The Dark History of the Birth Control Pill in Puerto Rico

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Michelle is an intersectional feminist who spends her time following politics, thrifting, and reading second hand books. She is passionate about reproductive justice, eradicating collegiate sexual assault, and discussing the school to prison pipeline. Follow her on Tumblr and Twitter, where she is ranting under the moniker @hovelofmirth. She is also the moderator for NYC Feminist Action Network.

Author’s Note: This is the third article in an exclusive series originally published at Guerrilla Feminism titled “Porto Rico: America’s Forgotten Colony.” The title was ‘inspired’ by United States’ Government’s attempts to rename their colony following their 1898 invasion. This column aims to explore how Puerto Rico’s colonial past continues to affect today’s Puerto Ricans by amplifying the voices of Puerto Rican feminists and activists.

Few feminists would hesitate to describe the birth control pill as the most significant innovation of the twentieth century. Mass distribution of the ‘magic pill’ granted women ultimate control over their bodies for the first time in human history. However, if one mentions the birth control pill in Puerto Rico, women’s responses are far more complex.

In the 1950’s, Planned Parenthood organized widespread human trials of an early version of the pill on Puerto Rico’s most vulnerable women without informed consent. The pill trials were motivated by the United State’s popularly held racist and classist attitudes toward their colony. As a result of the trails, three women died without recognition or explanation.

The birth control pill’s dark past has largely remained unknown to American feminists. Despite the few short articles that emerge every few years, (see: RH Reality Check,, and PBS) American feminism has not yet acknowledged the impact the birth control trials has had on Puerto Rico or Puerto Rican women. Over fifty years later, our understanding of the birth control pill’s history is severally lacking. To right this great injustice, it is incumbent on feminists to not only remember the trials in Puerto Rico but to strive to understand the complex intersections of racism, classism, and capitalism that precipitated the trials.

A New Colonial Power

Immediately after the United State’s annexed its new colony, administrators in Washington dedicated themselves to profiting from their new acquisition. Legislators instituted laws that stripped Puerto Ricans of their farms and sources of income. In the first years of colonial occupation, Americans traded the long-term welfare of the Puerto Rican people in exchange for economic gain.

By the 1920’s, a majority of the island lived in abject poverty. A typical farmhand would make $4 a week and would spend a majority of that in the company store that owned the land that he farmed, land that was previously owned by Puerto Ricans. The system ensured that Puerto Ricans would never be able to purchase their own land. Since Puerto Rico is not a state, its people are not protected by the Constitution. Puerto Ricans worked for less than minimum wage and were systematically denied any opportunity to organize for better working conditions.

In addition to owning nearly 80% of the sugar cane farms, American entrepreneurs began to fixate on the island as the perfect place to build various factories. There was a particular interest in building textile factories that would specifically hire women, at 26% of the cost of women workers in the United States. Wealthy Americans were then faced with a dilemma; how can they ensure that women were available to work in these new factories.

Birth Control
Photograph of a Puerto Rican seamstress, taken in 1941 by Jack Delano.


Racism Towards Puerto Ricans

 In 1899, The New York Times published the following summarization of the island’s inhabitants: “uneducated, simple-minded and harmless people, only interested in wine, women, music and dancing” (The New York Times 1899). Racist and xenophobic stereotypes characterized nearly all of the public comments about Puerto Rico throughout the first half of the twentieth century. Simultaneously, American social theorists and politicians began to use Neo-Malthusiast and eugenics theories to view poverty as a byproduct of a people’s race. American social thinkers began mistakenly interpreting Puerto Rico’s poverty and social ills as directly related to the overpopulation of an inferior race. In response, bureaucrats became very interested in limiting the island’s population while also maintaining a consistent workforce.

As various states began to outlaw family planning and access to information about birth control, Puerto Rico had almost 36 birth control centers by 1930. Many of these birth control and family planning centers were built in factories where women primarily worked. Puerto Rico’s women, and their ability to reproduce, became a focus of US policy in the colony. In 1937, a bill was passed that allowed doctors to sterilize Puerto Rican women without their consent or knowledge. We do not know how many women were sterilized without their consent. Currently, the Puerto Rican government denies the use of sterilization as an official birth control policy.

Birth control
Photograph of a Puerto Rican sugar worker’s family

Why Puerto Rico?

 In the early 1950’s, Margaret Sanger, the founder of Planned Parenthood, became aware of Dr. Gregory Pincus who invented a pill that could prevent women from conceiving. However, he was unable to find an appropriate location to begin large scale testing of the new pill on women in the states. Instead, he and Margaret Sanger set their sights on America’s colony in the Caribbean.

In 2013, Planned Parenthood published a brief dedicated to challenging popular “fallacious charges of racism” that were being cast at the organization as a result of birth control pill trials in Puerto Rico. The brief offers several reasons for why Puerto Rico was chosen: including the island’s acceptance of contraception, geographic closeness to the United States, and high population of illiterate women that would allow researchers to test if uneducated women could responsibly take the pill.

Considering the United States’ already established history of racism toward Puerto Ricans, Planned Parenthood’s explanation is highly suspect. It’s entirely possible that Planned Parenthood’s interest in Puerto Rico as a testing site stemmed from the already biased perceptions many Americans had of the island’s population. However, it is also true that several of Planned Parenthood’s claims are true. Yes, the island had an already established system of family planning centers. And yes, a majority of the women who participated in the trial were illiterate. But it would be too hasty to dismiss the already established evidence of colonial control that Washington exhibited over Puerto Rico as well as the documented cases of racism. It is impossible to completely dismiss the role capitalist intentions as well as the desire to limit the birth rate played in choosing Puerto Rico.

In 1956, testing of the pill officially began. Two locations, Rio Piedras and Humacao, were chosen. It was decided that the women who were to participate in this study, were not going to be told that the pill was in the trial stage. Instead, they believed that they were taking an already established method of birth control. The women were unaware of the potential dangers and side effects that might occur.

 Results of the Trials

After only one year of testing, the Puerto Rican doctor leading the testing, Dr. Edna Rice-Wray, concluded that the pill prevented conception 100% of the time in 100% of the women. The pill was a success. However, Dr. Rice-Wray also conveyed to Dr. Gregory Pincus the multitude of side effects at least 17% of women were experiencing, including: severe cramping, nausea, dizziness, headaches, stomach pain, and vomiting.

Dr. Pincus decided to ignore the reports of side effects. Instead, he chose to believe that the women were experiencing psychosomatic side effects. Dr. Rice-Wray also conveyed to Dr. Pincus that the dosage of the pill might be too high, leading to the side effects. During the trials, three women died. Dr. Pincus refused to look into their deaths, ensuring that these women would fade into history.

When examining Dr. Pincus’ decision to dismiss women’s experiences, it’s difficult to ignore how popularly held racist and classist ideas may have clouded his judgment. Did he mistrust the Puerto Rican women because of their illiteracy and poverty? Or did he mistrust them because they were Puerto Rican, and thus ‘less’ reliable?

Reverberations Throughout History

In the 1960’s, the pill was tested throughout the world. These tests led to a safer pill, reflecting Dr. Edna Rice-Wray’s initial recommendation of a lower dose. Today, the birth control pill is recognized as a significant medical achievement. Generations of women have been able to control their bodies and thus their futures.

While the pill continues to empower women, the Puerto Rican trials are becoming simply a footnote in American history.

But in Puerto Rico it is still possible to meet women who remember doctors coming to their homes to recruit themselves or their mothers to take the pill. Even millennial women are telling and retelling the stories of the pill trials, passed down from their mothers and their grandmothers. Here in Puerto Rico, the dark history of the pill is alive and well.

What responsibility do today’s feminists have in the face of the pill’s dark history? As feminists continue to respond to the intersectional and complex issues that affect our communities, the history of the pill must become a part of our lexicon. Becoming aware of how racism and classism led to Planned Parenthood’s support of the trials must become a part of 20th century feminist history. Criticizing this past does not make us less supportive of Planned Parenthood, instead, it empowers us to continually challenge social justice organizations to support all women, regardless of color or socio-economic class.

In the 1990’s, several Puerto Rican doctors and social justice activists began to re-examine the birth control pill trials here in Puerto Rico. During the course of the investigations, one doctor commented that “women make choices based on alternatives, and there haven’t been many alternatives in Puerto Rico.” For the women of Puerto Rico, American colonial control has bred state lies about their bodies, from forced sterilization to trials of an unknown birth control pill. It is impossible to right the wrongs of history, but ignoring the past will not make our movement stronger.


This article was originally published by Guerrilla Feminism.

Part one of this series, At the Heart of Puerto Rico’s Debt Crisis are the Ugly Remnants of Colonialism

Part two of this series: Inside Puerto Rico’s Street Art Scene