By Eimear Vize

He was articulate, he was reassuring, he was handsome, and he transformed the reproductive practices of the twentieth century.
 
Dr John Rock was the world’s most recognised advocate for the birth control pill, which celebrates its 50th anniversary this year.

It is difficult to overstate the influence of Boston physician Dr John Rock, the son of Irish immigrants who became a pioneer in the study of human fertility and is celebrated not only as the co-developer of the birth control pill, but also for popularising and selling it to a sceptical world.
 
Rock symbolised that rare juncture when medicine and social history merged, and it is fitting therefore that the authors of his first full-scale historical biography put their respective expertise in medicine and history to work in presenting an eminently readable account of this fascinating and important figure.
 
The Fertility Doctor: John Rock and the Reproductive Revolution (John Hopkins University Press) is the commendable result of a collaboration between two sisters, Margaret Marsh, a distinguished Professor of History at Rutgers University-Camden in Philadelphia, and Wanda Ronner, a Clinical Associate Professor of Obstetrics and Gynaecology at the University of Pennsylvania School of Medicine.
 
The Fertility Doctor closely examines Dr John Rock’s five-decade career, offering a compelling look at a man whose work defined the reproductive revolution, with its dual developments in contraception and technologically assisted conception.
 
The son of Irish immigrants, John Rock was born in 1890 in Marlborough, Massachusetts. Although his dad envisaged a business career for his son, John “rebelled” and eventually attended Harvard College and Medical School. When his medical residencies were completed, he married a Boston socialite, Anna ‘Nan’ Thorndike, in 1925 and seemed bound for a lucrative career in private practice.

Naturally, John’s financially strapped family expected him to rapidly develop a successful and lucrative medical practice and funnel money back to his parents. But his ambitions led him in a different direction.
He took a residency at the Free Hospital for Women in Boston and received a pittance for his exceptional clinical work and research over the next few decades.

In the course of his practice, Rock had witnessed the suffering women endured from unwanted pregnancies. He had seen collapsed wombs, premature aging, and desperation caused by too many mouths to feed.

The experiences of his patients had a profound impact on the man. Despite his faithful Catholicism and the church's opposition to contraceptives, Rock came to support contraception within the confines of marriage.
He believed in the power of birth control to stem poverty and prevent medical problems associated with pregnancy.

In his medical practice, Rock treated women from Boston and its suburbs and those from around the world, from Hollywood movie start to at least one African princess, from upper crust to the indigent.

Chronically short of money throughout the 1930s, John often turned to his brother Charlie, now the wealthiest of the three Rock brothers, “to write a cheque”. With this support, John was enabled to combine practice and his less profitable research, and he continued to be committed to providing care to whoever needed it.

At that time his main concern was solving reproductive problems rather than birth control. In 1938, Rock and Arthur Hertig, a Harvard Professor of Pathology, embarked on a study of the process of conception from the moment of ovulation until implantation of the embryo in the womb and its early growth.

Four years later, they presented pictures of the earliest human embryos ever seen - seven to ten days old.
In his second huge research study, Rock and his assistant Miriam Merkin attempted what is now called in vitro fertilisation - the initiation of life outside the body.

After six long years of weekly attempts, the announcement in 1944 that they had fertilised a human ova outside the womb brought Rock a great deal of journalistic attention.

He became a media darling for the first but by no means the last time. Rock’s research career had reached new heights. His growing fame, however, was accompanied by personal heartbreak, ill health and tragedy.

The first blow was the death of his eldest brother, Charlie, in 1940. Four years later, at the age of 54, Rock suffered what would be the first of six heart attacks. Then in the summer of 1946, his only son Jack, who was in the Marines, died from injuries he sustained in a car accident.

Somehow, Rock’s personal tragedy seems not to have affected his professional life. He had achieved an international reputation as an infertility expert. While many consider it a delicious irony that one of the world’s most prominent doctors in the treatment of infertility would end up being most remembered for his work on the oral contraception, Rock saw little contradiction between his work to enhance fertility and his work to control it.
 
In 1949, he co-authored a book, Voluntary Parenthood, explaining birth control methods for the general reader. And, in the early 1950s, he had also come to believe in the need for world population control. At a time in his life when he could have been settling into comfortable retirement, Rock agreed to work with biologist Gregory Pincus on a controversial project to create a "magic pill" contraceptive.

As part of the infertility research at his clinic, Rock was able to conduct the first human trials for the Pill in Boston and sidestep Massachusetts' rigid anti-birth control law.
 
Rock tried several different progesterone preparations on his patients, including oral and injectable preparations in several different solutions, with and without oestrogen. But nothing was foolproof. Then, in late 1954, everything changed. Pincus became quite enthusiastic about two new compounds known collectively as the 19-nor-steriods – synthetic analogues to progesterone. Rock began to focus his studies on these new drugs.
 
In the autumn of 1955, Rock had tested what would become the first birth-control pill on only four women. Although he was reluctant to publish at such an early stage, he went along with Pincus and announced preliminary results of their research in Science in 1956. Soon after, the new progestin compounds were tested in larger field trials in Porto Rico and, in 1960, the Pill - “Envoid” - received FDA approval.
 
At age 70, Rock launched a one-man campaign to gain Vatican approval of the Pill. “Rock was truly persuaded that the oral contraceptive could solve the birth-control problems for Catholics,” explain the authors Marsh and Ronner. “His coreligionists in working-class Boston were among the heaviest sufferers from the ill effects of too many children and too little money.”
 
He became the Pill’s outspoken champion, but behind the scenes, Rock’s personal life was being torn to shreds. His beloved wife Nan had been battling colon cancer for a number of years, but in 1961 her cancer returned. “The return of her illness, and her death that same year, would unmoor him completely. He needed to keep busy, the busier the better.”

Rock argued that using the Pill was a more precise way of following the rhythm method. He strongly believed that the church should consider it a "natural", and therefore acceptable, form of birth control, because it contained the same hormones already present in every woman’s reproductive system and just extended the "safe period" a woman would have every month.
 
In 1963, he gained national attention for his cause with the publication of his second book on birth control: The Time Has Come: A Catholic Doctor's Proposals to End the Battle over Birth Control. As Rock became a familiar figure in America and abroad, his view quickly took root among laity of the church as well as among many Catholic religious leaders.
 
Confident that the Church would eventually approve the use of the Pill, Rock was crushed when Pope Paul VI officially banned the Pill in the encyclical Humanae Vitae (Of Human Life) in 1968. In his later years, having lost faith in the Church, the man who once attended mass daily stopped going to church altogether.

Yet, despite the Church's continued opposition to the Pill, a profound change had taken place among Catholics. Since the encyclical, millions of Catholics around the world have chosen to follow their own consciences on the matter of birth control. Rock's views on the Pill, once daring and radical, had become commonplace among the rank and file of the Church.

In 1972, the aging doctor closed his medical practice and retired with only a little money to New Hampshire, but he lived on for more than a decade, long enough to see irrefutable proof that in vitro fertilisation could produce a healthy baby when in 1978 the world’s first test-tube baby, Louise Brown was born in the UK.

Rock turned 90 on March 24, 1980, surrounded by his children and all nineteen of his grandchildren. By this time he had grown quite frail, and although he had lived through a number of ailments, it was heart disease that claimed him in the end.
 
On Sunday, December 3, 1984 – three months shy of his 95th birthday – Rock asked to be admitted to hospital, where he later died. “The nurse who sat up with him through the night recalled that before he died, he told her he was seeing angels. The sight would have given him comfort. During the last year or so, he had been returning to his faith,” say the authors.
 
In 2010 the pill celebrates its fiftieth birthday, and Louise Brown will turn 32. Rock would be please to know that 90 percent of Catholics approve the use of contraceptives. He had a profound faith in the ordinary individual’s ability to make the right choice.

See also 'Celebrating the Pill's 50th birthday'

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