Anger over Puerto Rico's pill test lingers

By: Ray Quintanilla — krt campus

Posted: 4/12/04

HUMACAO, Puerto Rico - When Delia Mestre was a young woman, a hospital social worker would visit families throughout her barrio, offering the women something that seemed too good to be true: A tiny tablet to keep them from getting pregnant.

"We all jumped on it quickly and didn't look back," Mestre, 60, recalled.

"Women were told this was medicine that would keep them from having children they couldn't support."

Nearly a half-century has passed since doctors began arriving here to begin the longest-running experiment of its kind: nine years of veiled research that helped pave the way for a "magic pill" now regarded as one of the pivotal social and medical changes of the 20th century.

What unfolded from the mid-1950s to the early 1960s in this remote farming town in the foothills near Puerto Rico's east coast made Mestre and hundreds of other women the unwitting pioneers of the modern sexual revolution.

It remains one of the most controversial chapters in the island's history - notably because participants weren't informed that they were guinea pigs in an experiment to test the world's first birth-control pill, a tablet with three times as much hormones as today's version.

There were other test groups on the mainland at the time, but similar experiments in Boston and other cities didn't last very long, partly because of the pill's side effects.

In Humacao, the testing went on for years.

It's difficult to think of those days, said Mestre, among the last generation of Humacao women who took part in the clinical trials of Enovid and a collection of similar drugs that have come to be known universally as "the pill."

Generations later, bitter feelings still simmer. Secrecy about the
experimental nature of the pills helped prompt federal officials to ban such practices.

"The experiments were both good and bad. Why didn't anyone let us make some decisions for ourselves?" she asked, her eyes welling with tears. "I have difficulty explaining that time to my own grown children.

"I have very mixed feelings about the entire thing."

Humacao is a gritty village tucked between the Cerro and Labarbera mountains. It was here that doctors found their best "control group," starting in 1955.

The doctors provided hundreds of women - descendants of Puerto Rico's jibaro agricultural underclass - with refined versions of the pill for free until 1964 to test its safety and how well it worked.

In the early days, the doctor who ran the tests noted publicly, that two
seemingly healthy women participating in the trials died. No autopsies were done to determine what caused their deaths.

Those who remember the times best recall U.S. doctors, dressed in white lab coats, arriving to deliver their babies. Soon, however, they were recruiting women to try the drug.

Margaret Sanger, the women's activist who in the 1930s first envisioned a "magic pill" to prevent pregnancy, reportedly visited doctors in the town to lend moral support.

In no time, new mothers at Ryder Memorial Hospital were accepting birth-control pills. Physicians dispatched their assistants to rap on doors
throughout the town's slums, telling women they didn't have to have another child if they took the pills regularly.

That's how many of the test recruits were found, said Conchita Santos, 80, a Humacao resident her entire life.

It was only a few years after Puerto Rico became a U.S. commonwealth
that doctors began seeking people to test their pills in these neighborhoods - barrios of small concrete homes where chickens roam and some people still get around on horseback.

Santos and other Roman Catholic women were warned by their parish priests not to take the pills. It was not only a sin, they were told, but it also altered God's will.

Santos, a homemaker, accepted her first package of pills in 1955, shortly after the birth of her first and only child.

By the end of 1957, doctors at Ryder had recruited about 500 participants.