cause to be deposited, or cause to be deposited, for mailing or delivery, any of the hereinbefore mentioned articles or things, and any person who…shall take, or cause to be taken, from the mail any such letter or package, shall be deemed guilty of a misdemeanor, and on conviction thereof, shall, for every offense, be fined not less than one hundred dollars nor more than five thousand dollars, or imprisoned at hard labor not less than one year nor more than ten years, or both, in the discretion of the judge. This bill will impact the way contraceptives are made and sold for the next century

3. Enforcing the Comstock Law From the beginning there were issues with enforcing the Comstock Law • There were not enough agents to enforce the law, congress never insisted on hiring new agents. • The difficulty of eliminating the birth control trade was exacerbated by the balance of federal and state regulatory power. The regulation of contraception was principally a federal matter. • Because of status and position there were many men who were breaking the law but it was ignored, while many of the smaller men involved in the industry were getting busted. For example Samuel Colgate president of the NYSVV, who was advertising the use of Vaseline (which was being made by his company) as being a contraceptive. • Many birth control entrepreneurs used multiple aliases. • Purveyors would creatively disguise their products with relabeling • 38% of the individuals arrested by the NYSVV agents between 1873 to 1898 for birth control crimes were not convicted. If they were convicted they rarely faced stiff sentences. • Almost every contraceptive could be said to possess medical or therapeutic value. If they were not classified as a contraceptive then they weren’t breaking the law.

4. Early Contraceptive Entrepreneurs • Joseph Backrach , was a German born immigrant who made condoms, ticklers, and male caps in his home. • Julius Schmidt , was an immigrant from Germany as well. He found a job working in a sausage casing firm where he cleaned the animal intestines. In 1883 with a surplus of intestines, Schmidt launched a side business of selling “skins”. • Many of the early entrepreneurs in the contraceptive trade were immigrants, women, and Jews. • After 1873 established pharmaceutical and rubber firms made devices and chemicals know to have contraceptive benefits but they did not market them as birth control. IUDs were sold to “correct prolapsed uteri” and carbolic acid, used for contraceptives douching, was marketed “for burns, scalds, whooping cough…etc.” • In the absence of medical leadership women and med turned to the marketplace to acquire what doctors denied them. There they found men such as Julius Schmidt, with skins aplenty & Joseph Bakrach with womb veils to spare.

5. Black-Market Birth Control Black-market birth control carried significant risks, but these risks didn’t just victimize the contraceptive consumer, it made people move into action. People started to invent strategies to shield themselves from product failure and commercial exploitation. Men and women at the turn of the century did their best to convert awareness of birth control hazards into techniques for self protection. Without government safeguards to protect consumers against unscrupulous merchants and shoddy wares, American birth control buyers were on their own. Many people would blow up their own condoms to see if there were holes in it…etc. to test contraceptives before use.

6. Prophylaxis Between April 1917 and December 1919 380,000 soldiers, roughly one in eleven, were diagnosed with VD. It was estimated that by the end of WWI the Army had spent $50 million on treating their soldiers. This was not a new problem, the military had been experiences problems with soldiers coming into contact with VD for a long time. Chemical prophylaxis, not condoms, were the solution to this problem for a long time. The reason for this is because, chemical prophylaxis is applied after possible exposure to VD, and a condom would encourage sexual promiscuity. By 1909 the use of post exposure chemical prophylaxis had become standard military policy. So what is a post exposure prophylaxis; A soldier would be asked if he has had sexual encounters, if he said ,”yes”, then a medical officer would examine his genitals and then wash them with a cotton sponge doused in a dichloride mercury solution. Then, the soldier would an anti-gonorrhea urethra injection of 2% protagrol, which retained for thirty seconds to a minute. After this, he would medical officer would rub 50% calomel ointment, we now use as an insecticide, into his glans penis, foreskin, and shank of penis. There were many problems with this technique. First, many soldiers would not admit to having sexual contact because it was a humiliating process that “hurt like hell”. Also, many soldiers would take leave for the night. This does not work if it is not applied very soon after contact. During WWI many soldiers took to using condoms they could buy on the “open market” over seas. This made it so that men would not admit to having sex since they had used a condom, this also helped to spread the awareness of condoms in the states. Soldiers would come home and talk about how effective the condom was. The military tried to preach abstinence to their soldiers as their next technique to stop the spread of VD. It was not until 1930 that the Army and Navy quietly added condoms to their approved list of prophylaxis.

7. Margaret Sanger Margaret Sanger was a nurse who opened the first illegal birth control clinic in Brooklyn, New York October 16, 1916, with her sister Ethel Byrne. For 10 days the clinic operated and helped the birth control needs of 488 women until the police raided and closed down the clinic, and arrested Sanger and Byrne. They both served one month in jail when their case was headed for appeal by Jude Crane. Crane affirmed the legality of contraceptives as disease prophylaxis. This gave Sanger enough legal ammunition to open the first permanent Birth Control Clinic in the U.S. in 1923. Through out her career Margaret Sanger proves to play a huge role contraceptive history.

8. Margaret wanted the birth control movement to be strictly under medical auspices. She did not want people to get birth control from anyone but their doctor. She believed this was the only way. • She was the reason that by 1930 the diaphragm and jelly was the most frequently prescribed birth control. • She wanted a cheap and effective birth control that could help women who were poor. Unfortunately the diaphragm was not the solution for this. Sanger would be a big part of the development of the birth control pill • She did not look at birth control as a way for a man to control women, she looked at it as a women to be independent and have control over their own body.

9. “Feminine Hygiene” • “Feminine Hygiene” was a term coined by manufactures for over-the-counter contraceptives. Advertising methods of birth control were against the law. These “hygiene” products were mainly vaginal jellies, liquids, suppositories, foaming tablets, and the ever popular antiseptic douche. Contrary to what Sanger wanted, diaphragms were the least used form of contraceptive. Diaphragms were expensive, messy, required planning, and women were uncomfortable talking to their doctors about contraceptives and many were not comfortable having to touch their bodies in that way. • Pharmaceutical firms, rubber manufactures, mail-order, and door to door sales women supplied birth control that was conveniently located, discreetly obtained, and affordably priced. By the 1930’s the five and dime stores were the most popular distributor of contraceptive. And by the 1940s the douche was the most popular birth control method. Many of these companies lied about their products. The products were not safe, they didn’t work, and they were not tested. Manufactures used false advertising to their full benefit. Manufactures got away with this because they were not making “contraceptives”, that would be illegal. • For example; douching did not prevent pregnancy. It typically did more damage than good. The douche was advertised as a product you could use to “clean” yourself with and also disinfect your house! They were known to cause vaginal burns, blisters, and bleeding among other problems. • The FDA insisted that contraceptives were not drugs, and so they were not in their jurisdiction. This left the FTC in charge of regulating contraceptive commerce. The FTCs authority was limited, it was confined to the elimination of false and misleading advertising. Something many manufactures got around.

10. The Condom Empire By the 1940s small scale condom entrepreneurs were a thing of the past, the FDA made sure of that. In 1937 the FDA hopped on the regulation bandwagon stating that condoms and rubbers were to be subject to FDA jurisdiction and inspection. Since condoms were made to prevent disease, and pregnancy is not a disease, this is why they were in the FDAs jurisdiction and contraceptives were not. Youngs Rubber and Julius Schmidt were the only condom companies to pass the FDAs comprehensive tests, and their chief brands – Ramses, Sheiks, and Trojans – were the only rubbers to make the Consumer Union’s “recommended” list.

11. Julius Schmid During WWI Julius Schmid was the only condom manufacturer in the U.S. that could meet the allies needs, with the Germans out of the picture. In 1938 Schmid was the undisputed king on the American condom empire, with his “Ramses” condoms. And in 1940 Schmid rubbers were the first to ever be endorsed by the U.S. Army.

12. Merle Youngs Merle Youngs was the the founder of Youngs Rubber Corporation, maker of the Trojan condom. Advertised as being “ for the prevention of disease only” Trojans were sold legally. To distinguish Trojans, Youngs made the decision to sell his condoms exclusively in drug stores by “ethical” druggist. This may have been one of his smartest moves. He also was the first company to purchase Fred killians machine. Fred invented the first machine that would take latex (which had just been invented in 1920) and form it into a finished condom. This machine allowed Youngs to produce in one day the same amount of condoms they would produce in a couple of months.

13. The People Behind The Development of the Pill By the mid 1960’s Americans new the wonder of “the pill”. Oral contraceptives had been approved by the FDA in 1960. We have Gregory Pincus, John Rock, Min-Chueh Chang to thank for the development of the pill. But without Margarat Sanger and Katherine McCormick, the pill would not be here today. Margaret Sanger was the driving force behind developing the pill, Sanger was the one who sought out Pincus to start the development of the pill. Katherine McCormick was the financial backing of the development of the pill, she fully funded the pill. John Rock was crucial in the development. Rock was working to help women to conceive, while Pincus was trying to help women to not conceive. They both worked together to test the progestin and estrogen on women. Rock was testing to see if it made women more fertile while Pincus was testing to see if it made women not conceive. Together they helped develop the right amount of progestin and estrogen to be put in the pill for it to be effective. Min-Chueh Chang also helped with this development by administering tests and monitoring the results.

14. Envoid Test Run When it came time to do test trial on women Pincus chose to administer these trials in Costa Rica. Why Cost Rica? He believed that women were more eager for a form of birth control. So, in 1956 he went to Costa Rica to start clinical trials. The Pill was Called Envoid, and it had many side effects recorded. For example, nausea, dizziness, headaches, stomach pain, and vomiting. There was also breakthrough bleeding and migraine headaches reported. Pincus did not think that these were big issues. Pincus shared his results with G.D. Searle, who had supplies the Envoid for the trials, about his results. And in 1957 the FDA approved Envoid as prescribed treatments for gynecological disorders. By 1959 at least a half a million women had gone on “the pill” and Pincus asked the FDAs permission to market Envoid as an oral contraceptive. Which was denied. It was not until May 1960 that the FDA approved Envoid of for contraceptive use.

15. The Problem With The Pill American women were quick to accept the pill as an oral contraceptive. Within two years of FDA approval, 1.2 million women were taking the pill, within five years, over six million. There were unpleasant side effects that developed almost immediately. Women reported wait gain, headaches, and bloating. By 1968, Americans were twice as likely to use the pill as they were condoms. In 1961 two young women died of pulmonary embolisms, and both of them had been taking Envoid. And as of August 1, 1962, twenty eight cases of blood clots among more than one million Envoid users had been reported in the United States. Not until 1978 did the FDA require patient inserts in oral contraceptive, warning women of the possible side effects.

16. The IUD In 1971 about twelve million women around the world were wearing an IUD, and over three million of these women were American. For many people the IUD was a godsend, specially for people who lived in poverty. The IUD was cheaper than the pill, virtually impossible to remove, and required only a single act to to have one put in. In the eyes of people who wanted to limit the amount of children poor people were having, this was too good to be true. One of these supporters was the Population council and by 1965 they launched a campaign to distribute American made IUDs to developing nations. The Dalkon Shield was the most popular IUD of the day, but in 1974 everything changed when reports of death and injury resulted from the Dalkon Shield.

17. Complications With The IUD By the time the A.H. Robins began marketing the Dalkon Shield in 1971, the majority of IUD users in American were middle class women. When the device made hundreds of them sick and allowed numerous pregnancies, when eighteen died, there was indeed “quite a stink”, one that sent shock waves through the birth control community and forever changed the face of American Contraceptive research and development.

18. Something better The history of contraceptive in our country has been a battle. Starting with Comstock and still continuing today. In the battle today, we are looking for something better. Americans now want a birth control pill that has no sides effects and can protect against STDs. We have now come out with a vaginal ring, the depo shot, and implants that can be placed in a woman's arm. But As a country we are always going to want more.