University of Wollongong Thesis Collections University of Wollongong Thesis Collection University of Wollongong Year Devices and desires: constructing the intrauterine device, 1908-1988 Ann Dugdale University of Wollongong Dugdale, Ann, Devices and desires: constructing the intrauterine device, 1908-1988, Doctor of Philosophy thesis, Department of Science and Technology Studies, University of Wollongong, 1995. http://ro.uow.edu.au/theses/1710 This paper is posted at Research Online. Devices and Desires: Constructing tlie Intrauterine Device, 1908-1988 A thesis submitted In fulfilment of the requirements for the award of the degree PhD from University of Wollongong by Ann Dugdale BSc, DipEd, l\/IA Department of Science and Technology Studies 1995 Except where otherwise acknowledged, the work presented in this dissertation is original. Ann Dugdale 15 November 1995 ACKNOWLEDGEMENTS In 1988 when I began this research, Australian feminist agendas were increasingly being expressed through a discourse of women's health, and consumer organisations were vigorously expanding their traditional interests into the health consumer arena. Australians enjoy both a publicly funded Medicare scheme and a publicly funded Pharmaceutical Benefits Scheme, and the Federal Labor Government at that time was actively fostering health consumer voices in public debates in the health arena. I soon found myself appointed as a consumer representative to an expert panel, formed by what is now the Therapeutic Goods Administration (a part of the Health Department of the Australian Federal Government), to advise the government on what action should be taken over intrauterine devices. The committee had been hurriedly formed, following the ovenwhelming response to the Chief Medical Officer's invitation to consumers to inform the Health Department of any problems they had experienced with intrauterine devices, an invitation issued on national television as part of a report on the withdrawal of the Copper-7 intrauterine device, still available at that time in Australia, from the United States market. This thesis had its genesis in my attempts to represent consumers in that environment, and the many stimulating conversations that I had with workers from women's health centres, with activists from the Consumer Health Forum and related organisations, and with lawyers who at some time had been involved with the Public Interest Advocacy Centre. There are some people whose practical support and intellectual generosity have been integral to the writing of this thesis. Dr Evelleen Richards and Dr Brian Martin from STS, University of Wollongong have been exemplary supervisors, both in their own unique ways. During the year I spent in the School of Hygiene and Public Health at Johns Hopkins University, Dr Elizabeth Fee provided invaluable guidance and assistance. Rosemary Robins and Helen Verran have contributed much by being great colleagues at the University of Melbourne's History and Philosophy of Science Department where I have been a lecturer for the past 4 years. There are many others whose ideas and encouragement have contributed to this work: Thank you Rebecca Albury, Dorothy Broome, Adele Clarke, Vivienne Colles, Jeanne Daly, Joan Fujimura, Marilys Guilleman, Jenny Harding, John Law, Harry Marks, Ed Mormon, Margie Ripper, Stewart Russell, Jennifer Tucker, Judy Wajcman, and Kevin White. I am also much indebted to the postgraduate students with whom I have worked and talked over the years, to the many undergraduate students who have influenced me in surprising ways, and to the workshop and conference participants who listened and engaged seriously with various chapters presented over the long time that I have taken to complete this work. In particular the participants in the Sex/Gender in Techno-Science Worlds Coherence held in Melbourne in 1993 inspired me to continue with the assurance that there was an audience for my work. Practical assistance from many people has also been invaluable. Sue Martin and Marilys Guilleman read drafts and considerably improved my syntax. Libby Robin gave me a great deal of help with locating references. Tom Rosenbaum from the Rockefeller Archive Centre provided invaluable guidance, and I could not have asked for better support than I received from the archivists of The Alan Mason Chesney Archives at the The Johns Hopkins Medical Institutions, and at the Countway Library of Medicine at the Harvard Medical School. The librarians at the Ballieu Library, University of Melbourne have also provided considerable and always timely assistance. Sandra Waldman, the information officer with the Population Council helped me arrange several interviews including with Irv Sivin, Howard Nash and Parker Mauldin. In America I also spoke with Hans Lehfeldt, Judy Norsigian, Jerry Keuster, and in Australia Roger Edwards, Edith Weisberg, Stefania Siedlecky, Angela Nanson, Peter Cashman, and Yong Sook Kwok - all gave generously of their time. Thanks also to the workers at the Boston Women's Health Book Collective, Public Citizen's Health Research Group, and the National Women's Health Network. Whilst this thesis is based primarily on documentary rather than interview material, the background information gained during these discussions was invaluable. This research would not have been possible without the financial support I received from the University of Wollongong and from the American Association of University Women. As an international scholar with the latter for 9 months I not only had the opportunity to attend Johns Hopkins University and to consult valuable collections in the United States, but I also met many inspiring women scholars from around the world and felt honoured to be associated with the organisation. Finally, thanks to my family, my house mates, my friends, and Suzanne, for your faith in me, your encouragement of my work, and for keeping my life interesting. SUMMARY By 1908 a new, doctor inserted, scientific contraceptive had gained some acceptance in areas of Germany. This technology t>ecame known as the intrauterine contraceptive device. By 1930 it enjoyed limited international success through its alliance with the International Sex Reform movement. The devices became linked with campaigns to take the suffrage struggle into the private sphere, a technological means for achieving modernity for women. In the 1960s the Population Council remade this contraceptive system as a mass produced global network of population control. Then in the 1970s the Dalkon Shield became synonymous with corporate misconduct. The women's health movement accused intrauterine device protagonists of exploiting women's inequality to produce a dangerous technology that was destroying women's health. Whilst copper intrauterine devices escaped the tarnish of the Dalkon Shield, the litigation over the Copper-7 that resulted in a punitive damages finding against Searle in 1988, resulted in a serious decline in further research into intrauterine devices. This thesis explores the production processes through which the discovery, success, development and failure of intrauterine devices were constructed. My work is a case study located at the intersection of feminist critiques of science and technology, and constructivist sociology of science. I investigate gendered outcomes of the heterogeneous negotiations that stabilise intrauterine device technologies, paying attention to the effects generated by the active participation of social movements in such negotiations. This study is informed by a modified actor network framework (Latour and Gallon), presenting the social, identity, the technical, the natural and the boundary between them as network effects. I focus on the translations of human and non-human actants constitutive of intrauterine device contraceptives as socio-technical networks, whether they occur in courts or in laboratories. I examine how authority is distributed to particular research sites, and how we learn to trust in numbers as calculations of risks and benefits. I suggest that such a form of story-telling about technologies opens novel possibilities for solidarity formation and collective engagement with socio- technical networks, including issues of regulation and policy formation. Contents HIstoricizing technology: notes towards a feminist history of 1 the intrauterine contraceptive device Writing histories of contraceptive technologies 11 The struggle to historicize knowledge, practices and technologies 17 in the biomedical sciences Early interventions: medical technologies as social 19 processes Recovering context: science and ideology 24 The social construction of scientific knowledge 30 Breaking down the text/context boundary: actor-network 35 theory Combining social constructivism and actor-network theory 41 The argument and structure of the thesis 49 From local tinkering to global network: silk coils, family 52 limitation and sex reform The contraceptive context 56 The immediate stimulus for experimentation - Local tinkering in 64 Germany, 1900-1930 Germany and the politicisation of health 64 Local tinkering - a proliferation of contraceptives and the 69 emergence of the fully internal intrauterine device Grafenberg establishes the intrauterine device as a contraceptive 72 paradigm Translating the intrauterine device into the sex reform movement: 77 the woman question Inventing a Technology 84 Tietze, the Population Council, and the United Nations: The 91 1960s reconstruction of a stronger lUD socio-technical network A foothold: The Grafenberg