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Season 1

Long-play: Dr Sarah Hill

ft. Sarah Hill

The contraceptive pill has an interesting and, at times, ethically dubious history. Biologists John Rock and Gregory Pincus team up to develop the birth control pill, funded by two million dollars from philanthropist Katharine Dexter McCormick and spurred on by contraceptive crusader Margaret Sanger. 


For years Pincus had been searching for a project that might establish his greatness. While there were many possible risks in taking on the pill project, it concerned the area of science he knew best: mammalian reproduction. 


He knew that his progestins (synthetic progesterone) stopped ovulation in rabbits and rats. The next step was to test them on women. And to do that, he would need a doctor who could reassure patients they were safe. 


There had never been a medicine made for healthy people—and certainly not one that would be taken daily. The risks were enormous. Pincus settled on gynaecologist John Rock. Rock was attractive, well respected and most importantly, Catholic.


After teaming up, Pincus and Rock began trials in 1954. State laws prohibiting contraceptive research made it difficult to set up trials, so Rock and Pincus controversially first tested the drug on male and female patients at the Worcester State Psychiatric Hospital in Massachusetts and then on women in the slums of Puerto Rico and Haiti.


The first oral contraceptive pill (Enovid) was approved by the US Food and Drugs Administration on 9 May 1960. It was released in Australia on 1 February 1961 under the name Anovlar.


More than half a century on, the impacts of the pill are remarkable. It’s hard to think of an invention that has impacted women’s position in society more. Women were free of the social boxes and biology that had previously constrained them. They didn’t have to fear unwanted pregnancies and could have risk-free sex, just like men. From this, we saw the sexual revolution. 


Approximately 70% of Australian women of reproductive age employ some form of birth control. On the basis of 2013 data, 27–34% of women used oral contraception. This number has been steady for decades. 


Despite its ubiquity, dialogue about how the pill works and how it can impact women is rare. And as it turns out, its potential side effects aren’t insignificant. The pill has been found to impact the mood, stress response, and sexual appetite of many women who take it. The pill can change everything from how women cope with stress to who women want to have sex with. It’s also been associated with an increased risk of anxiety and depression, particularly in younger women. 


So how does the pill work? What effect does it have on the people who take it? And what run-on effects does this have for wider society?


To answer these questions, Caroline enlisted the help of Dr Sarah E Hill. Sarah is an award-winning research psychologist and professor at TCU in Fort Worth, Texas. Working at the intersection of evolutionary biology, social psychology, and neuroscience, her research is aimed at understanding the role hormones, the immune system, and the environment play in sexual and relationship behaviours, especially in women. Her book ‘How The Pill Changes Everything’ was released in 2019.


Sarah and Caroline discuss the role of evolutionary psychology in helping us understand sexual behaviour, what the pill is and what it can change for those who use it.


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