Objectionable Injection? Views of the Contraceptive Depo-Provera
Beginning in the early 20th century, leaders in the population control movement reported the world was experiencing a ‘population explosion’ in the poorest nations, and looked to contraceptive technology to limit fertility. During the late 1970s and early 1980s, a new form of contraception gained increasing public attention. Depot medroxyprogesterone acetate, known by its trade name Depo-Provera (DP), had been developed by the American pharmaceutical company Upjohn in 1960. The contraceptive was injected by a medical practitioner into a large muscle such as the thigh, and a 150ml dose was intended to last three months. The drug, nicknamed ‘the jab’ spread quickly to developing countries, including Thailand and Bangladesh, throughout the 1970s. To proponents, Depo-Provera seemed the perfect solution, as it did not require substantial patient responsibility.
Women’s health advocates, black activists, and feminists began to criticize the drug’s use in developing nations in the 1970s, claiming there was a lack of informed consent, and pointing out adverse effects such as menstrual bleeding. These critics marked Depo as a tool to control women’s fertility and limit unwanted minority populations. However, some doctors in Western countries advocated the drug as a valid contraceptive option for all women, arguing that it should be available for those who could not or did not want to use other methods. It is worth noting that the FDA (Federal Drug Administration), the drug licensing authority in the US, did not approve the drug as a long-term contraceptive until 1992 because of safety concerns, but doctors there prescribed Depo as a contraceptive off-label beginning in the 1960s. Similarly, in the UK, although it never accounted for a large proportion of contraceptive users, the drug was used widely in family planning clinics. It was approved as a short-term contraceptive in 1974, and for long-term contraception, as a drug of last resort, in 1984.
Dr. Libby Wilson, head of the Glasgow Domiciliary Family Planning Service, distributed Depo throughout the 1970s. She had heard of the drug from an English doctor while traveling in Hong Kong. Although Depo was not widely distributed in the UK, Wilson made it available to women in the slums of Glasgow, who she felt had no alternative. She even traveled to women to inject the drug in person, thus helping them control their fertility.
Wilson experienced pushback, and in her 2004 biography Sex on the Rates, recounted the accusations of a local priest, who charged her with using his parishioners as guinea pigs for an experimental injection. However, Wilson countered that the drug was used extensively worldwide and was endorsed by reputable health leaders such as the World Health Organization (WHO). Personally, she believed she was helping the women in her care. Wilson was known for her commitment to improving the lives of women of all races and classes. She helped found the first family planning clinic for single women, and this view has been echoed in her recent obituaries in British newspapers.
While anti-Depo activists often accused proponents of targeting minority populations as a form of genocide, not all of those prescribing the drug subscribed to population control beliefs. Many women’s health feminists organized campaigns against Depo, but Wilson felt she was acting out her feminist beliefs by helping women obtain contraception. Wilson acted as an advocate for Depo throughout the 1970s and, as an independent doctor, she did this by combining her feminist views and medical knowledge.
Campaign Against Depo-Provera. “Campaign Against Depo-Provera Aims.” London, 1979. DADZIE/1/10. Black Cultural Archives.
Connelly, Matthew James. Fatal Misconception: The Struggle to Control World Population. Cambridge, Mass: Belknap Press of Harvard University Press, 2008.
Critchlow, Donald T. Intended Consequences: Birth Control, Abortion, and the Federal Government in Modern America. New York: Oxford University Press, 1999.
FPA. “Factsheet – Conception: Past, Present and Future,” November 2010. http://www.fpa.org.uk/sites/default/files/contraception-past-present-and-future-factsheet-november-2010.pdf.
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