Birth Control Its Past and Future

By Garrett Hardin
Volume 3, Number 1 (Fall 1992)
Issue theme: "Revealing the costs of immigration"



By Carl Djerassi

Basic Books, 1992

319 pp., $25

Not many autobiographies of scientists are of interest to the general reader, but Djerassi's is an exception. Fleeing Sofia and Vienna in 1939 at the age of sixteen, he embarked on a spectacularly successful career in the United States. After receiving his training in chemistry, he went to Mexico for two years where he put Syntex on the map as an internationally important manufacturer of basic biochemicals. At age 28, he brought the contraceptive pill into practical production. During the 1950s, Djerassi, now back in the U.S., contributed in many ways to the success of the 'Pill.' At Stanford, he developed into a fantastically successful trainer of graduate students, all the while guiding the Syntex company to prosperity. At age 49, he turned his attention to the education of undergraduates, with equal success.

'...restrictions on government aid

in getting birth control materials

and instructions to foreign populations to swell the army of poor people

striving to be admitted as immigrants

to the United States.'

Readers of a eugenic turn of mind may note his distinguished heritage. Both parents were physicians. His father was notably youthful at all ages he took up skiing at 50, driving at age 60, and swimming at 85, despite an intense fear of the water. The senior Dr. Djerassi died at age 96.

The social and political resistances to the introduction of the Pill in the 1950s seem trifling to us now. The American branch of the Roman Catholic church was not yet fully alarmed. In Spain and Italy, the Pill was introduced as an agent of 'menstrual regulation,' as a true but hardly a completely frank acknowledgement of its purpose. Such euphemistic tact would be wasted today the abortifacient capabilities of 'RU 486,' for instance, are well known and beyond disguise (though this new drug does have other medicinal qualities). Even the true contraceptives, now almost universally accepted by the American public, have been harried by the government. Though nominally without religious commitment, the Reagan administration put Roman Catholics in key positions of power over medical matters, as - for the first time - an American ambassador was sent to the Vatican. The long existing American policy of helping poor nations in their struggle to achieve control of their birth rates has been transmuted into something scarcely distinguishable from a policy that might have come out of the Vatican. Coincidence? In the light of the feature story in Time magazine, 24 February 1992, such an innocent coincidence is hardly credible. Perhaps some day government archives will tell us the whole story. In the meantime, new restrictions on government aid in getting birth control materials and instructions to foreign populations - restrictions never subjected to democratic review - help to swell the army of poor people striving to be admitted as immigrants into the United States.

The 'father of the Pill' notes another factor that may contribute to the lessening of public interest in contraception intellectual fatigue, manifesting itself as a change in fashion. When Djerassi first started teaching his birth control class of undergraduates, the males in the class were as numerous as the females. A mere ten years later, well into the Reagan years, scarcely a fifth of the class were men. The proven success of the Pill may have helped to diminish its interest as a topic of general conversation. Whatever the cause, the result, says Djerassi, is that 'one more responsibility - this time that of contraception - has fallen on the shoulders of women. Many women, of course, accepted it eagerly as an important sign of emancipation and freedom from male dominance, but one of the consequences of that achievement has been a collective shrug of male shoulders, an outcome I deeply regret' (p. 150).

The factors now adversely affecting the advances of birth control are much more than a shrug of the shoulders. The ever-present threat of liability suits chills creativity in medical research. As a matter of method, every innovation on trial should be suspected of producing unwanted side effects. With the legal profession standing by, side effects produce litigation. All the anticipated costs of innovation must be factored into the retail price of each new drug. In the United States, expensive litigation plus equally expensive liability insurance have expanded to the point that $20 million is regarded as the minimum cost of developing an effective new contraceptive. Measured against the Gross National Product, contraceptive pills sold in our country cost four times as much as they do in Sweden, and ten times as much as in Singapore. The steroids that go into these pills are now all manufactured outside the U.S. Moreover, not a single major drug house in America is now engaged in the search for new contraceptives.

Like a Third World country, we are dependent on other nations for both supplies and progress. We have become, as Carl Djerassi says, a 'banana republic.' He is embarrassed. We all should be. The end result, as nations compete in new ways, may cost more than mere embarrassment to our overly litigious nation.

Not everything 'Mr. Syntex' touched turned out well. His most conspicuous failure was as a movie producer. A cops-and-robbers production started in Mexico was slated for completion in forty days. It was nine years before 'The Big Drop' had its one and only showing on the Stanford campus; it should have been called 'The Big Flop.' As for his marital career - he had three wives - his own comment perhaps tells the story best 'living with a scientist ... who brought his mistress home every night, must have been hardly bearable.' His mistress, of course, was chemistry.

Of his two children, the daughter, an artist, killed herself for reasons the father tragically could not understand. At the present time Djerassi, now very wealthy, has become an important collector of Paul Klee's pictures. His interest in art and artifacts is wide ranging. On a visit to the British Museum, he corrected many of the labels on the museum's pre-Columbian holdings. (This information comes from David Moreau, and is not retold in Djerassi's book.) He writes familiar essays, poetry and novels, all the while supporting an artists' colony. He no doubt agrees with the judgment of George Sarton, the great historian of science 'It is impossible to live reasonably without science, or beautifully without arts and letters.' The life of Carl Djerassi has been full of all three. 