The Dalkon Shield to the IUD Renaissance: How One Device Destroyed a Category for 30 Years
A defective IUD killed women, bankrupted a corporation, and convinced an entire generation of gynecologists that intrauterine contraception was dangerous. The device was the problem.
In the early 1970s, nearly 10% of American women using contraception relied on an IUD. By the late 1990s, fewer than 1% did. The collapse of IUD use in the United States was not caused by evidence that IUDs were ineffective. It was caused by a single defective product, a corporate cover-up, and a legal and medical overreaction that denied women access to the most effective reversible contraception for three decades.
The Dalkon Shield was introduced in 1971 by the A.H. Robins Company. Hugh Davis, its co-inventor, published a study in the American Journal of Obstetrics and Gynecology claiming a pregnancy rate of 1.1%, better than any other IUD or oral contraceptive. He did not disclose his financial interest. The data were fraudulent. The actual failure rate was 3 to 5%.
The device had a design flaw that was not merely unfortunate but predictable. Its multifilament tail string acted as a wick, allowing vaginal bacteria to ascend into the sterile uterine cavity. Women developed pelvic inflammatory disease, septic abortions, and septicemia. At least four women died. Thousands more suffered chronic pain, infertility, and emergency hysterectomies.
A.H. Robins knew about the problems by 1972. They continued selling the device in the United States until 1974, when the FDA requested suspension. They continued selling it overseas for years after that. The company filed for bankruptcy in 1985. The trust fund for victims reached $2.3 billion.
The Dalkon Shield catastrophe was not a failure of IUD technology. It was a failure of a single, badly designed device marketed with fraudulent data by a company that concealed evidence of harm. But the lesson the profession drew was broader: IUDs are dangerous.
🎯 Free Subscriber Bottom Line: Five contraceptive practices have been abandoned or fundamentally reformed since the 1970s: the Dalkon Shield, high-dose oral contraceptives, requiring a pelvic exam for OCP prescriptions, withholding IUDs from nulliparous women, and mandatory husband consent for sterilization. Each was driven by commercial interests, paternalism, or the misapplication of data from a single catastrophic device to an entire category of contraception.
Below, paid subscribers get: - The complete Dalkon Shield timeline and the corporate cover-up - High-dose OCPs (50+ mcg ethinyl estradiol) and the dose-response for VTE, stroke, and MI - Why requiring a pelvic exam for a pill prescription was never evidence-based - The 30-year exclusion of nulliparous women from IUDs: Dalkon fallout vs evidence - Mandatory husband consent and the paternalism that defined contraceptive access - What the IUD renaissance teaches about recovering from medical overreaction.
