A Birth Control Champion You've Probably Never Heard Of

He's a reproductive physiologist who has been teaching about, and doing research on, birth control in his predominately Catholic country of Chile since the early 1960s, at some peril to his career. His name is Horacio Croxatto.
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Feeling gratitude is a rather old-fashioned concept these days. We're too busy, too tired, perhaps too annoyed, to take a moment and realize how fortunate we are. And to say thank you.

There are many things I am grateful for -- my family, my friends, the fact that I get to write for a living. It's a rather ordinary list. I would add one more thing to the list today: How fortunate we are to have a variety of reliable choices for planning the number of children we want and can support, as well as the timing and circumstances under which we have children. In light of current efforts by certain Republican politicians to make contraception less accessible, gratitude seems particularly appropriate.

I'm grateful for the revolutionaries who in the mid- to late-20th century, at their peril, improved the quality of, and increased access to, artificial methods of birth control. In his lively new book, The Birth of the Pill, Jonathan Eig singles out a quartet of these early radicals: birth control activist/nurse Margaret Sanger, researcher Gregory Pincus, wealthy widow Katharine Dexter McCormick and Catholic doctor John Rock.

I'm also thankful for another significant contributor to the field of reproductive health. He's nowhere in Eig's book nor is he known by ordinary Americans, yet he has played an enormous role in the development and improvement of contraceptive methods. Unlike Eig's heros, he's also still alive. He's a reproductive physiologist who has been teaching about, and doing research on, birth control in his predominately Catholic country of Chile since the early 1960s, at some peril to his career. His name is Horacio Croxatto.

According to the Society of Family Planning (SFP), Croxatto has taken part in research on all major contraceptive products. He has written or contributed to 300 publications and more than 60 book chapters. He has 17 patents, including seven in the United States. Earlier this year, he received a lifetime achievement award from the SFP, an organization that fosters scholarly activity and leadership in the areas of reproductive health and family planning.

Vivian Brache, director of biomedical research at Profamilia, a provider of sexual and reproductive health services in the Dominican Republic, says this:

He has been a mentor to many young scientists, including myself....He is generous and humble in sharing his knowledge and working in collaboration with others....(He) has been a strong advocate for the right of women to have access to emergency contraception, not only in Chile, but in many Latin American countries.

Forty-four years ago, in 1970, Croxatto was experimenting with intrauterine devices (IUDs) to determine how they work. He continued that research into the 21st century, showing that IUDs made of copper interfere with fertilization -- meaning that, in his words, "the egg and sperm get sick very soon," making it unlikely that embryos will form.

He did the first studies on the contraceptive implant, according to Dan Mishell, a physician and editor-in-chief of Contraception: An International Reproductive Health Journal. Croxatto and another inventor, Sheldon Segal, developed the long-acting method Norplant, the first contraceptive of its kind to be sold on the market. They then refined it to become the second-generation method called Jadelle.

Croxatto came up with the concept of a vaginal ring system using synthetic progesterone. The ring was particularly useful for new mothers who were breast-feeding. He has done research showing that emergency contraception, which can prevent pregnancy up to five days after unprotected sex, does not, as some opponents argue, cause abortion.

What intrigues me is that Croxatto has remained in Chile, a country whose population is overwhelmingly Catholic, to do his work. From 1977 to 2006, he was a member of the Faculty of Biological Sciences at the Pontifical Catholic University of Chile. When his work on emergency contraception riled university authorities, he moved to another university in Chile, and then to another. He's currently a professor and directs the Center for Integrative Medicine and Innovating Science at the Universidad Andres Bello in Chile.

Not everyone admires his work, of course. He has, for example, been derided as a "career missionary exonerator of contraceptives" by Dominic Pedulla, an Oklahoma physician and president of The Edith Stein Foundation, an organization that, in its own words, "seeks to expose the profound and tragic effects that contraception has had on women and therefore on society as a whole."

There will always be those like Pedulla who condemn contraception. There will also be those who support some methods but not others. What's important to remember is that the dissidents are small in number. In the United States, for example, three out of four adults -- Republicans as well as Democrats -- support policies that increase affordable access to the full range of birth control methods, according to a recent national survey by SSRS, an independent research company. We have Croxatto and numerous other courageous researchers to thank for those birth control choices.

On the day when tens of thousands of people are using social media to say #ThxBirthControl, recognizing Croxatto seems particularly timely.

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