Malcolm Potts, a physician, reproductive scientist and contraceptive evangelist who helped develop and promote the device most frequently used to perform surgical abortions, and who spent more than half a century directing programs that provide reproductive health services to women in developing countries, died on April 25 at his home in Berkeley, Calif. He was 90.
The cause was Alzheimer’s disease, said his stepdaughter, Madison Iler.
Although he didn’t identify himself as such, Dr. Potts was essentially a neo-Malthusian. Like Thomas Robert Malthus, the economist of the late 18th and early 19th centuries. he saw population control as critical to preventing war, famine and environmental collapse, particularly in Africa, where for decades he oversaw women’s health programs, first as medical director of the International Planned Parenthood Federation and then as president of Family Health International, another global organization. He felt that women’s ability to control their own reproductive lives was crucial to that aim — an enormous challenge in the conservative countries he served.
“Malcolm felt we were heading for catastrophe if we didn’t do a better job in family planning,” said Stefano Bertozzi, a former dean at the University of California, Berkeley School of Public Health, where Dr. Potts held an endowed chair in population and family planning. The two met when they were working on H.I.V. prevention in Africa for different organizations.
“He was a ferocious ally for women having unfettered access to the tools they needed to manage their own fertility,” Dr. Bertozzi said in an interview.
The British-born Dr. Potts was rumpled, tweedy and irreverent. He was of a generation that did not pander to political correctness, and he had a collection of ties printed with condoms. He was also one of Berkeley’s most popular professors. His classes on human sexuality, at which he dispensed policy points, naughty anecdotes and common sense, were filled to overflowing. Dr. Bertozzi called him the Bernie Sanders of Berkeley.
“He was the biggest feminist I ever met — and the most unlikely,” said Alisha Graves, a public-health policy expert and former student of Dr. Potts’s. Together the two of them founded OASIS (the initials stand for Organizing to Advance Solutions in the Sahel), an organization that serves women in the Sahel, a region just below the Sahara that encompasses 10 countries and has been battered by climate change, poverty and high rates of fertility — as well as its terrible byproduct, maternal mortality.
Dr. Potts’s focus was global, but his first brush with the fallout from unwanted pregnancies happened at home.
A newly minted obstetrician, he was fresh out of medical school at the University of Cambridge when he was posted to a busy hospital in North London. There, he regularly treated women suffering from incomplete abortions — meaning that they were still pregnant, but losing blood.
It was the early 1960s, abortion was not yet legal in England, and, Dr. Potts said, the experience was an epiphany.
He opened a clinic to provide contraception to single women and vasectomies to men. And he joined a lobbying group of medical professionals working for the legalization of abortion in Britain, which happened in 1967.
Dr. Potts became a well-known booster of oral contraceptives; he once told a newspaper reporter that the Pill was so safe, he would give it to his 2-year-old daughter. He famously appeared on David Frost’s late-1960s talk show, “The Frost Programme,” to debate the merits of oral contraceptives with a conservative gynecologist. The gynecologist averred that they were so dangerous, he would prescribe them only to prostitutes. Dr. Potts responded by pouring a bag of rice onto a table and picking out two grains, to indicate the percentage of women at risk of death from taking birth control pills. He then counted out 27 grains to illustrate the percentage of women at risk of dying from an unintended pregnancy.
“It would be a service to mankind if the Pill were available in vending machines and cigarettes were placed on prescription,” Dr. Potts told Reader’s Digest in 1969. (It was a sign of the times that cigarettes were then sold in vending machines, like candy.)
In 1968, Dr. Potts became the medical director of the International Planned Parenthood Federation. In that position, he saw firsthand how the low status of women in poor countries led to harsh outcomes in their reproductive health.
He began to research ways to provide safe abortions in places where medical care was delivered in less-than-optimal conditions. He read about Harvey Karman, an eccentric activist and psychologist in training at the University of California, Los Angeles, who had come up with a way of performing abortions that was safer and less painful than what was then the more frequently used method, dilation and curettage. Vacuum extraction, as the technique is called, is now the most common surgical procedure for ending a pregnancy.
Dr. Potts sought out Mr. Karman, and together they refined the device he invented to perform vacuum extraction. They wrote about it for The Lancet, the British medical journal, whose editors were unaware that Dr. Potts’s co-author was not a medical doctor. Dr. Potts received a grant from the United States Agency for International Development to provide the device to International Planned Parenthood Federation clinics around the world.
In 1972, the two men brought the device to Bangladesh, where they were part of a team of medical professionals invited by the government to perform abortions on rape victims and to train local doctors in the procedure. (Some 1,500 women and girls, many as young as 10 years old, had been raped by Pakistani soldiers during the Indo-Pakistan war of 1971, when Bangladesh won its independence.)
In India, Dr. Potts traveled to Mumbai (then known as Bombay) to provide vasectomies; he set up a clinic on a train station platform because men there were fearful of hospitals. In Thailand, he organized a community-based distribution system of birth control pills and condoms, training market vendors, shopkeepers, schoolteachers and one undertaker to dispense them properly.
A decade ago, Dr. Potts started a company called Cadence with Nap Hosang, an obstetrician who was his colleague at Berkeley, and Samantha Miller, a pharmaceutical industry veteran, to produce a birth control pill that could be sold without a prescription. After years of holdups by the Food and Drug Administration, exacerbated in recent months by layoffs at the agency, it has yet to be approved.
Zena, as it’s called, is a combination progesterone-estrogen pill that carries a low risk of blood clots. (An online questionnaire, should the pill receive the go-ahead, would evaluate each woman’s risk.)
The company has been more successful with its Morning After Pill, which is sold online, in convenience stores like 7-Eleven and in vending machines on college campuses.
David Malcolm Potts was born on Jan. 8, 1935, in Sunderland, England, the youngest of three sons of Kathleen (Cole) Potts and Ronald Windle Potts. He grew up in Newcastle and attended Cambridge, where he earned his medical degree and a Ph.D. in embryology.
Dr. Potts was married four times. His marriages to Dera Joyce Cook and Caroline Merula Deys ended in divorce. His third wife, Marcia Jaffe Potts, died in 1993. His fourth wife, Martha Madison Campbell, died in 2022.
In addition to Ms. Iler, his stepdaughter, Dr. Potts is survived by a son, Oliver Macdonald, from his first marriage; a daughter, Sarah Deyes Longlands, and a son, Henry Potts, from his second; a daughter, Sandra Potts Jaffe, from his third; two stepsons, Douglas Iler and Bruce Iler; seven grandchildren; and four great-grandchildren.
Dr. Potts was the author of a number of books — not only practical textbooks on contraception, but also quirkier fare, including “Queen Victoria’s Gene: Haemophilia and the Royal Family” (1995), written with his brother William, which suggested that Queen Victoria had been illegitimate. They noted that none of her ancestors had possessed the genetic mutation for hemophilia, which she famously passed along to royalty throughout Europe. Therefore, they argued, her father could not have been Prince Edward.
When the book came out, Dr. Potts told The Sunday Times of London that he thought Queen Victoria’s body should be exhumed for DNA testing to settle the matter. A spokesman for the royal family responded, “I don’t think there’s been any attempt ever to dig up members of the royal family.”
“Sex and War: How Biology Explains Warfare and Terrorism and Offers a Path to a Safer World” (2008), which Dr. Potts wrote with Thomas Hayden, a journalist, explored what they called the male predisposition to team aggression, tracing it from prehistory and primatology to current horrors.
Educating women and girls to increase the number of women in leadership roles was one of their suggestions for a way to “help make peace break out.”
“Peace needs strong allies in order to persist,” they wrote, “and the ally that has been the most consistently overlooked is the one that makes up slightly over half the human race — women.”
Penelope Green is a Times reporter on the Obituaries desk.
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