Technology and Culture

Introduction

In state-socialist Poland, abortion became legal for socioeconomic reasons in 1956 and was widely available in public health care from the late 1950s to the early 1980s, with an annual average of 120,000 abortions.¹ A 2013 study by the Polish Public Opinion Research Centre estimated that over one-third of Polish women born before 1978 had undergone at least one [End Page 182] abortion.² Polish women were therefore using abortion to control their fertility, even though the vast majority were Catholic and the Polish Catholic hierarchy fiercely opposed the liberalization of the abortion law, and abortion in general.³ The paradoxical commonality of abortion in a Catholic country with a particularly conservative ecclesiastic hierarchy regarding sexuality and contraception, together with the state-sponsored framing of abortion as dangerous, is an important yet unresolved puzzle in Polish cultural history, strongly influencing debates on abortion and reproductive rights.⁴

Contemporary observers, family planning experts as well as journalists, have attributed abortion's stable role as birth control measure in Poland to the limited access and poor quality of contraceptive products and devices.⁵ The fluctuating availability and reliability of products arguably meant that women continued to view abortion as the most available and reliable birth control resource. This theory has remained largely unchallenged. The circulation of contraceptive technologies in Poland, and East Central Europe in general, has not been systematically examined within the historiography of technology or consumption.⁶ Similarly, the dynamically expanding historiography of family planning in the region has paid limited attention to contraceptive technologies, with the exception of the oral contraceptive pill.⁷ This article fills these gaps and provides a more nuanced explanation for the high prevalence of abortion in Poland.

Building on earlier work on the gendering of contraceptive advice and on the circulation of the contraceptive pill in 1960s and 1970s Poland and Spain—a Catholic and nondemocratic state at the time, this article is the first to systematically examine different and new contraceptive technologies in the Polish market when family planning enjoyed active support from the communist authorities.⁸ Rather than refer to quantitative and qualitative shortages, this article argues that the material and symbolic trajectories of contraceptive methods in Poland were immersed in simultaneous and dynamic processes of contraceptive "innovation" and "failure."

The key examples of diaphragms and spermicides demonstrate the shifting perceptions of these technologies, over a decade, from heavily promoted [End Page 183] techno-methods to either unpractical (diaphragm) or "better than nothing" (spermicide) solutions. Their trajectories, shaped by the specific social, political, and economic context of a particular moment in Poland's history, were arguably the outcome of explicit and implicit negotiations between actors involved in the development, production, distribution, and popularization of contraceptives. These negotiations, charged with ambivalence and contradictions, involved socialist authorities, health care providers, experts linked to the state-sponsored family planning organization and international family planning movement, and end users. Underscoring the links between Polish and transnational contraceptive expertise also situates the "Second World" more firmly in the historiography of transnational flows of knowledge and contraceptive technology commodities, which thus far has focused on the Global North, the Global South, or their interrelationship.⁹

This analysis is informed by the feminist historiography of technology, particularly regarding contraceptives. Nelly Oudshoorn has demonstrated that these technologies are the material result of negotiation and selection processes that embody socially constructed practices and values.¹⁰ Adele Clarke and Theresa Montini have shown how contraceptive technologies are imprinted with gendered and racial hierarchies, shaped and reshaped in arenas sustained by various institutional and noninstitutional actors, including the real and imagined users.¹¹ Heather Munro Prescott argues that birth control technologies can simultaneously operate in two seemingly mutually exclusive frameworks, which she labels "pregnancy-as-disease" and "reproductive rights." By concentrating on pregnancy rather than the end users of technologies, governments and international organizations have promoted the elaboration and circulation of contraceptive methods with the primary aim of preventing pregnancies to combat poverty. Thus, provider-dependent technologies such as the contraceptive shot DepoProvera, contraceptive implants, and the intrauterine device (IUD) or coil are the preferred options, as they eliminate user error and subject reproductive agency to professional mediation.¹² Surgical sterilization exemplifies perfect birth control in this context, thanks to its effectiveness and irreversibility.¹³ Regarding "reproductive rights," the focus is on how contraceptive technologies, the oral contraceptive pill in particular, have enhanced women's reproductive autonomy.¹⁴ [End Page 184]

This article demonstrates, as Prescott has, and as Chikako Takeshita and Michelle Murphy have for other contraceptive technologies and contexts, that the "pregnancy-as-disease" and "reproductive rights" frameworks overlap, resulting in contradictory meanings.¹⁵ Polish experts simultaneously represented and popularized spermicides as a self-reliant and efficiently "simple" method that enhanced the effectiveness of female barrier methods. These were depicted in popular family planning literature as both manageable and overly challenging technologies, particularly for less educated women. Some literature blamed users rather than the technologies for their limited effectiveness. My research sources range from the collections of state medical publisher Państwowy Zakład Wydawnictw Lekarskich (PZWL, located in Milanówek, Warsaw), the Polish Ministry of Health, and the Supreme Chamber of Control and Polish Unified Pharmaceutical Industry, all in the Central Archives of Modern Records in Warsaw, as well as the Society for Conscious Motherhood publications on contraception, including its journal Problemy Rodziny, founded in 1961 and targeting family planning professionals. Further publications were systematic searches in Ginekologia Polska, the only Polish journal for gynecologists, and thematic searches in trade journals, the general press, and women's magazines. This wide scope of professional and nonprofessional forums sheds light on what it was like to purchase and use contraceptives in Poland from the late 1950s to the early 1980s.

This article starts by establishing the institutional and political context of Poland's post-1956 state-sponsored family planning campaign and then addresses the introduction and circulation of the key contraceptive methods in the late 1950s and 1960s: spermicides and female barrier methods. Condoms, IUDs, and the pill are not discussed here, as their trajectories were fundamentally different. Male contraceptives, also distributed by the Society for Conscious Motherhood, featured only marginally in the popularization campaign, and the manufacturing process was beyond its control. The IUD and the pill, both highly medicalized, highly effective, and coitus-independent female contraceptive methods, only became (relatively) accessible in Poland after the late 1960s, when state-sponsored family planning was already losing its momentum.¹⁶

Family Planning Campaign

Between 1957 and 1970, with the support of state-socialist health authorities and Western family planning experts, the production and promotion of female contraceptive methods began on an unprecedented scale in Poland. These were coordinated by a dedicated enterprise, Securitas, that the Society for Conscious Motherhood established in 1958. The key [End Page 185] characteristics in creating a contraceptive technology market were medicalization and standardization, supported by Western experts. A comparison with interwar family planning activism and the progressive de-prioritization of family planning in the 1970s and 1980s highlights the Society's important and unique approach. Influencing this de-prioritization during late state socialism in Poland were shifts in the Party-State's relationship with the Catholic Church and an alignment in population policies. However, the Society's ambition to reduce abortion rates by promoting (female) contraception remained unchanged.

The Society's foundation in 1957 marked the beginning of a health campaign promoting birth control. Historians disagree about the Society's relationship with the state. Sylwia Kuźma-Markowska's influential scholarship established the groundwork for critically examining Polish state-socialist family planning policies and services. She argues that this interdisciplinary organization—funded under the auspices of the Ministry of Health by doctors, journalists, and writers, many already birth control activists in the interwar period—should be viewed in terms of its agency and autonomy in the Party-State-assigned task of mainstreaming family planning as a statewide project.¹⁷ Natalia Jarska, on the other hand, emphasizes that the Society was instrumental in the Communist Party's early 1960s conflicts with the Catholic Church.¹⁸ Consideration of how contraceptive technologies were developed and circulated under the Society's patronage exemplifies how the organization was simultaneously autonomous and instrumentalized.

The Society was established shortly after the legalization of abortion for socioeconomic reasons in 1956 and thereafter bolstered by the communist authorities' moderate anti-natalist position.¹⁹ Consistently high birth rates (averaging 29.4 per 1,000 annually between 1946 and 1955) and population growth (an annual average of half a million between 1950 and 1955) were no longer interpreted as the postwar revitalization of a mutilated nation but as threats to Poland's development.²⁰

The Party-State greatly supported the Society's popularization and educational activities through the generous assignment of scarce, good-quality paper that enabled the printing of 3.5 million books and brochures on family planning during its first two years.²¹ The Society became responsible for supervising and consolidating a contraceptive market, which, as Catholic historian Katarzyna Jarkiewicz argues, the government had neglected [End Page 186] in the early 1950s. Then, the only available contraceptive products were contraband "zip pouches" (probably containing condoms), sold at street markets.²²

The Polish contraceptives market was apparently less developed in the early 1950s than before World War II. Senior family planning activists trained during the interwar period were a considerable asset and enabled the Society to revitalize this market. Sylwia Kuźma-Markowska has shown that birth control activists, who initially recruited medical professionals and socialist intellectuals, began promoting contraception in the 1930s already, particularly among the working classes. Specific clinics opened in several cities, first in Warsaw in 1931. Historian Magdalena Gawin shows that the most recommended birth control technologies at that time were barrier methods, especially condoms or "hard" and "soft" pessaries. The hard metal pessaries had to be placed over the cervix by a professional and removed once a month before menstruation. The soft rubber ones were self-inserted and recommended with spermicide jellies or tablets containing active substances such as boric acid or quinine. A few doctors recommended a vinegar solution as a cheap and accessible option for the most poverty-stricken women. The major concerns for 1930s family planners were the efficacy and safety of the available contraceptive methods. They believed that the quinine-based spermicides and "hard" pessaries, both intra- and extrauterine, caused toxicity and lesions.²³

A number of these methods reemerged in Poland two decades later, in a qualitatively different political and technological context: the emphasis had shifted to safe methods and their technologization and medicalization, carried out by the Society for Conscious Motherhood and Securitas. What remained stable was the emphasis on methods for women, linked to the ways legal abortion was framed in Polish expert discourses after 1956. Medicalized abortion, as Sylwia Kuźma-Markowska shows, was presented as an advance in socialist health care to protect women's bodies from the lesions caused by illegal termination. However, as she argues, it also increased the medical surveillance of women's reproduction.²⁴ Medical discourses from the late 1950s onward, chiefly those promoted by the Society, depicted abortion—legal and illegal—as dangerous surgery that could cause illness and infertility.²⁵ Thus, contraceptive technologies not only prevented women from becoming pregnant but also protected them from abortion and the associated health risks.²⁶ This emphasis on methods for women, to avoid potentially dangerous abortions, was simultaneously [End Page 187] dominant in the Soviet Union from the mid-1950s to the mid-1960s.²⁷ The combination of a female barrier method with a spermicide was also recommended in Czechoslovakia, but enveloped in a different discourse: a safe but also aesthetically pleasing contraception that would not prevent sexual pleasure.²⁸ The links between contraception and sexual pleasure were consistently weak in Poland's medical discourse, with family planners focusing more on the health and well-being of the family unit.²⁹

In Poland, initially the mass circulation of contraceptives in the late 1950s and early 1960s concentrated on two main aspects. The first was the rebranding and commodification of traditional methods: the sponge and simple spermicides based on boric acid. The second was introducing a Western-validated, standardized method: the diaphragm. The availability of this technology was increased through the Society's links with the British Family Planning Association and International Planned Parenthood—Europe Region, citing as key to its foundation British family planner Helena Wright's visit in 1957. The Society took pride in these links and was the first country in Central and Eastern Europe to join the international association in 1959.³⁰

With a Latin name conveying safety and reliability, Securitas elevated its status by associating with medical and scientific knowledge and became the main player in the standardization of contraceptive technologies. Securitas initially focused solely on promoting and distributing contraceptive methods, not production. The Society for Conscious Motherhood presented the establishment of Securitas both as the solution to difficulties in accessing contraceptives reported by men and women and to counteract some Party-State authorities convinced that demand for contraception was nonexistent. Securitas billed 50,000 złoty a month, a considerable sum compared to the average monthly salary in 1958 of c.1350 złoty.³¹

Several small cooperatives located in various cities produced the contraceptives listed in the Society's catalog. However, activists deemed that this unsystematic process produced insufficient quantities, and in 1961 the Society complained about "the shortages of necessary contraceptives which makes our propagandistic work inefficient."³² Possibly, a diametric process [End Page 188]

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Fig 1.

The unprecedented number and diversity of female barrier methods and spermicides demonstrate the boom in contraceptive technologies on the Polish market from the mid-1950s to the mid-1960s. (Data from: Czajkowska, "O Dopuszczalności Przerywania Ciąży," 172; Pumpiański, Jak Zapobiegać Ciąży; "Non Tabletki Zapobiegające Zapłodnieniu"; "Płyn Antykoncepcyjny Amo"; Securitas, "Kapturki Naszyjkowe"; Majle, Co Każde Małżeństwo, 1st ed. and 6th ed; Sprawozdanie za I Kwartał 1963 [Report on the first quarter 1963], f. 4, 29/1435/0/-/13, TRR; Securitas, "Zlecenie Wykonania Ulotki," 2877/I/1826, f. 25, WNA.)

was taking place: the small manufacturing cooperatives may not have been able to meet the propaganda-incited demand from both end users and doctors. By the 1950s, the Society was constructing a network of clinics in Poland's major cities to assist the public and train doctors. These clinics, together with the Society's publicity campaigns, could disseminate knowledge about contraception to an unprecedented extent.³³ In 1961, probably in response to the aforementioned challenges, Securitas also began manufacturing, no doubt believing that stronger centralization would facilitate production and distribution.

From the late 1950s, Securitas manufactured or coordinated the production of several brands of spermicides and female barrier methods (figure 1), as well as two gynecology products: Cervisol for treating cervical erosions, and the antifungal and antibacterial solution Sterovag.³⁴

In 1969, Securitas manufactured the Polish IUD Spiran and thereby controlled most contraceptive production in Poland, except for the pill, produced around the same time in the national drug factory at Jelenia Góra, and condoms from national rubber manufacturer Stomil.

By the mid-1970s, Securitas headquarters, a three-bedroom flat in central Warsaw, had twenty-five staff members and was executing an annual [End Page 189] 10 million złoty plan.³⁵ However, this growth saw ongoing complications as state support diminished. A change in Party-State leadership in December 1970, when Edward Gierek replaced Władysław Gomułka, along with an ideological alignment between the Party-State and the Catholic hierarchy on the promotion and protection of "family," had a direct impact on the Society and Securitas.³⁶ The first change was the organization's name in 1970, to Society for Family Planning, reflecting its broader scope and links with the international family planning movement; the second name change, to Society for Family Development in 1979, was prompted by pressure from the Party-State.³⁷ In 1985, International Planned Parenthood—Europe published a report in English on family planning policies and services in various countries. Society president Mikołaj Kozakiewicz, perhaps uninhibited by self-censorship when writing in Polish for the local media, claimed that Gierek had personally requested the switch from "Planning" to "Development."³⁸ Amid anxiety about the decelerating postwar baby boom in the 1970s, "family development" was common ground for the Party-State to work with the Catholic hierarchy.³⁹

Support for contraceptive production and popularization did not fit easily in this situation, especially given the Polish Catholic hierarchy's inflexible anti-contraception stance. While other Catholic countries had heated debates in the sixties about whether the pill was acceptable from a Catholic moral viewpoint, the Polish hierarchy unequivocally prohibited contraception.⁴⁰ Anthropologist Agnieszka Kościańska has shown that some sectors of lay Catholic intellectualism and activism exhibited a more flexible stance, yet the official position remained unapologetic, labeling Securitas-produced spermicides and the pill as harmful to health and broadcasting that the IUD and oral contraceptives did not prevent pregnancy but terminated it at an early stage.⁴¹

In the 1985 report, Kozakiewicz also referred to the government withdrawing the provision of paper in 1976 and the increasing systemic difficulties in collecting and receiving donations that threatened the Society's survival. Concurrently, the Securitas factory was facing difficulties accessing raw materials, while the public pharmaceutical distribution center CEFARM refused to distribute spermicides and IUDs manufactured by [End Page 190]

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Fig 2.

Sales of spermicides and female barrier methods in Poland (1967–79), according to public pharmaceutical distribution center CEFARM. The 1970s saw an increase in consumerism and access to consumer goods in Poland, but these did not include contraceptive technologies that dropped dramatically. (Source: Okólski, "Abortion and Contraception in Poland," 268.)

Securitas "under the pretext of lack of demand."⁴² Sales of diaphragms, cervical caps, and spermicides dropped systematically after the late 1960s, and especially spermicide sales dropped two-thirds by the end of the 1970s. Sales of spermicidal tablets and jelly fell from over 900,000 in 1967 to less than a quarter of a million in 1979, while female barrier methods dropped from 33,000 to 4,000 over the same period (figure 2).

In 1976, gynecologist and celebrity sexologist Michalina Wisłocka, a long-standing activist in the Society, discussed these problems in the popular magazine Polityka:

During a demographic crisis, contraception becomes a taboo to such an extent that society is not informed about available contraceptive methods. What also happens is that local activists complain during the national congress of the Society [for Family Planning] that there is a serious lack of reliable barrier and chemical contraceptives. They are reluctant to recommend Proven diaphragms because of their low quality.⁴³

Wisłocka's statement exemplifies how doctors and family planners navigated [End Page 191] the ebbs and flows of the contraceptive market in the mid-1970s, once the ambitious public health campaign's momentum had waned and both Securitas and the Society were struggling to survive: public debates considered whether Securitas's role should pass to the pharmaceutical industry.⁴⁴ These negotiations played a crucial role in the circulation of female barrier methods and spermicides from the late 1950s.

Disseminating Diaphragms and Caps

In 1957, the year the Society for Conscious Motherhood was established, the diaphragm and spermicide cream known as Proven, sold separately or as a set, were already in circulation. The Proven line would become one of the most recommended female contraceptive methods in Poland, with some Society for Conscious Motherhood–affiliated gynecologists promoting it well into the late 1970s.⁴⁵

This section examines female barrier methods as key technologies promoted by the Society for Conscious Motherhood during the 1957–70 campaign. In discussion with historian Sylwia Kuźma-Markowska's scholarship, I demonstrate two reasons why these technologies became favored by Polish family planners: first, because of the transnational transfer of knowledge from the international family planning movement; and second, because the Society's emphasis on methods for women was motivated by the wider state-socialist project of medicalizing female reproductive health and the Society's aim to reduce abortion. Despite their prioritization, the circulation and dissemination of female barrier methods were problematic, revealing ambiguities in the execution of the state-supported family planning campaign. Moreover, some family planners blamed women, rather than the technologies and contextual problems, for the low adoption of female barrier methods in Poland.

Transnational influence was a key reason for prioritizing female barrier methods. Surprisingly, this originated from the West, not the Soviet Union, despite its similar promotion of female barrier methods. Mie Nakachi has shown that the 1950s and 1960s were a "golden age for contraceptive research" in the Soviet Union, focused on barrier methods and spermicides.⁴⁶ However, affinities with its Soviet neighbor were not acknowledged in the Society's published and unpublished reports. Instead, the Society emphasized its links with the British Family Planning Association and International Planned Parenthood, which proved decisive in the development and testing of early Polish technologies. Kuźma-Markowska claimed that between 1957 and 1960 twenty Polish doctors visited London [End Page 192] for contraceptive training, which included testing the safety and effectiveness of contraceptive products, and strongly emphasized diaphragms and caps combined with spermicides.⁴⁷ This collaboration continued: in 1961, a team of four from the Society's Cracow branch spent two weeks in London, receiving "a gift in pounds, which helped [them] to start [their] venture and purchase necessary contraceptives."⁴⁸ Kuźma-Markowska has also demonstrated that this knowledge transfer was not only through Polish experts training abroad but also through Western experts visiting Poland. Helena Wright, a gynecologist and since the late 1920s one of the most prominent family planning activists in Britain, toured Poland in November 1957.⁴⁹ Kuźma-Markowska describes that Wright caused a sensation with her colorful model of the female pelvis to demonstrate the correct use of female barrier methods and spermicides. Wright's strong preference for diaphragms and cervical caps had a profound impact on the Society for Conscious Motherhood's operations and priorities, which also considered female barrier methods and spermicides the most effective contraceptive option.⁵⁰ Reports from the Society's Cracow branch show that visits from British family planners continued, as did Polish delegates' participation in International Planned Parenthood conferences.⁵¹

These priorities were also in line with the Polish interwar birth control tradition that relied on pessaries for women, and with the wider Party-State program medicalizing women's reproductive health. This health program aimed to protect women's fertility and reduce the high neonatal mortality rates, but it was also expected to enhance the broader well-being of the family, which could be more prosperous and efficiently managed if the number of children corresponded with housing conditions and financial means.⁵²

Family planning ideals corresponded with the logic of the state-socialist economy's central planning. A 1960 film produced by the Educational Film Studio in Łódź together with the Society for Conscious Motherhood informed viewers, "The family also needs to be planned. … A happy family is the one that can plan and regulate its life."⁵³ This planning rhetoric [End Page 193] was common in women's magazines' coverage of contraception and in brochures like gynecologist Joanna Tołwińska's 1961 Do You Plan Your Family's Happiness?⁵⁴

Conforming to this logic, the diaphragm had to be measured and fitted by a doctor or midwife, therefore encouraging women to attend the well-woman or family planning clinics. When used correctly, the Society's experts argued, the diaphragm was effective, was reusable, and could be placed without a husband's knowledge.⁵⁵ Its effectiveness, they emphasized, had been proven in "the U.K., the Netherlands, America and Sweden"—again, a validation through transnational alignments with the "First" rather than the "Second" World.⁵⁶

However, early circulation of the Proven set was far from smooth. The diaphragms were manufactured by the Pensioners' Cooperative Technochemia in Warsaw, while the Drogista cooperative produced the rest of the Proven set: both had problems maintaining quality and meeting demand.⁵⁷ The Society's local clinics and public health care well-woman clinics frequently reported that Proven diaphragms were unavailable and of poor quality. This situation revealed tension between the propaganda and its execution in the field and showed that local doctors and midwives, as well as women users, intentionally or otherwise, actively steered the circulation of contraceptive technologies. A 1963 report by the Cracow branch underlined that over one-third of all diaphragms delivered to its local clinic were rejected owing to holes or broken springs.⁵⁸ A similar 1962 report added excessive thickness to the list of faults, suspecting this would hamper insertion and manipulation of the diaphragm. Apparently, doctors and midwives did not recommend diaphragms owing to the poor quality, and patients hated them because they were uncomfortable, as well as difficult and embarrassing to use.⁵⁹

Boric acid and ricinoleic acid were the active ingredients of Proven spermicide cream, which was sold in tubes or with syringes to facilitate application.⁶⁰ It, too, experienced supply problems—as evidenced by readers' letters in the widely circulated and popular weekly magazine for working-class and rural women, Przyjaciółka, requesting advice on Proven cream substitutes three times between 1961 and 1964.⁶¹ The magazine's [End Page 194] "agony aunt," gynecologist Michalina Wisłocka, explained that the Drogista Cooperative had run out of one of the cream's ingredients. As a local substitute had proved ineffective, the ingredient was imported and production would soon resume. Wisłocka suggested visiting the Society's clinic in Warsaw, or if using over-the-counter spermicides, these should be Afro foaming tablets and not the ZET brand, which controversially interacted with and damaged rubber.⁶² Not only the ingredients but also the packaging were problematic. In a 1967 report on challenges in Poland's contraceptives market, published in Problemy Rodziny, the Society's activist Leokadia Grabowiecka asserted that when it came to packaging, toothpaste had priority over contraceptive cream.⁶³ Another problem with the diaphragm was the availability of different sizes. The 1960 film on family planning displayed 15 sizes ranging from 6 to 9 cm in diameter, a vital variety as perfect adjustment was essential for effectiveness. However, the Cracow branch reported in 1975 that the most popular sizes sold out more rapidly than they could be replenished.⁶⁴

Distribution channels also affected the diaphragm's effectiveness. In the early 1960s, diaphragm sales were by mail order, as well as at sale points in well-woman clinics and pharmacies, although these suffered from insufficient supplies. Family planning activists preferred sale points at sites providing contraceptive advice such as family planning or well-woman clinics and gynecology wards in public hospitals, to avoid women purchasing and using the technology without being fitted by a specialist. Grabowiecka's 1967 report highlighted pharmacists' "unprofessional behavior" when selling diaphragms, because by not paying attention to size they were making one of the most successful contraceptive methods completely ineffective.⁶⁵

The other female barrier method, the cervical cap, came on the Polish market later than Proven, around 1962, and was never branded.⁶⁶ In 1964, the journal Ginekologia Polska advertised the Securitas-manufactured polyethylene cap, available for purchase in gynecology and obstetrics wards, rural maternity homes, and well-woman clinics, but, in this case, not in pharmacies.⁶⁷ A 1971 brochure stated that the locally manufactured caps were available [End Page 195] in five sizes, for use with Preventin contraceptive jelly. Caps should never be boiled, warned the brochure's author Barbara Trębicka-Kwiatkowska, head of gynecology at Lublin Medical Academy.⁶⁸ Another prolific author of contraception brochures, gynecologist Krystyna Jordan, highlighted in 1973 that, "as used to be done," caps should be worn during the entire intermenstrual period. This echo of an interwar practice still needed clarification almost thirty years later, reflecting the ongoing importance of oral and generational channels of contraception knowledge transmission that coexisted alongside formalized, state-sponsored channels.⁶⁹

Popular family planning literature invariably presented female barrier methods as highly effective, especially combined with spermicides. Gynecologists associated with the Society who wrote about contraception for the general public attributed its failure rate solely to the user. In a 1965 brochure on contraceptive methods, Michalina Wisłocka argued that "failure was a consequence of arbitrary changes the patients themselves introduce."⁷⁰ Almost a decade later, Trębicka-Kwiatkowska, writing on preventing abortion as a birth control method, claimed that "according to statistical evidence, this method failed most frequently in women with a low cultural level."⁷¹ The female barrier method/spermicide combination was thus simultaneously suitable and yet unsuitable for less educated women. Polish experts, unlike in the working-class Global North and South, asserted that contraceptive suitability was not directly linked to housing limitations, such as a lack of running water to easily rinse devices after use, a reality in Poland's semi-permanent housing crisis during the state-socialist period.⁷² Arguably, housing limitations did indeed prompt the promotion of solo spermicides as a convenient alternative and part of the Society's quest to provide technological and standardized contraceptives.

Ups and Downs of Spermicides

During the early stages of family planning campaigns starting in the late 1950s, the production and popularization of spermicides followed seemingly contradictory routes. The Society for Conscious Motherhood manufactured spermicides for use with female barrier methods to enhance their effectiveness. It also produced and presented multipurpose spermicidal liquids as improvements to homemade vinegar or lemon juice solutions. The Society developed spermicidal tablets, promoting them as effective techniques tested in collaboration with Western experts. These tablets were meant to work effectively with or without female barrier methods or [End Page 196] the rhythm method. Over time, however, industrial spermicides became synonymous with a "better than nothing" approach to contraception. This transition to tablets experienced ups and downs similar to female barrier methods: production and distribution problems, disagreements between experts, and the contradictory advice that confused women about the most effective combinations and potentially discouraged their use.

In the late 1950s, in addition to the favored diaphragm/spermicide pairing, the Society invested in developing and promoting spermicides for use with or without sponges. A 1958 Securitas advert in Ginekologia Polska presented three brands of condoms (Luxi Gum, Jatex, and Łapino) and the Proven line (contraceptive cream, syringe, and diaphragm), highlighting an unbranded contraceptive sponge and spermicide under the sensual name Amo.⁷³ This Amo solution, containing boric and lactic acid, was manufactured by medical supplier Chirurgofil in Poznań, 200 km northwest of Warsaw.⁷⁴ The advert for this spermicide highlighted that it "destroyed sperm, prevented pregnancy and trichomonas infection," was harmless, and could be used frequently.

Amo was a technologized alternative to the sponge and vinegar solution: superior, yet paradoxically interchangeable with "homemade" methods. In a 1962 booklet written for less educated women, the protagonist gives her friends this advice: "While the contraceptive brochures recommend the [Amo] solution and not vinegar, I nevertheless used vinegar during our trip to the countryside, when I forgot to bring my diaphragm."⁷⁵ According to one marriage guidance manual, by 1963 the Amo solution had been rebranded as Sex.⁷⁶ However, with technologization curtailed by market problems, popular family planning literature continued for decades to mention homemade contraceptives with sponges or cotton tampons as suitable for enhancing the effectiveness of coitus interruptus, or "better than nothing" in an emergency. "It is not the best method, but it's relatively safe and easy to use," wrote gynecologist Zbigniew Sternadel in 1969.⁷⁷ As late as 1990, a popular book on contraception by gynecologist Longin Marianowski and sexologist Zbigniew Lew-Starowicz mentions rinsing the vagina with a vinegar or salt solution if a condom had ruptured or a cap fallen off.⁷⁸

By contrast, Securitas's star product, Globulki Z or ZET foaming tablets, signified the hope that a chemical contraceptive would be both simple to use and effective. These were not the only tablet-form suppositories on the Polish market, but certainly the first ones purposefully designed, [End Page 197]

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Fig 3.

A plastic container for ZET tablets. The label shows the price, the Ministry of Health's authorization number, and instructions to store the tablets in a cool place. (Courtesy: Division of Medicine and Science, National Museum of American History, Smithsonian Institution. Catalogue: 1982.0531.046.)

branded, and advertised. Their predecessors included Non-tablets, in circulation between 1958 and 1961, based on natrium bicarbonate, boric and malic acid, and zinc sulphocarbolate. It is unclear whether ZET foaming tablets were a simple rebranding of Non-tablets or a new type of spermicide; a package of the ZETS from the National Museum of American History, acquired in 1982 as a gift from the Margaret Sanger Center, listed phenoxy-hydrargyrum nitricum as the main active ingredient (figure 3).

The Society vividly emphasized the scientific genesis and local and international testing of ZET tablets. Its 1961 report underlined that the tablets were developed by the Institute of Pharmacy, a public research institute linked to the nationalized pharmaceutical industry, and that affiliated doctors in Warsaw and the International Planned Parenthood Association had conducted the preliminary tests.⁷⁹ This validation was also communicated to the public in the 1961 bestselling booklet How to Prevent Pregnancy, by the Society's key activist, gynecologist Jadwiga Beaupre: "Z(ET) are named after "trust" (zaufanie), and you can trust them indeed. Their manufacturer is the Society for Conscious Motherhood in Warsaw. The International Planned Parenthood Association, who received samples, gave them a very high score, as a valuable spermicide."⁸⁰

That same year, the magazine Przyjaciółka claimed that ZET tablets were "one of the best chemical contraceptives in the world."⁸¹ Similar claims appeared in popular brochures that encouraged women to overcome "false shame and purchase the suppositories in pharmacies in another [End Page 198] district or order them from Securitas."⁸² Experts emphasized that the best combination was a spermicide with a barrier method, especially during the fertile window. Yet the emphasis on ZETs' efficacy and foreign testing initially created the impression that they could adequately prevent unwanted pregnancy.

Intensive advertising in women's magazines like Przyjaciółka certainly spurred the immense popularity of ZET tablets. They featured prominently in the regular adverts for Securitas-distributed contraceptives in the 1960s. These adverts diminished in the early 1970s and disappeared completely by 1972, perhaps due to the Party-State's deteriorating interest in family planning. Destined to be disseminated through pharmacies and well-woman clinics, but also alongside condoms in newsagent kiosks, ZET tablets were an example of what population control programs in the Global South called the availability approach: the greater a method's availability, the more likely people would use it.⁸³ Selling ZETs though nonmedical channels not only boosted availability but also reduced their price. In the early 1960s, a pack of 10 ZETs cost 2.10 złoty with a prescription, 7 złoty without.⁸⁴ In comparison, the Proven diaphragm cost 18 złoty (15.60 złoty with prescription). Despite requiring a higher initial outlay, the diaphragm was more economical in the long run. Overall, Securitas-managed contraceptive methods were modestly priced and certainly affordable for people with an average monthly salary exceeding 1,600 złoty.⁸⁵

Not all activists were happy about the pricing or distribution channels, claiming that the cheap and accessible ZET tablet threatened the more effective diaphragm/spermicide combination. Cracow-branch activists emphasized that ZET tablets were an oversimplified technological fix that in fact discouraged doctors from promoting more time-consuming methods such as the diaphragm.⁸⁶ Diaphragm users probably combined the ZETs with Proven diaphragms if they were unable to purchase Proven cream, or used the tablets with condoms.

Only in 1963 did popular medical literature explicitly warn users about the incompatibility of ZET tablets with rubber barrier methods. A 1963 manual for women, You and Your Family, tackling various family "hygiene" aspects including pregnancy, childcare, and contraception, mentioned that ZET tablets were safe with cervical caps but not with diaphragms, for which it recommended the Afro foaming tablet.⁸⁷ The [End Page 199] manual's following edition was more explicit about the consequences of mismatching the spermicide with barrier methods: "ZET tablets should not be combined with rubber barrier methods, because they interact with rubber and damage it."⁸⁸ Afro tablets came on the market in 1963, perhaps in response to the user-driven application of foaming tablets that threatened the contraceptive efficacy of barrier methods.⁸⁹ They were still in circulation in the mid-1970s along with ZETs.⁹⁰ At the time, even Securitas admitted the tablets' limited effectiveness. In a 1976 interview in Polityka, Jadwiga Bednarska, director of Securitas, announced that it had received an order for half a million ZET tablets, declaring that they "do not offer a [contraceptive] guarantee, but [at least] are widely available."⁹¹

Conclusion

Bednarska's statement demonstrates that the status of foaming tablets had shifted from a heavily promoted techno-method to another "better than nothing" solution, encapsulating the trajectory of spermicides in Poland between the late 1950s and early 1970s as a period of simultaneous boom and crisis on the contraceptives market. This trajectory occurred when the delayed mass introduction of the pill and the IUD preserved the position of spermicides, with or without female barrier methods. Ilana Löwy's study of spermicides in the 1950s Global North and South shows that the availability of more effective contraceptive methods had an immediate effect on the distribution of chemical contraceptives in the "First" and "Third" Worlds. The pill and new IUD models were promoted across the globe, albeit with different methods of persuasion for wealthy women in the West and poor women in the South. In "Second World" Poland, however, the protracted introduction of the pill and IUDs left female barrier methods with or without spermicides as the main sources of contraception. These sources had been discursively transformed: Securitas's emphasis on harmless methods and their standardization and technologization through controlled, Western-inspired production shifted to resignation. In the case of spermicides, this resignation meant a "better than nothing" strategy. In the case of barrier methods, it meant accepting periodic shortages and erratic quality. Neither prescribers nor users succumbed passively to these strategies, but actively expressed criticism, doubts, or praise.

The early standardization and technologization of spermicides and [End Page 200] barrier methods were boosted through the circulation of knowledge between Polish family planning activists and the international family planning movement. Society of Conscious Motherhood experts not only trained in London but also used the "IPPF" and "the West" symbolically in discourses to legitimize and reinvent contraceptive technologies and their efficacy. While concepts relating to these technologies circulated through the Iron Curtain, local production of contraceptive commodities was a significant challenge in a central planning context. Despite declarations of active Party-State support throughout the late 1950s and 1960s, Securitas and the Society had to compete for resources, from printing paper to plastic tubes for Proven cream. Although support continued officially, it was easy to withdraw actual investment in contraceptive technologies by claiming "lack of demand." This term—intrinsic to capitalism—was therefore employed instrumentally in line with central planning principles. Consequently, contraceptive technologies received punctuated rather than systematic support from the authorities. At the same time, fluctuation in the contraceptive market provided a ready explanation for stable abortion figures.

Female barrier methods and spermicides in Poland between the late 1950s and early 1970s held multiple and at times contradictory meanings, ranging from standardized techno-efficacy (compromised by user error and the user embodied as a lower-class, uneducated woman) to a "better than nothing" almost "homemade" solution, the antithesis of contraceptive "technology." In this scenario, women's and couple's reproductive agency was obscured, displaced, or even erased.