Can you imagine living in a world where you could buy your birth control pills the same way you buy aspirin or cough syrup? This is the reality for women in several South American countries where oral contraceptives are available without a prescription. A recent study, conducted by two University of Texas campuses and Ibis Reproductive Health, suggests that many US women would purchase birth control without a prescription if it were available.
The study, led by researchers, advocates and clinicians, comprised of more than 1,000 El Paso women living on the US-Mexico border. The groups were evenly divided into women who obtained their contraceptive pills in Mexican pharmacies and women who obtained their birth control in US clinics. Women from both groups believed that the facility where they obtained the pills was cheaper than the options from across the border. In addition, 90% of women who got their pills from US clinics felt confident they were given good information and liked the other services offered by the clinic. On the other hand, only 46% of women using Mexican pharmacies felt confident about the information they received and 90% wanted the option to bypass the prescription and be able to send family or friends to pick up the medication. The research indicates a clear interest in OTC birth control, which begs the question of whether or not it’s time for the US to remove the prescription-only policy for birth control pills.
Access to safe, affordable birth control is imperative to women’s reproductive health. Many people believe birth control pills are easy to obtain, but not all women have equal access. Low income women and undocumented immigrants disproportionately experience obstacles like lack of insurance coverage, transportation and child care that are exacerbated by the requirement for a physician’s prescription. Making birth control available over the counter would certainly remove/reduce some of these barriers. In a policy review by Guttmacher, Sneha Barot writes that advocates have pushed for oral contraceptives on open shelves because of its relative safety (low risks with high benefits). In addition, risk factors associated with the pill, like hypertension (high blood pressure), can be tested at self-administered kiosks or checked by pharmacists. These options are simpler and faster than going to the doctor’s office.
While removing the restriction would increase accessibility, it is important to think about potential unintended consequences. For example, the need for birth control is the primary reason many women see a physician. At these visits they are likely to receive other important screenings for cancer and STIs. While removing the obstacle of a prescription would increase the availability of the pill, it may also lead to a decrease in the number of women getting these important screenings. Furthermore, removing the prescription requirement for oral contraception could make pills unaffordable for low income women- especially if the end result was the removal of Medicaid coverage.
We need to critically think about the feasibility of an over-the-counter birth control pills option in the US. The vast majority of people would agree that increasing access to birth control is a good thing. But is OTC birth control the best way to do this? What do you think? Will oral contraceptives ever be available over-the-counter in the US?