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John Charles Rock (March 24, 1890 – December 4, 1984) was an American
obstetrician Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgi ...
and
gynecologist Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area ...
. He is best known for the major role he played in the development of the first
birth control pill The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. The pill contains two important hormones: progest ...
, colloquially called "the pill".


Early life and career

John Charles Rock was born on March 24, 1890, in
Marlborough, Massachusetts Marlborough is a city in Middlesex County, Massachusetts, United States. The population was 41,793 at the 2020 census. Marlborough became a prosperous industrial town in the 19th century and made the transition to high technology industry in the ...
, and died on December 4, 1984, in Peterborough, New Hampshire, at the age of 94. He was born into a Roman Catholic family and was one of four children. Rock was a known scientist, obstetrician and gynecologist, but he was also an author who wrote a few books after his discovery of the contraceptive pill. Prior to John Rock's discovery of the first contraceptive method, he did not express an interest in pharmacology. During his early years at the High School of Commerce in Boston, he a desire to pursue a career in business. With an education and experience working on plantations for the United Fruit Company in Guatemala and an engineering firm in Rhode Island, he came to the realization that this career path was not his calling. He became good friends with the company's doctor, Neil MacPhail, who mentored John and allowed him to assist in surgeries at the hospital he managed. After his time in Guatemala, John Rock furthered his education at Harvard University in Cambridge, Massachusetts in 1912 where he received his bachelor's degree in 1915. He then attended and graduated from
Harvard University Medical School Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consis ...
in 1918. He originally planned to specialize in the nervous disorders, however he decided to change it to obstetrics and gynecology and founded his own medical practice a few years later and retired in 1956. Rock was the founder of the Rock Reproductive Study Center at the Free Hospital for Women in Brookline, Massachusetts and was also a Clinical Professor of Gynecology at Harvard Medical School. He was appointed director of the Sterility Clinic at the Free Hospital for Women and would hold this position for 30 more years. Rock and his wife raised five children. Rock was a pioneer in
in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) ...
and sperm freezing. He helped many of his patients achieve pregnancy and became known as a "ground-breaking infertility specialist". As his career progressed, and despite being a devout Catholic, Rock also became known for his acceptance of
birth control Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
. (Birth control was illegal in Massachusetts until the 1965 Supreme Court case ''
Griswold v. Connecticut ''Griswold v. Connecticut'', 381 U.S. 479 (1965), was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States protects the liberty of married couples to buy and use contraceptives withou ...
''.) In the 1930s, he founded a clinic to teach the
rhythm method Calendar-based methods are various methods of estimating a woman's likelihood of fertility, based on a record of the length of previous menstrual cycles. Various methods are known as the Knaus–Ogino method and the rhythm method. The standard days ...
, the only birth control conditionally regarded as moral by the Catholic Church at the time. In 1931, Rock was the only Catholic physician to sign a petition to legalize birth control. In the 1940s, he taught at Harvard Medical School—and included birth control methods in his curriculum. Rock also coauthored a birth control guide for the general reader, titled ''Voluntary Parenthood'' and published in 1949. For most of Rock's medical career, he directed and practiced at the Fertility and Endocrine Clinic at the
Free Hospital for Women Free may refer to: Concept * Freedom, having the ability to do something, without having to obey anyone/anything * Freethought, a position that beliefs should be formed only on the basis of logic, reason, and empiricism * Emancipate, to procure ...
in Boston, Massachusetts. In addition to practicing as a medical doctor, he was an active researcher, striving to discover new knowledge and offer more help to his female patients. In collaboration with Marshall Bartlett, Rock conducted research on the schedule of ovulation and the sequential stages of the endometrium during a woman's menstrual cycle. Rock's research throughout the 1930s to 1950s focused on two large projects that advanced reproductive medicine. Working with Arthur Hertig, Rock identified implantation and the following stages of embryonic development. At this time, no one knew how, where, or when a woman's eggs were fertilized. In another project, with Miriam Menkin as his assistant, they researched human
in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) ...
. Their study reported in 1944 that eggs fertilized outside the human body had successfully initiated embryonic cleavage for the first time in a lab setting. The report obtained national attention and was dubbed “test-tube fertilization”. This research opened a door of possibilities for future technology to overcome obstacles in reproductive medicine, providing hope to many women experiencing infertility. Although Rock and Menkin's findings were groundbreaking, the research for in vitro fertilization was not advanced and safe enough to be used in clinical practice until many decades later. These two major studies with Hertig and Menkin were just the beginning of the research and developments that were to come in the field of reproductive medicine for decades.


In vitro fertilization research

Gregory Pincus Gregory Goodwin Pincus (April 9, 1903 – August 22, 1967) was an American biologist and researcher who co-invented the combined oral contraceptive pill. Early life Gregory Goodwin Pincus was born in Woodbine, New Jersey to Jewish parents, who we ...
began his groundbreaking research on in vitro fertilization in rabbits in the early 1930s and just a few years later, announced his success in the creation of offspring via in vitro fertilization. With IVF already being controversial, Pincus's findings resulted in negative publicity. Consequently, he was denied
tenure Tenure is a category of academic appointment existing in some countries. A tenured post is an indefinite academic appointment that can be terminated only for cause or under extraordinary circumstances, such as financial exigency or program disco ...
and, ultimately, fired from his Harvard position. Although Pincus was no longer an employee of Harvard and conducting research anymore, the results of Pincus's experiment inspired John Rock to apply the findings to human conception. John Rock hired Miriam Menkin, a research technician who assisted Gregory Pincus in the rabbit IVF experiments. They researched and experimented for 6 years until, finally, on February 6, 1944, Menkin fertilized her first egg. When a procedure to preserve the specimen was not decided on quick enough, the egg had disappeared. Not long after, Menkin fertilized 3 eggs and properly preserved them and took pictures. Rock announced their accomplishment and received some skepticism and doubt from other scientists and a notable
zoologist Zoology ()The pronunciation of zoology as is usually regarded as nonstandard, though it is not uncommon. is the branch of biology that studies the Animal, animal kingdom, including the anatomy, structure, embryology, evolution, Biological clas ...
, Carl Hartman. It was not until a baby was born in 1978, did fellow scientists, researchers, and the public attribute the first human in vitro fertilization to Rock and Menkin. In order to help women struggling with infertility, Rock's principal objective was to develop a fetus in an artificial womb. He believed in vitro fertilization would help women all over the country who were infertile and could not have children. Rock was known for being caring, respectful and honest with his patients who so badly wanted to conceive a child. Towards the end of the 1940s, Rock received letters from a number of women across the country who wanted to try in vitro fertilization. Since there were still a multitude of questions about the process of IVF that needed to be answered and technology that needed to be developed, Rock tried to convey that IVF pregnancies were not likely. With the likelihood of IVF pregnancies still being decades down the road, he took a step back from his IVF research and entertained alternative treatments for infertility.


Pill development and promotion

In 1951 and 1952,
Margaret Sanger Margaret Higgins Sanger (born Margaret Louise Higgins; September 14, 1879September 6, 1966), also known as Margaret Sanger Slee, was an American birth control activist, sex educator, writer, and nurse. Sanger popularized the term "birth control ...
arranged for funding for
Gregory Pincus Gregory Goodwin Pincus (April 9, 1903 – August 22, 1967) was an American biologist and researcher who co-invented the combined oral contraceptive pill. Early life Gregory Goodwin Pincus was born in Woodbine, New Jersey to Jewish parents, who we ...
's research of
hormonal contraception Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The origin ...
. In 1952, John Rock was recruited to investigate clinical use of progesterone to prevent ovulation. In 1955, the team announced successful clinical use of progestins to prevent ovulation., which cites: :
Enovid Mestranol/norethynodrel was the first combined oral contraceptive pill (COCP) being mestranol and norethynodrel. It sold as Enovid in the United States and as Enavid in the United Kingdom. Developed by Gregory Pincus at G. D. Searle & Company ...
, the brand name of the first pill, was approved by the
U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA) and put on the market in 1957 as a menstrual regulator. In 1960, Enovid gained approval from the FDA for contraceptive use. Rock was 70 years old when Enovid was approved for contraceptive use. Over the next eight years, Rock campaigned vigorously for Roman Catholic approval of the pill. He published a book, ''The Time Has Come: A Catholic Doctor's Proposals to End the Battle over Birth Control'', and was subsequently featured in ''
Time Time is the continued sequence of existence and events that occurs in an apparently irreversible succession from the past, through the present, into the future. It is a component quantity of various measurements used to sequence events, to ...
'' and ''
Newsweek ''Newsweek'' is an American weekly online news magazine co-owned 50 percent each by Dev Pragad, its president and CEO, and Johnathan Davis (businessman), Johnathan Davis, who has no operational role at ''Newsweek''. Founded as a weekly print m ...
'', and gave a one-hour interview to
NBC The National Broadcasting Company (NBC) is an Television in the United States, American English-language Commercial broadcasting, commercial television network, broadcast television and radio network. The flagship property of the NBC Enterta ...
. In 1958,
Pope Pius XII Pope Pius XII ( it, Pio XII), born Eugenio Maria Giuseppe Giovanni Pacelli (; 2 March 18769 October 1958), was head of the Catholic Church and sovereign of the Vatican City State from 2 March 1939 until his death in October 1958. Before his e ...
declared that use of the pill to treat menstrual disorders was not contrary to Catholic morals. Rock believed it was only a matter of time before the Catholic Church approved its use as a contraceptive. In 1968 the papal encyclical ''
Humanae vitae ''Humanae vitae'' (Latin: ''Of Human Life'') is an encyclical written by Pope Paul VI and dated 25 July 1968. The text was issued at a Vatican press conference on 29 July. Subtitled ''On the Regulation of Birth'', it re-affirmed the teaching of ...
'' laid out definitively the Catholic Church's opposition to hormonal and all other artificial means of contraception. Rock was profoundly disappointed. Consequently, he withdrew from the Church that he loved so much. Although it has been claimed by some journalists that Rock was to blame for adding "unnecessary" breaks in use of the pill (instructing one week of taking
placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...
sugar pills every month), Jane Dickson of the
Faculty of Sexual and Reproductive Healthcare The Faculty of Sexual and Reproductive Healthcare (FSRH) is a faculty of the Royal College of Obstetricians and Gynaecologists The Royal College of Obstetricians and Gynaecologists (RCOG) is a professional association based in London, Unite ...
of RCOG stated in an interview that there were many more reasons for a placebo period, including as a recovery period from the then high dosage of hormones from the pill, and as reassurance that in having menstrual flow (although it was not a true period) one was not pregnant.


The Pill Trials

The initial clinical trials were codeveloped by John Rock and were funded by Katherine McCormick, a collaborator of
Margaret Sanger Margaret Higgins Sanger (born Margaret Louise Higgins; September 14, 1879September 6, 1966), also known as Margaret Sanger Slee, was an American birth control activist, sex educator, writer, and nurse. Sanger popularized the term "birth control ...
who dreamed for the creation of a female-controlled
contraceptive Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
method. With this funding, Gregory Pincus joined John Rock to observe contraceptive effects of
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
on Rock's female patients. In 1954, the two doctors began their first trials on 50 women in Massachusetts. Rock and Pincus used an oral contraceptive pill containing synthetic progesterone supplied by a pharmaceutical company, Searle. These trials occurred under what appeared to be considered a
fertility Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertili ...
study, as contraception was illegal in Massachusetts. The pill containing progesterone, was taken by women for 21 days followed by a 7-day break. Rock and Pincus wanted to give the body an opportunity for
menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hor ...
, so that this drug would not conflict with the natural biological processes in women. The concluding results revealed no
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
occurred in any of the women during drug administration. Rock's written scientific research explained how this drug succeeded to inhibit ovulation, but skepticism remained present in authorities. In order to provide further evidence of their developed oral contraceptive pill, Pincus and Rock moved their studies to Puerto Rico to conduct their trials on a larger scale in 1956. The pill was reported successful regarding preventative purposes but brought too many
side effect In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
s for legal consideration, which was stated by the medical director of the clinical trials in Puerto Rico. While Pincus believed that only a few, mild side effects would come about, roughly half of the participants in the study dropped out due to side effects like severe headaches, nausea, and vomiting. It was noticed after that the transportation of pills from Searle was contaminated, due to a mixture of synthetic
estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal acti ...
with the progesterone. This was an obstacle for the two doctors, but their further research and testing revealed the addition of estrogen in combination with progesterone can help reduce menstrual comfort. In 1960, the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) approved the use of the oral contraceptive, developed by Rock and Pincus. This female-controlled contraceptive method, known as
the Pill The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. The pill contains two important hormones: proges ...
, became a rapid, nationwide use for protection against
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
.


Later years

In later years, Rock and Menkin would receive many letters from people about Rock's early optimism for how long it would take for IVF to be used in the clinic. Rock was said to have been filled with sadness as he had to inform women that the IVF technology would not be ready in time. He had then predicted that it would be decades before in vitro fertilization was used to successfully make women pregnant. After realizing he could no longer contribute to the IVF project, Rock decided to move on. He wanted to develop a more successful way of opening blocked
Fallopian tube The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In ot ...
s, therefore his last idea before abandoning his research was the creation of artificial or plastic Fallopian tubes. Rock retired in 1969 from his practice and moved into a farmhouse in Temple, New Hampshire. After his retirement, he founded the independent Rock Reproductive Study Center, later renamed as Rock Reproductive Clinic, Inc., in Brookline, Massachusetts. This center was known to focus on fertility, sterility, and the development of the oral contraceptives, now known as the birth control pill. He remained working at the clinic until around the late 1960s and eventually sold his practice to Dr. John H. Derry of Newton who renamed it to Derry-Rock Clinic in Roxbury, Massachusetts. He died in Peterborough, Massachusetts on December 4, 1984, at the age of 94 from myocardial infarction in Peterborough in southern New Hampshire.


References


Further reading

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External links


John C. Rock personal and professional papers, 1921-1985. H MS c161. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass.
{{DEFAULTSORT:Rock, John 1890 births 1984 deaths Harvard Medical School faculty American obstetricians American gynecologists People from Marlborough, Massachusetts Catholics from Massachusetts Harvard Medical School alumni