Large-scale, field trials of emerging contraceptives occurred in Puerto Rico between 1956 and 1966. Most famously, the largest trials of the first Food and Drug Administration (FDA) approved birth control pill, G.D. Searle & Company's Enovid, occurred in Rio Piedras and Humacao, Puerto Rico during this period. Despite scholarly attention to the pill and intrauterine device (IUD), relatively little is known about the trials that begot these consequential forms of birth and population control. When historians of medicine and science, women and gender, Puerto Rico, and the modern US have attended to the contraceptive field trials, they have narrowly focused on the tests leading to the 1960 FDA-approval of Enovid, and thus render the trials as a way station in broader historical processes. This dissertation responds to this shortcoming in the historiography by offering a longer history of the field trials in Puerto Rico. It argues that the trials of contraceptive pills and IUDs were no mere way station in the history of birth control, medicine, and Puerto Rico, but rather a generative event heralded by local actors and organizations in Puerto Rico in conversation with collaborators elsewhere. By narrating a longer history of the field trials, new insights into the nature of medical research in colonized spaces are elucidated. Ground-level physicians, allied health professionals, and women taking contraceptives come to the fore as the trials' architects. Mainland US-origin physicians Edris Rice-Wray and Adaline Pendleton Satterthwaite worked in concert, and at times at odds, with Puerto Rican professionals like Iris Rodriguez and Noemi Rodriguez. These professional women worked during a time in which Puerto Rico was grappling with changing meanings of modernization and an evolving colonial relationship with the US. As such, the public and private agencies that sponsored their work promoted modernization and contraceptives amid the tension created by US colonialism. Trial leaders' personal and professional aspirations also influenced the trials. Their motivations were circumscribed by gender norms from the US mainland, which were in turn shaped by Puerto Rican modernization projects and the US colonialism that undergirded it. These dynamics only come to light by focusing on the ground-level happenings. By exploring the trials well beyond 1960 and at the level of day-to-day doing of medical science, this dissertation makes it clear that the trials' success depended upon the women taking the pill and IUD. To better understand these women and their consequential role in the creation of medical science, this dissertation uses the notion of trial "participant" in specific ways. In so doing, this dissertation attempts to go beyond the established dualism of patients and experimental subjects, reconsider the doctor-patient relationship discussed in the scholarship, and more fully attend to the subjectivity of people enrolled in field trials. This approach allows us to understand how day-to-day aspects of medical science, as much as colonial domination, shaped decisions that women made in their reproductive lives. The use of "participant" also helps us to articulate what we can and cannot know about the trials from the existing historical sources. The dissertation comprehensively examines the decade from 1956 to 1966. The field trials were initiated to answer questions on the safety and efficacy of Enovid. They expanded to address these concerns for multiple contraceptive pills and IUDs. By the mid-1960s, researchers investigated safety and efficacy, conducted basic science research, and aimed to create a public birth control program. That a public birth control program, offering many contraceptives, seemed possible by 1966 represented a sea change from the beginning of the field trials, indicating the important roles that the trials played both before and after the FDA-approval of Enovid.
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