Lentis/The Pill, the Vatican, and American Catholics

The US Food and Drug Administration (FDA) approved the first oral contraceptive pill in 1960. Until Pope Paul VI's 1968 encyclical Humanae Vitae condemning contraception, American Catholics did not receive papal guidance on the morality of "the Pill". This chapter explores American Catholic response to the Pill and Humanae Vitae.

Patient Package Insert for Oral Contraceptives (FDA 079) (8249451687).jpg
oral contraceptives, 1970s

Historical BackgroundEdit

The Church’s BeliefsEdit

The Catholic Church has historically condemned sex without the intent to procreate. The Book of Genesis establishes God's desire that his followers “be fruitful and multiply” and avoid using contraception [1][2]. These biblical passages were the Vatican's only official teachings on contraception until the early 20th century, when contraceptive techniques became more widespread and effective. In 1930, Pope Pius XI responded to the growing accessibility and popularity of artificial contraception with the encyclical Casti Connubii, which prohibited Catholics from using artificial contraceptive methods:

...matrimony exercised in such a way that the act is deliberately frustrated in its natural power to generate life is an offense against the law of God and of nature, and those who indulge in such are branded with the guilt of a grave sin. [3]

Margaret Sanger and the Birth Control MovementEdit

The first issue of The Woman Rebel.

"We hold that children should be (1) Conceived in love; (2) Born of the mother's conscious desire; (3) And only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied."

American Birth Control League founding statement[4]

Margaret Sanger, a feminist writer and nurse, believed that every woman should be "the absolute mistress of her own body" [5]. Sanger launched the US birth control movement in 1914 with her newsletter The Woman Rebel, which promoted contraceptives and rebranded "family planning" to "birth control," a term Sanger saw as concise, nontechnical, and memorable [6]. Over the next decade, Sanger opened the first birth control clinics and founded the American Birth Control League (ABCL), which later became Planned Parenthood [6]. The ABCL's founding statement illustrated the goals of the birth control movement: separation of sex and procreation and establishing contraception as socially acceptable [4]. Contraception gained widespread acceptance in the 1920s and 30s, and by 1938 there were over 400 contraceptive manufacturers making combined annual revenues exceeding $250 million, with female contraceptives accounting for 85 percent of annual sales [6][7].

Creation of the PillEdit

By 1951, Sanger had been successful in fighting legal restrictions on contraception, and the Planned Parenthood Federation of America ran about 200 birth control clinics. Sanger was however still frustrated by the lack of new birth control options for women. She decided to pursue her life-long dream of a "magic pill" that would prevent pregnancies entirely, and after being introduced to Gregory Pincus at a dinner party, she enlisted his help. Pincus, an American biologist known for his research in hormones and in vitro fertilization, agreed to help if Sanger could provide the funding to support the research [8].

In 1953, Sanger introduced Pincus to Katherine McCormick, a wealthy philanthropist and supporter of the birth control movement. McCormick became a major benefactor of the research, personally contributing nearly all of the two million dollars required for Pincus' experiments. Her funding allowed the research to advance quickly [9].

Because Pincus was not a licensed physician, he could not legally conduct drug trials; so, in 1952, Pincus asked Bostonian gynecologist John Rock to join the cause. Rock, a Catholic fertility doctor, nevertheless believed in the need for population control and for women to avoid unwanted children, and he agreed to help [10]. In 1954, Rock and Pincus began the first human trials of the Pill, testing it on 50 women. Because Massachusetts had extremely restrictive anti-birth control laws, they designed their trials as a fertility study [10][11][12]. They also carried out drug trials in Puerto Rico.

By 1955, their results were conclusive: none of the 50 women in their initial trial had ovulated while on their drug. They had succeeded in creating the Pill [8][10].

FDA Approval and the Spread of the PillEdit


Bottle of Enovid pills.

In 1957, pharmaceutical company Searle sought approval from the FDA for Enovid. Enovid was developed as an oral contraceptive, but the FDA approved Enovid for treating menstrual disorders, with pregnancy prevention as a side effect [13]. On June 23, 1960, Searle received FDA approval for Enovid specifically as a contraceptive [14]. Enovid was advertised first as a menstrual regulator then as an oral contraceptive; the first advertisement for Enovid after it was approved for contraception showed the mythical Andromeda free from her chains, symbolizing the reproductive freedom of women on the pill [15]. Searle established a monopoly on oral contraceptives, and Enovid sales increased from $37 million in 1960 to $89 million in 1965 [8].

Social BackgroundEdit

The 1960s in the US were characterized by social tensions and movements as civil rights, free speech, environmentalism, and feminism [16]. These movements quickly gained traction in mainstream society, creating an anti-establishment counterculture and encouraging experimentation [16][17]. The idea of reproductive freedom and women having control over their bodies aligned with feminist ideals in particular. Further, a "sexual revolution" saw an increase in sex amid growing overpopulation concerns; this marked a distinct separation of sex and procreation and paved the way for widespread adoption of contraceptives such as the Pill [18][19].

Adoption of the PillEdit

Married women were the first to adopt the oral contraceptive pill; by 1965, 41 percent of married women below the age of 30 who practiced contraception used the Pill [20]. This proportion peaked in 1967, but subsequent legal decisions granting unmarried women access to the Pill enabled its rapid diffusion among single women [20]. By 1976, 73 percent of 18- and 19-year-old women who had ever used contraception had used the Pill [20]. Although health concerns of oral contraceptives entered the spotlight with the Nelson Pill Hearings in the US Senate, "pill scares" only slowed the adoption of oral contraceptives; in 1995, the Pill was still the preferred contraceptive method among both married and single women [20][21].

Initial Church ResponseEdit

Vatican IIEdit

The form of Mass practiced before Vatican II (priest facing away from congregation).

In 1962, Pope John XXIII initiated "Vatican II" to address perceived issues in Church doctrine and practice. The Council reformed many aspects of the Church, most notably by altering Mass so that priests spoke in the vernacular and faced churchgoers rather than the altar [22]. The Vatican II reforms changed teachings and traditions that had stood for almost a century; Catholics responded optimistically, but they also began to see their faith as mutable rather than rigidly derived from papal authority [22].

John RockEdit

In 1963, Rock published The Time Has Come: A Catholic Doctor's Proposals to End the Battle over Birth Control, a treatise that turned Rock into the public face of Catholic pro-Pill sentiment [23]. The Time Has Come promotes oral contraceptives for combating overpopulation and advancing women's reproductive health, and it also argues that the Pill did not violate Casti Connubii since it uses the body's natural hormones to extend a woman's infertile period rather than using a barrier to block sperm from fertilizing an egg [23]. This contention, in addition to Rock's assertions that abstaining from sex in order to avoid pregnancy harms marital relations, resonated with the Catholic public, and many Catholic priests and Vatican officials held a similar stance [24].

Catholic Sentiment Towards the PillEdit

The proportion of Catholic wives using non-Church-approved methods of birth control increased steadily from 1955 to 1965. The 1965 National Fertility Survey found that 53 percent of Catholic wives had used artificial contraception at least once [25].

Catholic perception of birth control was also becoming more positive. In a 1967 survey, 60% of Catholics favored the distribution of birth control information, and 78% believed that birth control should be publicly available [26] [27]. In addition, many prominent Church figures agreed that the Pill should be approved for use by married couples.

In 1963, Pope Paul VI expanded a commission tasked with writing a new statement on marriage and examining family planning, and the commission eventually recommended that the church rescind its ban on artificial contraception [28]. In 1965, the commission made its final report in favor of the Pill; however, the commission's decision had already been leaked to the public, and many Catholics believed that the Vatican supported oral contraceptives [28].

Humanae VitaeEdit

On July 25th, 1968, Pope Paul VI issued the encyclical Humanae Vitae, rejecting the findings of the commission and condemning artificial contraception [29].

Pope Paul VI issued Humanae Vitae in 1968

Effect on American CatholicsEdit

The responses to Humanae Vitae ranged from disappointment to outright dismissal. By this time, many Catholics had already made up their minds about birth control. A Manhattan housewife told the Times:

I don't care what the pope says. I have a feeling the clergy are talking to themselves on this issue. I have made my decision and couldn't care less about people at the Vatican [28].

Just a year after Humanae Vitae, 44% of Catholic women who were regular churchgoers were using artificial contraception. By 1974, 83% of Catholics said they disagreed with Humanae Vitae [28]. By 2011, among all Catholic women who have ever had sex, 98% of them have ever used a contraceptive method other than natural family planning, and 68% of women use highly effective contraceptive measures including sterilization, the Pill, hormones, or an intrauterine device [30].

These women were often supported by Church leaders. Father Charles Curran, a professor at Catholic University, was highly critical of the encyclical and composed a statement concluding that spouses may decide amongst themselves whether artificial contraception was permissible. His statement was signed by over 600 theologians and academics. Catholic leaders and bishops around the world issued statements declaring that "no one should, therefore, on account of such diverg­ing opinions alone, be regarded as an inferior Catholic" [29].

Church AttendanceEdit

The encyclical triggered a decline in church attendance in the Catholic Church over the next decade. Researchers determined in 1975 that at least half of the decline in Church attendance was due to Humanae Vitae, and another quarter was due to the pope as head of the church [28][31].

Decline in Catholic church attendance can also be shown in comparison to church attendance in Protestants. Throughout the decade following Humanae Vitae, Protestant church attendance remained more or less constant as Catholic church attendance declined [32].

Perception of the ChurchEdit

The encyclical damaged the church beyond attendance. According to American priest Padovano, "As a result of Humane Vitae, ignoring church teaching became an acceptable strategy and the laity became indifferent to much church teaching" [28].

This is borne out in surveys on Catholic laity: in 1999, surveys showed that even Catholics who consider themselves committed to the church and say that the church is one of the most important influences in their lives nevertheless distance themselves from the church's formal teachings on marriage and sexual issues. Only 20% of Catholics thought the Church held the final moral authority on divorce, 23% on premarital sex, and 11% on birth control [33].


The Criminalization of Common BehaviorEdit

In March of 2007, lawyer and activist Lawrence Lessig gave a TED talk titled "Laws that choke creativity." In it, he uses user-generated content as a leading example in his argument for more sensible intellectual property laws that are better-suited for the digital age. His conclusion is that technology drives the ability of people to participate in what he calls a Read/Write culture, where users are "writing" creative content in addition to "reading" it. However, current IP laws have not kept up with this culture shift, and so instead of celebrating this shift, we are criminalizing it.

We live in this weird time. It's kind of an age of prohibitions, where in many areas of our life, we live life constantly against the law. Ordinary people live life against the law, and that's what we are doing to our kids. They live life knowing they live it against the law. That realization is extraordinarily corrosive, extraordinarily corrupting [34].

Regardless of whether the Catholic Church was morally correct in their decision to ban all forms of contraception, contraception was already regarded as common practice. By the time the encyclical was released, a majority of Catholic women had already been using non-sanctioned birth control methods [25]. The encyclical thus only served to criminalize common behavior, and instead of changing their habits to match Church practice, women largely ignored the encyclical, leading to the subsequent decline Catholic belief in the supreme moral authority of the Church. The type of "corrosive environment" Lessig warns of in the criminalization of user-generated content came about in the Church following the pope's release of Humanae Vitae.

Bad PresentationEdit

Since the Vatican remained silent for nearly a decade following FDA approval of the Pill, American Catholics looked elsewhere for moral authority on oral contraceptives. By the time Humanae Vitae was published, the Pill was already massively popular, with 12.5 million women using it worldwide [8].

Even within the Church, Catholics found reason to anticipate a favorable ruling. Vatican II had shown that historical Church traditions could change, and a papal decision on the Pill was noticeably absent [22]. The Pontifical Commission on Birth Control, a committee of advisors to the Pope responsible for analyzing the morality of the Pill, recommended allowing the pill and following “the side of the Protestant churches in 1930” [24].

The Vatican's delayed response to the Pill gave American Catholics time to develop their own opinions; had Humanae Vitae been published much earlier, perhaps the Vatican would have been able to play a larger role in preventing the adoption of the Pill among American Catholics.

Effect of Social Landscape on Adoption of New TechnologyEdit

Elaine Tyler May, author of America and the Pill: A History of Promise, Peril, and Liberation, argues that "The revolutionary potential of the Pill could never have been achieved without the opportunities that came about because of women's activism" [35]. Junod & Marks go further, writing "Much of [the birth control pill's] history cannot be disentangled from the wider political, economic, and social issues of the day" [14]. Although the Pill is a "revolutionary" technology, perhaps it would not have achieved such high levels of adoption and support without the feminist movement, for example, or a pharmaceutical company seeing an opportunity to reap massive profits from a burgeoning market. This can be generalized to the introduction of any technology; a technology's success depends on the social, economic, and political landscape as much as the "revolutionary potential" of the technology. This theme has parallels in the Industrial Revolution, the Space Race, and many other technology-aided "revolutions."



In a press conference in 1959, President Eisenhower said this when asked about the government's role in distributing information on birth control:

This Government has no, and will not as long as I am here, have a positive political doctrine in its program that has to do with this problem of birth control. That's not our business [36].

Like the Vatican, at a crucial time in the history of the pill, the President of the United States refused to get involved. 15 years later, however, the federal government was supporting birth control clinics in over 2,000 counties across the U.S.[8]. Possible expansion could explore the impact of the U.S. Federal Government on the public's opinion and use of the pill.

Health ConcernsEdit

There were concerns about the safety of the Pill throughout its development and adoption. In the early 1960s, there were reports of serious side effects associated with the Pill, such as blood clotting [8]. In 1969, Barbara Seaman published The Doctor's Case Against the Pill, bringing public attention to these dangerous side effects [21]. This led to the 1970 Nelson Pill Hearings, and the FDA did not officially consider oral contraceptives safe until 1990 [8]. These health concerns and their effect on perception and spread of the Pill warrant further investigation.

Ethics and Morality in the Development of the PillEdit

Strict anti-birth control laws could have imprisoned Pincus and Rock for their work developing the Pill. As such, they often worked undercover, lying to women about the tests being performed on them and disguising drug trials as fertility studies [11] [37]. According to Jonathan Eig, author of The Birth of the Pill:

The laws and the ethics of science were very different in the 1950s than they are today — you didn't have to give informed consent, you didn't have to have anybody sign forms giving away their rights, telling them about what these experiments are for. So in a way, we do have women being treated like lab animals so that we may find a form of birth control that frees them. There's a great irony there [37].

Investigating these questionable research ethics is a possible area for expansion; were the researchers' decisions to hide their work immoral? If so, does the development of a "form of birth control that frees [women]" [37] justify the means used to obtain it?


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