With the threat of drastically-limited access to birth control looming large, women around the country could soon be facing huge barriers to having the ability to control their own reproductive systems. President Trump and his supporters in Congress have introduced no less than 3 new healthcare bills to date that aimed to make good on his campaign promise to repeal and replace the Affordable Care Act and, with it, access to many vital reproductive health goods and services. Though all 3 bills have failed thus far, the concern remains huge that women will soon lose access to maternal services and effective birth control.
That’s why the news that a new, over-the-counter birth control pill is in the works in the US has made such a splash. French pharmaceutical company FDA Pharma announced late last year that they were partnering with international nonprofit research organization Ibis Reproductive Health to begin the research necessary to present an application for a progestin-only, over-the-counter birth control pill to the Food and Drug Administration. Though the research and approval process is expected to take several years, the fact that an OTC birth control option is finally being considered is, for many people, cause for celebration.
Currently, all forms of hormonal birth control in the United States must be obtained through a prescription, with the exception of emergency contraception (also known as Plan B). However, the idea of having birth control available over-the-counter has been something reproductive health advocates have been advancing for some time. In fact, the American College of Obstetricians and Gynecologists issued a statement in 2012 proclaiming that the time had come to “allow over-the-counter access to OCs [oral contraceptives].”
In recent years, some states have taken steps to facilitate access to effective birth control — in 2015, Oregon became the first state (with California following closely behind) to enact a law that bypasses a trip to the doctor and allows women to receive birth control from their pharmacists. Instead of having to make an appointment to see their OB/GYNs, women in those states can now go directly to their local pharmacy, complete a simple questionnaire, and receive contraceptives from their pharmacists.
While this model still technically requires a prescription, it constitutes a broadening of birth control access that is widely supported by physicians. According to one study, over 74% of physicians surveyed expressed support for this kind of pharmacist-initiated contraceptive access. And, though the model stops short of a true over-the-counter experience, it is a promising step forward in removing barriers of cost and inconvenience associated with going to the doctor’s office each time a new prescription is needed.
But around the world, requiring a prescription to obtain birth control is actually the exception, not the rule. A 2013 article in Reuters revealed that only 45 countries require a prescription, and interestingly, they tend to be the wealthier countries on average. Women in a whopping 102 countries can access birth control over-the-counter or after completing a simple screening. While these statistics may or may not ultimately sway American policies on OTC contraceptive access, at the least they serve to show that making birth control available without a prescription is not a radical concept.
Indeed, it’s a concept that many women in the US would like to see become a reality. In a 2013 survey, over two-thirds of women said that they were in favor of over-the-counter birth control methods, with 30% of women using no form of birth control or using only condoms responding that they would likely take the pill if it was offered with no prescription necessary.
It’s easy to see why this is the case. In a society in which nearly 11 million women depend on the pill to control reproduction, making it easier to access means that women would never have to worry about constantly having to renew their prescriptions. As an article in The Outline recently wrote, “though it's not exactly hard to get a prescription for birth control, having to do so is widely considered to be a barrier for younger women who may feel afraid of talking to their doctors, and it is also a consistent, nagging pain for many others.” Not only must women endure the inconvenience of frequent travel to a doctor’s office to renew a prescription, they also often have to pay each time they visit. Making birth control available as an over-the-counter option removes these barriers.
This also translates to more consistent use of birth control. A 2011 study demonstrated that eliminating trips to the doctor’s office for prescriptions increased the likelihood that women would stay on contraceptives, indicating that convenience is key to continued use. Additionally, teenaged girls are also overwhelmingly in support of making birth control available over-the-counter: as a population uniquely at risk for unwanted pregnancy, yet who are still largely under the thumb of parents or guardians who may not approve of contraception, teens expressed that they would be far more likely to use birth control if the prescription requirement was removed.
Economic incentives are equally as compelling. In 2006, researchers at UCSF designed a statistical model supposing that over-the-counter birth control methods would be available at little to no cost to women. The model found that an additional 11-21% of low-income women would start using the pill, resulting in an estimated 7-25% decrease in unintended pregnancies and ultimately saving the state the money it would have spent on pregnancy, birth, and childcare. Additionally, as a 2015 Slate article maintains, broadening women’s access to birth control methods means that they are more able to “contribute to the economy and attain educational and professional goals.”
Given all of this promising evidence, it’s difficult to understand why some people are pushing back against the advent of over-the-counter contraception. The conservative argument -- namely, that access to free or low-cost birth control will mean increased promiscuity -- is, of course, being brought into the debate, despite the fact that there is no evidence to back up that claim. Some physicians worry that removing the requirement to visit a doctor for a prescription will result in women not being as vigilant as they should about other necessary reproductive health screenings, while other people believe that women may not be able to safely make birth control decisions on their own because they won’t have all the requisite medical information to make an informed choice.
Such arguments fail to give women the credit and autonomy that they deserve -- namely, that they are more than capable of making their own decisions about contraception. In fact, a 2006 study in Seattle found that when comparing women’s self-evaluations about whether or not they should take the pill with a doctor’s evaluations, over 90% of the time they matched up.
So what does this mean for women of today? It is likely that over-the-counter birth control will be making its way onto the scene in the near future, so it’s more important than ever for women to familiarize themselves with their own bodies and medical histories, and to get educated about all of the reproductive health options available to them.
Emily Johnson is a 27-year-old born-and-raised ATLien who currently works in the social media marketing space. Fun facts about Emily include that she speaks a crazy language called Jaxanke (picked up from a two-year stint in the Peace Corps), she has memorized almost every episode of Friends, and she has a mild obsession with unicorns.
Photo Credit: everydayhealth.com