Stuff You Missed in History Class · iHeartPodcasts

SYMHC Classics: Nelson Pill Hearings

March 21, 2026·38 min·3 clips

Three women died in the pill trials, but doctors ignored side effects as 'psychosomatic'—why?

1. Stuff You Missed in History Class examines the 1970 Nelson Pill Hearings, Congressional hearings that forced public disclosure of birth control pill risks that had been documented for years but largely withheld from patients. 2. Hosts Tracy V. Wilson and Holly Fry present the episode as a rebroadcast 'classic' from May 2021, updated with a note that a February 2026 New England Journal of Medicine study identified the genetic mechanism behind the AstraZeneca and Johnson & Johnson vaccine clotting reactions. 3. The episode's core argument is that the connection between oral contraceptives and blood clots was established and then suppressed or downplayed for a decade, and that patients were not informed of risks they had a right to know. 4. The first oral contraceptive, Inovid, was approved by the FDA on June 23, 1960 after trials that included participants who were not told they were in a clinical trial and were not asked for informed consent; three women died during Puerto Rico trials and no post-mortems were conducted. 5. Inovid's Puerto Rico trials were partly selected for racist and paternalistic reasons — as the hosts explain, some trial organizers characterized Puerto Ricans as easier to use as test subjects because they were 'ignorant and uneducated.' 6. The trials were conducted in Puerto Rico in part because Massachusetts, where pill developers John Rock and Gregory Pincus were based, had laws making it illegal to distribute contraceptives or information about them. 7. By 1961, doctors were reporting blood clots, heart attacks, and strokes in women taking the pill; a Lancet report that year documented fatal clots in Britain, though causation was disputed. 8. At a 1962 conference convened by G.D. Searle and Company, an estimated one million women were already on Inovid and there had been 28 documented cases of blood clots, six fatal; attendees called for more research but most felt a causal link was unproven. 9. A British Medical Journal study published in May 1967 found that 50 out of every 100,000 pill users would be hospitalized for thromboembolism annually — ten times the rate of non-users — and that pill users aged 20-34 died from complications at a rate of 1.5 per 100,000, versus 0.2 for non-users. 10. Because specialist papers on clot complications were published in ophthalmology and other specialist journals, general practitioners prescribing the pill often learned about concerning studies only after mainstream news outlets covered them. 11. Journalist Barbara Seaman published The Doctor's Case Against the Pill in 1969, documenting that patients were not being informed of risks; she was personally motivated because her aunt died from a cancer linked to high-estrogen hormone replacement therapy. 12. On September 23, 1969, Seaman wrote to Senator Gaylord Nelson of Wisconsin describing how a high proportion of women on the pill were also being prescribed diuretics, tranquilizers, and anticoagulants to manage side effects. 13. Senator Nelson announced hearings on December 22, 1969; they opened January 14, 1970 and ran into March, with all three major TV networks covering at least four of the five scheduled days. 14. The first and most prominent witness, Dr. Hugh J. Davis of Johns Hopkins, called oral contraceptives 'an experiment on millions of healthy women' and described synthetic hormones as carcinogens — while concealing that he was developing a rival IUD that would later prove to be the Dalkon Shield, linked to at least 18 deaths and 200,000 infections. 15. Only four of the people invited to testify were women; the first woman to testify did so on February 24, over a month into the hearings, and only one woman testified to personal experience with the pill. 16. On January 23, 1970, DC Women's Liberation, led by Alice Wolfson, interrupted NIH official Philip Korfman's testimony, distributed flyers asking 'Why aren't there women testifying?' and 'Why isn't there a male pill?' and were cleared from the room by Nelson, who the hosts describe as dismissive and patronizing. 17. A Gallup poll released after the hearings found that 87% of American women aged 21-45 had heard about them, and two-thirds reported that their doctor had never discussed the pill's risks with them; about 18% of pill users stopped and another 23% were considering it. 18. The most durable outcome was the patient package insert: oral contraceptives became the first drug in U.S. history required to carry a warning addressed directly to patients rather than doctors, though the initial version was a watered-down seven-sentence card rather than the original 600-word draft. 19. This episode suits listeners interested in women's health history, feminist political history, or the FDA's regulatory history and the development of informed consent in medicine. 20. Listeners seeking a broader social and political history of the pill's role in second-wave feminism or reproductive rights will find this episode focused narrowly on safety and regulation.

As heard by us

A careful, context-rich look at pill safety concerns as drug regulation and public health scrutiny were changing.

Stuff You Missed in History Class frames the Nelson Pill Hearings within a period when confidence in drug safety was under real strain. The discussion ties birth-control pill concerns to the recent thalidomide disaster, tighter expectations for drug testing, and the broader…

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