By Ella MacColl
Looking disturbingly (and sadly presciently) like devices of torture, the Dalkon Shield contraceptive came onto the scene in 1971 and fast became the most popular intrauterine device (IUD) on the US market. Hailed as the ‘the IUD that’s changing current thinking about contraceptives’, it was inserted into the patient’s uterus by the physician and, according to adverts, was ‘anatomically engineered’ for optimum fit. Now a woman could ‘throw away her calendars, charts, and dispensers,’ as she would be protected 24 hours a day from pregnancy. However, this success was to be short-lived, as reports soon emerged of miscarriages, infertility, serious infections and even deaths from women fitted with these IUDs.
These were tragic outcomes for women like Meryl Gordon, who believed they were making a health-conscious decision and they stand in stark contrast to the advertisements for the device that hailed it as safe, comfortable and highly effective. Whilst historians like Kathryn Goldberg assert that the creators of this device had not meant to harm women, looking at one advertisement published in medical journals in 1971 allows us to explore how women were objectified and patronised through medical science by reducing them to their biological function.
The company who sold the IUD, A.H. Robins, published an advertisement in medical journals – such as Obstetrics and Gynaecology – in 1972 called ‘A progress report: The IUD that’s changing current thinking about contraceptives’. This 8-page booklet gave physicians an overview of the IUD’s ‘ingenious’ design, quoted clinical tests, explained who it was for and gave practical instructions on insertion. What stands out in this advert is the lack of any patient involvement or choice in whether she wanted this method of contraception. Instead, it addresses the physician alone and how he might choose to treat his patients. The advert opens up by saying the IUD was introduced to the medical profession with more and more doctors (and their patients) being concerned about the side-effects of the pill and continues to assure that compared to other IUDs, the Dalkon Shield ‘is preferred by many physicians’. The woman receiving the IUD is rendered a passive recipient of the device, rather than an independent agent making an active choice about what is right for her body.
One scholar, Chikako Takeshita uncovered this as a recurrent theme in the development of IUDs, whereby women were rendered ‘passive recipients of contraceptive technologies’ rather than agential decision-makers. Doctors are cast in a paternalistic role throughout this booklet, encouraging them to keep up with modernity and look out for the woman who ‘wants to be liberated from troublesome birth control devices’. Furthermore, an emphasis was placed on its suitability for women who might be too disorganized to use other forms of contraception. Similarly, it is interesting that, instead of engaging in direct eye contact, all the women in the advert are looking away from the reader. Studies of visual design suggest this ‘allows the viewer to scrutinize the represented characters as though they were specimens in a display case’. The clear message to the doctor is that these women are passive objects, in need of help.
Whilst this paternalistic tone is a notable element, what is also interesting is how women are reduced to their biological functions, leaving even less room for agency. The producer of the pamphlet, A.H. Robins explains how the IUD is ‘anatomically engineered for optimum uterine placement, fit, tolerance, and retention’ as it was designed based on a standardised uterus, allowing for easy, comfortable and ‘rational’ insertion. Individual women’s bodies were sidestepped in order to universalize women and relocate ‘individual women’s agency to the reproductive organ’. Stressing its ‘ingenious’ design meant that any complications that arose could potentially be attributed to the individual woman, whose uterus did not conform to this anatomically engineered device, rather than the device itself – in other words, the woman was at fault, not the Dalkon Shield. The advert goes on to point out, ‘The need for removal and/or replacement of the Dalkon Shield is dictated largely by patient tolerance’, locating intolerance at the patient level. This is particularly pertinent, given several testimonies from women who had the IUD inserted said that their physicians failed to acknowledge their discomfort both during insertion and the months that followed. This is also echoed in court proceedings for women taking legal action against A.H. Robins, whereby the company attempted to discredit women’s painful stories by framing them as emotional, subjective and irrational. The pain these women experienced could, therefore, be located as psychological instead of physical – given the ergonomic design of the IUD – making it easier to dismiss.
The pathologising of women and their bodies has a long and complicated history; feminist historians have detailed, at length, interactions between women and the medical field which have left women reduced to their composite parts. Likewise, the language, discourses and images used in this advert work to dismiss women’s subjectivity in a medical setting. It shows a disorganised woman, in need of help, with a doctor who can liberate her with modern technology. The stories told through this advertisement add much to the unfortunate history of the Dalkon Shield and those who suffered as a result.
 ‘Regulation of Medical Devices (Intrauterine Contraceptive Devices): Hearing before a Subcommittee…93-1 May 30, 31; June 1, 12, and 13, 1973’ United States. Congress. House. Government., https://bit.ly/2Y3UZdJ, [Accessed 5 June 2020], pp.85-92.
 Kathryn Goldberg, ‘Designing the popularity of the Dalkon Shield’, (unpublished thesis, Case Western Reserve University, 2012), https://etd.ohiolink.edu/!etd.send_file?accession=case1333737047&disposition=inline, [Accessed 10 February 2020].
 ‘Regulation of Medical Devices (Intrauterine Contraceptive Devices)’, p.398; Interestingly, on p.402 of this hearing report, David Bickbart (who, at the time, worked for the National Advertising Division) states that the advert may have been printed multiple times. How many were printed and where exactly remains largely unknown to both Bickbart and wider academic audiences.
 ‘Regulation of Medical Devices (Intrauterine Contraceptive Devices)’, p.85.
 Chikako Takeshita, The global biopolitics of the IUD, (Cambridge, Mass: MIT Press, 2011) p.18.
 Gunther Kress and Theo van Leeuwen, Reading Images: The Grammar of Visual Design, 2nd edn (London: Routledge, 2006), p.43.
 Takeshita, p.53.
 Lisa Baker, ‘Control and the Dalkon Shield’, Violence Against Women, 7:11 (2001), pp.1303-1317; Goldberg.
 Baker, p.1313.
 See Gena Corea, The Hidden Malpractice: How American Medicine Mistreats Women (New York: William Morrow, 1985).