Anticoncepción hormonal en España y Polonia: discursos, debates y prácticas entre 1960 y 1980

This thesis is a comparative study of the history of oral contraceptives in Spain and Poland between 1960 and 1980 from a gender perspective. It focuses on debates, discourses, and practices relating to the contraceptive pill as it circulated through four interconnected spaces: the pharmaceutical market; the medical community; mass media; and female users. Data was accessed from a variety of sources: archival and legal documents; medical literature; general interest magazines and magazines for women; pharmaceutical advertising; sociological surveys on fertility, family, and birth control; and oral history interviews. These sources were analyzed from a perspective combining multiple historiographic trends and methodologies: comparative history; the social and cultural history of medicine and pharmaceuticals; women’s and gender history; oral history; and critical discourse analysis.Chapters 1 and 2 outline the conceptual framework of this thesis and describe the sources utilized. The third chapter sketches the broader contexts in which the pill circulated through Spain and Poland during the 1960s and 1970s. Characteristics of medical practice and the reproductive policies and legal norms regarding birth control are examined in both state-socialist Poland, and Spain under Franco and during the democratic transition. The introduction of the pill from the perspective of the pharmaceutical market and industry is the focus of the fourth chapter. In the fifth chapter the reaction of medical professionals to the pill, the circulation of related expert knowledge, and domestic research carried out on the drug in both countries are analyzed. The ways in which the pill was represented in the general press and women’s magazines in Spain and Poland are examined in the sixth chapter. The final chapter is a preliminary analysis of perceptions of the pill and its use in the context of Spanish and Polish women’s contraceptive practices during the 1960s and 1970s, approached through magazines for women and oral history interviews. In Spain, where the sale and advertisement of all contraceptive methods were illegal between 1941 and 1978, the pill began to circulate in the early 1960s and was officially introduced as a prescription drug for the treatment of a variety of gynecological problems. Demand for the pill grew dramatically during the first two decades of its circulation, partly due to the successful marketing and advertising of anovulatory drugs by international pharmaceutical companies operating in Spain. Despite the legal ban on disseminating information about contraception, the pill was widely discussed in both the medical and general press. These discussions were considerably influenced by contemporary debates about the pill within the Catholic Church. Therapeutic indications of the pill were deliberated in the medical press, the understanding of “therapy” contracting or expanding according to the religious and ideological stance of the contributor. The Catholic standpoint, despite influencing the methodology of some local clinical trials of the pill, was not the only ideological option for Spanish doctors. At least since the second half of the 1960s, an increasing number of professionals had defended couples’ right to birth control and encouraged colleagues to take a proactive role in providing their patients with contraceptive advice. From the mid-1960s, the pill was also discussed in the general press, emerging in the context of contemporary debates about “responsible parenthood” within the Catholic Church. Media representations of the pill facilitated open social discussion about parents’ right to choose the size of their family and played an important role in disseminating information about oral contraception. In some magazines negative opinions of the pill prevailed throughout the period covered, and frequently merged religious opposition towards the pill and contraception in general with health concerns about side effects. Women’s access to the pill in Spain was mediated by their class, education and residence: young,  well-educated women from large cities were those most likely to use the pill, which they accessed through private surgeries, sympathetic public health service doctors or pharmacies that sold the drug without prescription. Experience of life in other countries was also a key factor in determining women’s knowledge and access to the pill. In Poland, despite a lack of legal restrictions regarding contraception, the pill circulated to a far lesser degree. Western brands began to appear on the Polish market in the early 1960s, the first Polish pill only being manufactured towards the end of the decade. Easy access to abortion since the mid-1950s meant authorities placed little emphasis on providing women with effective contraceptive methods, and inefficient management of pharmaceutical production and distribution on the centrally planned market limited the drug’s circulation. This was true during both the antinatalist (1956-1970) and pronatalist (1970-1980) phases of the state’s population policy. A close examination of Polish medical literature reveals that Polish doctors’ knowledge about the pill was comparable to that of their Spanish colleagues. Religious arguments were absent from discussions about the drug in professional journals, where most contributors defended the pill’s safety if used under medical supervision. The same argument was put forward in the general press, which played a key role in promoting the pill and other contraceptive methods, but also highlighted problems with access to the drug and the much criticized alleged preference of Polish women for abortion. As information gathered from interviews demonstrates, the practice of abortion was normalized, but employed by women as a backup method rather than a first-choice birth control resource. Both use of the pill and the understanding of its ways of action were limited, with many women convinced of the danger of its side effects.