Beneath the Surface: The Dalkon Shield

This Collegian UR podcast explores how the Dalkon Shield changed a woman's life and the medical malpractice lawsuits in the shadow of E. Claiborne Robins' legacy on campus. 

Hosted by Madyson Fitzgerald. Reported and written by Jackie Llanos and produced by Caio Rodolfo. Music created by Nathan Burns. Podcast art created by Nolan Sykes and The Collegian. 

MADYSON FITZGERALD: This episode contains content that may be alarming to some listeners. Listener discretion is advised.

DONNA REECK: He told me it was a Dalkon Shield and that it was very dangerous. He took it out, and he shook it over me as I laid on my back, and I was spattered with my own blood. And I didn't understand any of it.

FITZGERALD: Donna Reeck was born in New York in 1955. At 17, she got engaged. After her engagement, her mom sat down with her to talk about what form of birth control she would use to avoid a teenage pregnancy; she chose the intrauterine device known as the Dalkon Shield. Reeck was one of 3.6 million women who made that choice, a choice that would cost some of them their lives and others their fertility.

Hugh Davis, a gynecology professor at Johns Hopkins University Medical School, and Irwin Lerner, an engineer, invented the Dalkon Shield in the late 1960s. In June of 1970, the A.H. Robins pharmaceutical company, owned by E. Claiborne Robins, purchased the Dalkon Shield and began its production. 

Robins is remembered at the University of Richmond for his donation of $50 million. In return, UR erected a statue in his honor, the only statue on campus. There are also six buildings that carry the Robins name, including the football stadium and business school. 

In this episode, we will hear about how the Dalkon Shield changed Reeck’s life and Robins' legacy on campus.

I’m Madyson Fitzgerald, your host for this episode of Beneath the Surface, a Collegian podcast. 

How did the crab-shaped IUD come to be? Contraceptive expert Elizabeth Watkins, provost, executive vice chancellor and professor of history at the University of California Riverside explains concerns about birth control pills in the 1960s that created the perfect market for the Dalkon Shield.

ELIZABETH WATKINS: Hugh Davis, who was the developer of the Dalkon Shield and who worked with A.H. Robins were very clever in positioning the Dalkon Shield IUD as a safer alternative to the birth control pill. There are a couple of national reports that came out in the late 1960s, which showed a higher risk for women who took the pill as compared to one who didn't take a pill for getting these potentially fatal blood clots. This led to Senate hearings in 1970. Very public. They were covered on the TV news in the evening. And at these Senate hearings, Hugh Davis testified about the dangers of the birth control [pill], and also used it as an opportunity to talk about this, you know, supposedly safer method, which was the IUD. Now, it turns out that the Dalkon Shield was anything but safe. 

FITZGERALD: The Dalkon Shield had over 70 IUDs to beat in the market, leading to a marketing campaign to present A.H. Robins’ device as an easier and more effective alternative to the others. To back up the marketing claims, A.H. Robins used Davis’ original research article, which claimed the device had a pregnancy rate of 1.1%. However, Davis didn’t disclose that he had invented the device and that his findings were inaccurate in the article. 

WATKINS: Clearly, this was a device that was marketed very quickly. It was allowed to come to market because there were not the same kinds of FDA oversight because it was a device and not a drug, which allowed it to come to market without the usual advisory committee, careful scientific peer review consideration.

FITZGERALD: Since the Dalkon Shield worked to prevent pregnancy through small amounts of copper that acted as a spermicide, which prevented sperm from fertilizing an egg, it was not classified as a drug. Therefore, the Federal Food and Drug Administration did not regulate the IUD with the same standards as it did other medications before it hit the market. 

Had the FDA been more thorough with the Dalkon Shield, it might have caught the design errors in the string of the device that allowed it to transmit bacteria from the vagina to the uterus. An employee of A.H. Robins discovered the flaw in the IUD as early as 1971, but it wasn’t until 1974 that the company suspended sales of the Dalkon Shield in the United States. 

The combination of the improperly sealed string and high failure rate resulting from the shape of the device caused devastating complications including spontaneous septic abortions, ectopic pregnancies, pelvic inflammatory disease, severe bleeding and birth defects in children who were born while their mothers were wearing the device. As a result of adverse effects, some women had to undergo hysterectomies, including Reeck.

REECK: My periods became very heavy and very clotty, and I had a lot more cramping almost from the beginning. I went for a one-year checkup; it was a much older doctor who said, ‘Don't worry about it.’ And then I forgot and I just didn't do anything. I got married, and I got divorced in 10 months. And I went to work, and I did not even have it checked regularly. I was young and dumb. 

FITZGERALD: At 21 years old, Reeck went to the gynecologist for another checkup. It was then that a doctor warned her about the Dalkon Shield, and she discovered she had an infection in her fallopian tubes. 

REECK: I had an abscess on my fallopian tubes and had a really bad infection and was hospitalized in a teaching hospital. My boyfriend came to visit me with flowers, and they had put ‘gonorrhea’ on my door. 

FITZGERALD: Doctors diagnosed Reeck, among many other women, with gonorrhea, and they did not document the Dalkon Shield as the cause of the infection. 

REECK: They also said that the abscess I had was so rare that because it was a teaching hospital they could call every resident in a line. And after about six who had done an internal on me, I said, ‘What is this? And what are you doing?’ And they said, ‘Well, it’s a teaching hospital, so, you know, we're letting them feel where your infection is.’ And I told them that it was stopping now, and I got up off the gurney and looked out the door and there were about 15 people lined up along the wall.

FITZGERALD: It wasn’t until about a decade after Reeck had the Dalkon Shield inserted that she found out about the lawsuits through a magazine article she stumbled upon. 

REECK: I saved that magazine for probably 20 years because it just radically changed my life.

FITZGERALD: The gonorrhea diagnosis prevented Reeck from receiving larger compensation, she said. 

Lawsuits against the A.H. Robins Company didn’t start until 1974, after the FDA held hearings for septic abortions caused by the device. A.H. Robins suspended domestic sales of the Dalkon Shield in 1974, but sales continued in other countries for months, leading to the deaths of 15 women in Latin America and Africa. The damage caused by the device extended to whole families. Women who got pregnant using the device had children with birth defects caused by bacterial infection of the placenta and fetus.

By 1980, the company settled and fought cases in court by the thousands. In 1984, a former attorney of A.H. Robins confessed in a hearing that company higher-ups told him to destroy evidence that they had knowledge of the safety issues caused by the device. 

As the lawsuits started to pick up, Reeck joined the Dalkon Shield Information Network, one of several grassroot groups started by women injured by the Dalkon Shield. The organization based out of Pennsylvania tried to reach as many people who could have been affected by the device as possible to give them information about the lawsuits. During the course of the lawsuits, Reeck and the president of the information network traveled to Richmond to find answers. 

REECK: When there were hearings in Richmond, Karen Hicks and I would go down together and try to educate ourselves and understand what was going on in the legal battle. They told us we couldn't stay. We weren't allowed in the courtroom. You're talking about my life. 

FITZGERALD: Reeck had difficult conversations with women who used the Dalkon Shield, and, for many of them, she said she was the first person to even tell them about the lawsuits.

REECK: I can't tell you how many times I cried hearing other women's stories that made mine look like a walk in the park.

FITZGERALD: She said she had made so many calls that at one point her phone bill had been higher than her rent, but that didn’t bother her.

REECK: I'm not sorry I did it. I think that it was my way of healing me and trying to educate other people.

FITZGERALD: Robins declared bankruptcy of his century-old company in August of 1985. The company, which he had inherited, still had over 5,000 unresolved cases at the time the company went bankrupt.

By 1987, there were more than 300,000 claims in the U.S. and other countries from women who said they were affected by the Dalkon Shield. Attorneys appointed by the court and A.H. Robins' attorneys started to come up with a sum of money to pay the women and their families. 

The judge in charge of overseeing the case ordered the company to fund the Dalkon Shield’s Claimants Trust to distribute 3.2 billion in settlements to those who had been affected. Since A.H. Robins could not afford to pay all the claimants, the American Home Products company bought out A.H. Robins in 1988.

The Robins family received 300 million dollars from the purchase of the company. 

GEORGENE VAIRO: We were the bad guy, in a sense, right? Because I'm the one that's telling you, ‘you're only going to get 40,000, not 140,000.’ But I had to make sure that the person sitting next to you was going to get their fair share.

FITZGERALD: That is Loyola law professor Georgene Vairo who was in charge of the Dalkon Shields Claimants Trust. She got involved with the case after the judge presiding over it asked her to look over the distribution of settlement funds because of her expertise in mass lawsuits. 

She describes leading the trust as the most important thing she has done in her life.

The claimants’ trust invented a three-tier system for the settlements. In option one, the person just had to sign a document saying they had been harmed by the Dalkon Shield, and they would receive $725. More than 130 thousand users of the device chose option one.

Under option two, those who had proof of their injuries but could not show that they had been caused by the Dalkon Shield received between $850 and $5,500. This was the least popular option, as only 18 thousand took it.

Option three required the most evidence. Claimants had to show medical proof that the device had caused their injuries. But, as we discussed earlier, doctors often diagnosed STIs as the cause of the patients’ injuries. And if the evidence was not good enough, they got nothing. 

The payout for option three reached up to $4 million, and 47 thousand people received settlements from this category. However, the average payout was $31,000

VAIRO: We wanted these to be best and final offers. We're not going to negotiate, we don't have the money to do that. That will advantage represented claimants as opposed to unrepresented claimants. So, that violated our rule that we wanted to treat them the same. So, we wanted them to get the same best and final offer as people who have lawyers. Now, that actually irritated the plaintiff's lawyers. But um, you know, we thought that was the fair way to do it.

FITZGERALD: While Vairo considers the outcome of the claimants' trust a success, Reeck thought the monetary compensation was not enough for the women who were harmed.

RECK: There was so much destruction in people's lives and futures and their dreams for young, fertile women. 

Big business just have a whole lot more power than, you know, a 20-something-year-old infertile woman. They just thought that we were greedy and that all we wanted was money, and I wanted justice. But you don’t always get it. 

FITZGERALD: Reeck said she got $30,000 in compensation, which was less than she made in a year at the time. Producer Jackie Llanos talked to Reeck about what the road to getting compensation was like.

JACKIE LLANOS: How was that process of filling out the forms and all of that?

REECK: They looked at my medical records, and I was devalued because when I was hospitalized, at first when I had an infection, and the fact that they said that I was diagnosed with gonorrhea. I was compromised.

LLANOS: How did that make you feel?

REECK: I was so mad. I was so mad because I don't write those records. Once again, it's male doctors. There were thousands of women who had that diagnosis, thousands of women. I was just one of them. And I was infertile by the time I was 19. That's not fair. 

FITZGERALD: She said she was still dealing with physical harm caused by the Dalkon Shield. 

REECK: There’s nothing left inside of me, but I still have other health issues from it like osteoporosis. I walked across my living room floor, twisted my ankle, and wound up with a spiral fracture in my foot.

FITZGERALD: To this day, Reeck said she is wary of doctors and contraceptives. 

REECK: Because it's between you and your physician, it's not publicly known. Nor is it known what the standard is for IUDs that are on the market today or the implants in your arm. I think it's just frightening. And that it really is just affecting women. 

FITZGERALD: Watkins, whose expertise is in the history of birth control, shares a similar sentiment as Reeck about the lack of development in the industry.

WATKINS: The result is that many companies got out of the research and development business and stopped doing research on new contraceptives, which is, I think, what leads us to where we are today. Which is there really hasn't been any new contraception since the pill and the IUD. And the IUD is an old technology. So, what we have on the market now are just different ways of getting hormones into women's bodies, right? So, there’s a vaginal ring, there’s a patch, there’s an implant, there’s an IUD. But they're all using the same technology, which is that these hormones prevent women from ovulating and then getting pregnant.

FITZGERALD: Ultimately, surviving the Dalkon Shield also left Reeck with emotional scars, she said.

REECK: Because I haven't been married since I was 19 and I'm 65. Just to have to go through and have to discuss that with people. And to be a 30-year-old woman, you know, dating somebody and, ‘Oh, you know, I'd really like to have kids.’ Well, guess what? I'm not the girl for you.

LLANOS: Did that close your options for finding a partner?

REECK: Yes, because if you said you wanted kids, I kind of walked away.

FITZGERALD: Even though most students know Robins for his donations to UR, there have been multiple protests throughout the years highlighting Robins’s responsibility in the deaths of the 21 women and the injuries to thousands. 

In March 2021, in the middle of protests about the memorialization of slaveholders and eugenicists on campus, flyers describing the company’s distribution of the Dalkon Shield appeared around campus. 

The smiling statue of Robins that stands in the quad students walk by on their way to class had the word “murderer” painted on it, and the sign outside the Robins Hall dormitory was also painted over. 

A maintenance crew washed off the red paint resembling blood on Robins statue hours after pictures began making appearances on social media. Now, there are three cameras pointed at the Robins statue at all times.  

UR’s Planned Parenthood Generation Action has also put on demonstrations to raise awareness of the Dalkon Shield. In 2017, the organization placed posters providing information about the harm caused by the device on Robins’s statue.

CLAIRE TATE: I just kind of went back and like talked to some folks about it, and I realized just like how integral Robins was to the whole catastrophe of it. And how integral he was to our college campus and how it's really never acknowledged.

FITZGERALD: Claire Tate organized the demonstration in 2017 when she was a sophomore and president of UR’s Planned Parenthood Generation Action. She first learned about the Dalkon Shield in a gender studies class.

TATE: The extent of the harm that was caused, I wasn't fully aware of, and the more that I learned, the more like atrocious it got. When his statue is there, we only talk about how he made Chapstick and donated so much to the university. If a statue of his whole body is going to be in the quad, let's be honest with ourselves about the whole spectrum of influence he had, which was donating to the University of Richmond and also huge medical malpractice in the pharmaceutical industry.

FITZGERALD: Watkins, a university administrator who has been involved in questions about memorialization, sees both sides of the argument for how to move forward in how we remember people who have caused harm.

WATKINS: I feel like we certainly should not be celebrating these bad actors. And I don't know what the right approach is, in terms of: Is there a way to remove this celebration, and at the same time, use it as a learning experience, right. That's what we do at universities, we teach and we learn so that we try not to, you know, make the same mistakes. 

FITZGERALD: Perhaps, there should be an emphasis placed on the opinions of those affected by the people whose memorialization we question. For Reeck, the answer is clear. 

LLANOS: How does it make you feel that that man has a statue on a college campus?

REECK: To have so many buildings is revolting to me, named after him. I think the fact that the Robins family is held in high esteem at your college is absolutely disgusting and absolutely misguided

FITZGERALD: A year after the protests that garnered national attention, The Board of Trustees renamed six buildings tied to enslavers and eugenicists and approved a plan for community members to request further name changes. However, the board still has ultimate authority over the question of memorialization. The advisory committee that will handle requests for name removals will begin its work in fall 2022. For now, Robins’s legacy on campus remains intact.

LLANOS: What would you say to university officials and the Board of Trustees? 

REECK: They need to hear my side of it. And people like me, there are thousands and thousands of us. Some women got nothing and were sicker than I ever was. 

The Dalkon Shield stole what would be a normal full female life because I did want children. I wanted those typical things. Thank you, Mr. Robins, for altering the whole trajectory of my life, and I hope your money kept you very warm.

FITZGERLAD: Thank you for listening to Beneath the Surface, a Collegian podcast. This episode was reported and written by editor-in-chief Jackie Llanos. Caio Rodolfo produced this episode, and our music was provided by Nathan Burns. I’m your host, Madyson Fitzgerald, and we’ll see you next time.

Contact editor-in-chief Jackie Llanos at jackie.llanoshernandez@richmond.edu.

SOURCES:

Papers of the Dalkon Shield Claimants Trust, [1970-1998]. Special Collections. University of Virginia Law Library. https://archives.law.virginia.edu/records/mss/00-4

The Dalkon Shield Claimants Trust: Paradigm Lost (Or Found)? By Georgene M. Vairo. Fordham L. Rev. 617 (1992). https://ir.lawnet.fordham.edu/cgi/viewcontent.cgi?article=3019&context=flr

$2.4-Billion Dalkon Shield Payout Options Disclosed. By Linda Williams. Los Angeles Times, March 18, 1990. https://www.latimes.com/archives/la-xpm-1990-03-18-mn-1045-story.html

The Right Question: One Man’s Effort to Tell Dalkon Story. By Barry Siegel. Los Angeles Times. August 22, 1985. https://www.latimes.com/archives/la-xpm-1985-08-22-mn-2247-story.html

E. Claiborne Robins Alumni Hall of Fame. The University of Richmond. https://robins.richmond.edu/faculty-staff/Alumni-Hall-Of-Fame/E-Claiborne-Robins.html

New Threat to A.H. Robins's Plan. By Tamar Lewin. The New York Times. May 3, 1988. https://www.nytimes.com/1988/05/03/business/new-threat-to-ah-robins-s-plan.html

Why People Were Scared of IUDs. By Alexandra Sifferlin. TIME. November 10, 2015. https://time.com/4106290/dalkon-shield-history/