19 Women Made Nation: Debates on Reproductive Rights in Puerto Rico in the 20th Century

Carla Peña-Vega


In 1898, Puerto Rico was annexed by the United States following the Spanish-American War. After 500 years under colonial Spanish rule the Puerto Rican archipelago was transferred to the power and protection of the United States and its burgeoning global empire. The U.S also annexed Guam and the Philippines during this period. The 20th century marked a new era of colonial rule for Puerto Rico and with it, new challenges. The question of Puerto Rican citizenship and political status remains the most important political question concerning this island even today. The question of civil and political rights on the island blossomed into the short-lived Puerto Rican nationalist movement, lead initially by Pedro Albizú Campos. The independence movement was brutally repressed by the U.S government and the Popular Democratic Party of Puerto Rico. Even possession of the Puerto Rican flag became a crime. This is all to provide the wider historical context for the debate surrounding forms of birth control and family planning on the island.

Women are often made into the symbol of national culture, they are made to represent the image of ideal nationhood and independence, in most cases this takes the form of the mother country. The Puerto Rican nationalist movement of the early 20th century was no different. The image of the always laboring mother was made into a symbol for the independence movement. Even though in Spanish the phrase is la patria, the fatherland, the woman was still discursively representing the nation. Many nationalists decried the use of birth control as a way of maintaining colonial rule and a plot by the U.S government to curb the Puerto Rican population and thus quell dissent. The Catholic Church also decried the use of birth control, citing it as an encouragement of non religious morals.

However, there was a large movement both on the island of Puerto Rico and in the diaspora pushing for access to birth control. While Catholic religious culture was very ingrained in population, many women, across class lines, were advocating for access to birth control. After this push for access to birth control, there was pushback from many of the same women who had once fought for these reproductive rights. La operación as it had come to be known was a sterilization procedure that had become common practice in lieu of birth control. Oral testimonies from women who underwent the procedure reported varying levels of information given to them by their doctors. Some were told the surgery was reversible when the truth is it is not, others were reported heavy coercion from their nurses and doctors to undergo the procedure, others were not informed at all and found out when they went through early menopause.

The above instances of coerced or forced sterilization are examples of legacies of racism and eugenics in the wider birth control movement. The language of “overpopulation” was commonly used in reference to Puerto Rico, especially of the poor, rural population. This racist narrative was promulgated by the U.S media, including the New York Times and birth control advocates alike. Margaret Sanger, a famous birth control activist, also advocated for the testing of birth control methods on poor, uneducated women. The use of this idea, the promotion of birth control methods to “improve the genetic pool of the population,” was a politics promoted by the Nazis in Germany and in the United States as well.

The article below is from the New York Times from August, 1963, discussing debates on birth control between the Catholic Church and those in the medical field.

Catholics and Birth Control: Puerto Rico Clinics[1]

Commonwealth Seeks Middle Ground with the Church on State-Sponsored Project

George Barrett
Behind the pastel walls of the government offices in San Juan, overlooking the sun-baked court, in the palm trees see-sawing in slow-motion, the health department spokesman talks guardedly about “Catholic doctors” who he said were still bitterly fighting birth control in Puerto Rico. He noted that the Caribbean commonwealth had set up one of the most extensive systems of public and private birth control clinics in the world, to help reduce a fertility rate that has made Puerto Rico one of the most densely packed areas on the globe.[2] He also noted aggressive opposition by the Catholic Church to the island-wide birth control services; he complained that the Catholic physician, and the Catholic nurse, and the Catholic technician who work directly out of the islands many health clinics were in a strategic position to undermine the whole birth control program. The program started several years ago to learn whether a large-scale birth preventive project was practicable, welcome, and effective in underdeveloped societies is something of a “test tube” example of the new way, often the unpublicized way, the Catholic church has been meeting the birth control challenge on the United States Mainland and in other countries.[3]

The Puerto Rican experience has its parallels and repercussions in points as far distant as Connecticut, Massachusetts, and Illinois. It is a fact that the Catholic hierarchy in Puerto Rico has had its successes in discouraging the birth control program, yet for the full story one must leave San Juan. Travel into the hills where the machete and the strong arm still do much of the hard labor, where mothers bear 9 or 12 or 15 children; where father send their children to school barefooted because they have no money for shoes, talk there, to the staff members of a government health clinic and another picture comes into view.[4]

At one village clinic, the medical director discusses the whole range of artificial contraceptives all of them banned by the Catholic church and says that they have been a boon for some of the poverty-ridden parents who is desperately to have no more children. but the devices are not good enough he adds they are too sophisticated for the uneducated and therefore too unreliable. He speaks of sterilization, a birth control measure  particularly condemned by the Catholic church but widely practiced in Puerto Rico. “Only sterilization really works,” he says. After six or seven children these people come in here and they agree that sterilization is what they really want.”

“But what about the Catholic doctor?” the director is asked. “Isn’t it true that the Catholic doctor in government health clinics discourages all these birth control services?”  The medical director looks up. There’s a quick frown, and then a quick grin:” What do you mean Catholic doctors you’re in Puerto Rico we are all Catholic doctors!”

Attitudes in Ferment

The difficulty of defining “the Catholic attitude” on birth control is nowhere better dramatized than in Puerto Rico, which reflects the same Catholic ferment that was revealed in scores of interviews during a 2-month survey on the United States mainland of lay and clerical Catholics thinking on the subject.  Puerto Rico is an island overwhelmingly Catholic. But it is also an island in which much of the populace became incensed when a Catholic political party, vehemently opposed birth control, was set up three years ago with the support of the bishops in an effort to defeat the Popular Democratic Party[5] of Governor Luis Muñoz Marín.[6]

A principal issue was the government’s birth control program. The governor’s party was under constant Church attack as “Godless, immoral, anti-christian, and against the Ten Commandments.”  Yet the Puerto Ricans, Catholics, gave the Catholic party only 51,295 votes out of the total of 788,607 ballots cast in that election. A particular issue was a popular conviction that Puerto Ricans should decide for themselves the propriety of birth control measures, instead of accepting church insistence that Divine Law banned artificial contraceptives and sterilization.[7] In a pastoral letter addressed directly to the Catholic congregation, the Bishops prohibited parishioners from voting for the government party because it was “anti-christian and anti-catholic and based on the modern heresy that the popular will and not the Divine Law decides what is moral or immoral.”

Clerics Challenged

However, great numbers of Puerto Ricans are so naturally committed to Catholicism from European tradition – few attend church regularly but they are born in the church, they are married in the church, they die in the church –  that the Puerto Rican Catholics (unlike many of his faith on the United States mainland) feels free, and often morally obligated to challenge his priest and his Bishop on any number of issues, including birth control.[8] The Catholic Church viewpoint can, of course, be formidable. The Family Planning Association of Puerto Rico recruits professional and volunteer  workers with the warning of that they “must have the backbone to stand up under attacks” by the Catholic Church and by Catholic community leaders.

Yet, the population council’s new bulletin, which discusses the current mass distribution in Puerto Rico of free supplies, the foam contraceptive[9], declares that the “effect of Catholic opposition to birth control and Puerto Rico is difficult to assess but studies on the relation of religious beliefs and attitudes to contraceptive practices among couples that lower socioeconomic levels indicate that the Catholic opposition has little impact there.”  The phrase “Catholic opposition” means essentially the Catholic Church opposition to birth control.

An analysis of 1,210 volunteer “leaders” of the Family Planning Association of Puerto Rico[10] shows that they represent at least 10 religious denominations but 982, more than 81% are Catholics.  Volunteers moreover, represent a socio-economic cross-section of the island: merchants, assistant midwives, teachers, farmers, janitors, three mayor’s, a legislator, tenders of fighting cocks, housewives and a high priestess of an esoteric sect.

It is the monsignor who tells the story about the Spanish priest in the small Puerto Rican parrish. The priest thundered from his pulpit one Sunday about the evils of a Family Planning Association Clinic that had been operating in a nearby community. Many of the women in the church looked in surprise at one another, they whispered, they talked excitedly after Mass about the wonderful new place where they could learn how to prevent babies, and early the next morning many of them were part of the queue at the clinic.

The birth control campaign in Puerto Rico, as in other parts of the world, is still, of course, in the starting stage. Its overall effectiveness (a sample survey of 1097 couples in one rule area reveals a drop of 50% in pregnancies) is difficult to measure.  but Mrs. Celestina Zalduondo, director of The Family Planning Association estimates that there are more than 25% of fertile married women on the island, most of them Catholics, of course, have received containers of a new foam contraceptive “of proven effectiveness and high acceptability.”

The story of birth control in Puerto Rico, illustrates the fact that on the island, and in many parts of the world, there is a radically wider range of Catholic views and Catholic practices concerning birth control than many non-catholics realize.  Moreover a significant development is now underway in Puerto Rico. The government’s network of Health Centers has long been the target of the Catholic hierarchy. One Parish priest, for example, draped the belfry of his church in Black strips for mourning when the birth control program reached his community.  An agreement, however, has just been reached between church and government under which Catholics may now go to the centers without incurring condemnation by the church.

Data on Rhythm System[11]

No formal pronouncement has been made, nor will it be made out of fear that an official public declaration  May jeopardize the program, but the agreement calls for the Department of Health to disseminate full information on the church approved rhythm system of birth control. ( Up to now, most of the personnel in the island’s health centers have been reluctant to prescribe the Rhythm method, which they consider complicated and unreliable.)

In exchange for offering a full and fair presentation of all methods for birth control and leaving it to each applicant to make the specific choice, the Department of Health understands that the Catholic hierarchy will cease blanket attacks against the government’s program.  The current moves in Puerto Rico to erase some of the sources of community antagonisms over birth control illustrate a resolved by many Catholic leaders to demand obedience to the church’s moral codes on birth control only from members of the faith. Visitors to the Vatican report with some high prelates have become disturbed over the image the church is cast before much of the world over this aspect of birth control. One major cause of criticism has been a contention by Catholic authorities that the use of artificial contraceptives is a violation of God’s law, not merely man’s law, and that the Catholic church is, therefore, under a moral obligation to keep contraceptives not only from Catholics but also from non-Catholics.

But this historical concept is undergoing a profound alteration; the alteration indicates that if the advocates of contraceptive devices genuinely seek a common understanding with Catholic leaders on public law policy (and they are doing so) there should be a gradual diminishing of the fierce community clashes that have so often engulfed Catholic and non-Catholics over birth control.

Works Cited

Back, Kurt W., Reuben Hill, and J. Mayone Stycos. “Population Control in Puerto Rico: The Formal and Informal Framework.” Law and Contemporary Problems 25, no. 3 (July 1, 1960): 558–76.

Briggs, Laura. Reproducing Empire: Race, Sex, Science, and U. S. Imperialism in Puerto Rico. Berkeley, United States: University of California Press, 2003. http://ebookcentral.proquest.com/lib/wfu/detail.action?docID=223645.

Kane, Penny. “Colonialism, Catholicism and Contraception: A History of Birth Control in Puerto Rico.” Population Studies 38, no. 2 (July 1, 1984): 334–35.

Mass, Bonnie. “Puerto Rico: A Case Study of Population Control.” Latin American Perspectives 4, no. 4 (1977): 66–81.

Volscho, Thomas W. “Sterilization Racism and Pan-Ethnic Disparities of the Past Decade: The  Continued Encroachment on Reproductive Rights.” Wicazo Sa Review 25, no. 1 (2010): 17–31.

Wilcox, Joyce. “The Face of Women’s Health: Helen Rodriguez-Trias.” American Journal of Public Health 92, no. 4 (April 2002): 566–69.

Stycos, J. Mayone. “Female Sterilization in Puerto Rico.” Eugenics Quarterly 1, no. 2 (June 1, 1954): 3–9.

Community Acknowledgement

This chapter is dedicated to the women of Puerto Rico who fought and continue to fight for their bodily autonomy and access to quality reproductive health care. Here are some community organizations working today to fight for reproductive justice and women’s issues on the island:

Colectivo Feminista Puerto Rico

Casa Protegida Julia de Burgos

Colectivo Ilé

Se Parir

Carla Peña-Vega is a senior at Wake Forest University. She is a Politics & International Affairs and Spanish double major from Alexandria, VA and Mayagüez, PR. 

  1. George Barrett, The New York Times, August 7, 1963, pp. 1, 18.
  2. The idea of overpopulation comes from Thomas Malthus. This idea has been widely discredited as it was used as a justification for the eugenics movement. Eugenics is the idea of applying "survival of the fittest" to humans and aims to "improve the genetic pool" by selective breeding. It was used as the doctrine in Nazi Germany and was the basis of violent, racist approaches to birth control and reproductive policies in the United States as well. (Stycos 1954).
  3. The main discourse on birth control in Puerto Rico during the mid 20th century occurred in conversation with the Catholic Church's teaching and the Family Planning Association. The position of the Catholic Church was to prevent medical birth control and sterilization practices because they went against the idea in the Catholic Church that the role of women was to be wives, and mothers of Catholic children (Ayala and Bernabe 2007)
  4. The image of the rural, machete wielding Puerto Rican farmer with a large number of children perpetrated harmful racist stereotypes that would be used to justify using Puerto Rico as a testing ground for the birth control pill and practices of coerced or forced sterilization. (Briggs 2003).
  5. The Popular Democratic Party or (Partido Popular Democratico in Spanish) is the party in Puerto Rico that historically and even today advocates for keeping the island’s commonwealth status, in addition to self-government for matters pertaining to the island (Ayala and Bernabe 2007).
  6. He was the first democratically elected governor of Puerto Rico and served in that position from 1949 - 1965. He is credited with modernizing the island’s economy and infrastructure. He is also known for his brutal repression of the Nationalist Party (Ayala and Bernabe 2007).
  7. Many women were in fact advocating for birth control and wanted access to it in order to take control of their lives. At the same time, a politics of reproductive rights does not adequately address issues of bodily autonomy or reproductive health and safety. A politics of reproductive justice, as coined by Angela Davis, addresses the needs of families to determine their destinies without interference from the state and protects the bodily autonomy of the most marginalized (Volscho 2010).
  8. Catholicism became the overwhelmingly dominant religion through Spanish colonization, beginning in the 15th century up until the Spanish-American war and the annexation of Puerto Rico by the United States in 1898 (Ayala and Bernabe 2007).
  9. The foam contraceptive refers to an early iteration of a contraceptive sponge which contained spermicide and was inserted into the vagina to prevent the entrance of sperm to the uterus (Kane 1984).
  10. The Family Planning Association was led by doctors on the mainland, in conjunction with medical elites on the island, to promote the use of contraceptives in Puerto Rico. This organization has also been implicated in pushing sterilization as the primary method of birth control on the island during the 1950s and 1960s.(Back, Hill, and Stycos 1960).
  11. The rhythm system of birth control (also referred to as “natural family planning”) relies on tracking a woman’s menstrual cycle to plan sexual activity around when her most fertile days are. It is the only system of birth control advocated for by the Catholic Church (Kane 1984).


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