The history of development of the first oral contraceptive reveals the coalescence of scientific and social forces in the late 1950s that led to his major advance in reproductive freedom for women. Improved knowledge of basic reproductive endocrinology, the development of oral compounds by pharmaceutical companies, and careful clinical trials to document efficacy each played pivotal roles in the story. In addition to industry, the National Institute of Child Health and Human Development and the U.S. Food and Drug Administration provided the research and regulatory support structures to nurture the field along its ultimately highly successful path. Still, it remains important to note that more than 500,000 women die each year from complications of child-bearing, a problem that is particularly acute in Africa. A significant portion of this mortality would be prevented by better knowledge of and access to oral contraceptives.