Should Birth Control Pills Be Over-The-Counter?

Is it time to start selling birth control pills over-the-counter (OTC)?

The easy answer is, yes.

But is it really an easy question to answer? No. Remember, we are living in a country where many parents are still against condoms being available to students, and where many schools are teaching abstinence only in place of sex-ed classes. I’m thinking this isn’t going to be as easy of a switch as some of these articles make it appear.

From The New York Times Op-Ed — Let the Pill Go Free:

The pill meets F.D.A. criteria for over-the-counter medications. Women don’t need a doctor to tell them whether they need the pill — they know when they are sexually active and want to avoid pregnancy. Pill instructions are easy to follow: Take one each day. There’s no chance of becoming addicted. Taking too many will make you nauseated, but won’t endanger your life, in contrast to some over-the-counter drugs, like analgesics. (There are even side benefits to taking the pill, like reduced risks of ovarian and uterine cancer.)

From — Why Over-The-Counter Birth Control Access Makes Sense:

The bottom line is this: we believe an OTC switch for a birth control pill would increase access to contraception by providing a highly effective, woman-controlled option that can be obtained without a trip to the doctor’s office, and the difficulties that often entails. We think this will be good for women. And it may even have the potential to transform the way we think about birth control by decreasing stigma and normalizing contraceptive use.

From NewsWeek — Should the Pill Be Sold Over the Counter?

Teenagers are particularly vulnerable to access problems because it is harder for them to get to a doctor without a parent’s help. Almost 20 percent of sexually active teens who do not want to become pregnant are not using contraceptives, according to the Guttmacher Institute. And teenage girls who do not use contraception during their first sexual experience are twice as likely to become teen mothers as their counterparts who use protection.

What do you think? Are you “cool” with knowing your 15 year-old (or younger) could walk into a Wallgreens or CVS to buy some chewing gum and also pick up birth control pills? As a mother who has a good relationship with my teen daughter, making birth control pills available OTC wouldn’t be a problem for me. Personally, I think it’s a great idea to give more women access to birth control pills. However, I do have a few concerns.

First, when it comes to issues of woman’s health (particularly for teens and the uninsured), I think we need to see more access to health professionals, not less. I agree that not every woman should need to have consultations with a physician before getting birth control pills, but many — specifically teens — should. I would hate to see it become a situation where only the insured and the wealthy had access to medical consultations for birth control, while the rest have to rely on over-the-counter options with no access to medical advice.

And contrary to what many articles are reporting, birth control pills do have side-effects, and they can be different for each woman. The benefit of having a physician monitoring you when you first begin using birth control pills is the doctor’s ability to recognize adverse effects and change to different pills accordingly.

It’s not just major side-effects that concern me, it’s the little ones too… If a teen girl buys birth control pills on her own, and then her face breaks out with acne or she begins to gain weight, what do you think she will do? Will she stop having sex so she can stop taking birth control pills? Or will she just stop taking the birth control pills? What would you have done at that age?

Another worry I have is with the cost. It seems that every time a prescription medication is released for over-the-counter use it is quite expensive. Could the key demographic for this change to OTC birth control pills end up being priced out? Not only that, but often insurance companies take advantage of this situation too, by not covering prescription medications that are available OTC. So if you have a $10 copay for prescriptions and then are forced to buy it over-the-counter, you almost always pay more — often a lot more. I believe the cost for birth control pills are between $15 and $50 depending on the type you choose, but I haven’t read anything that estimates the cost of an OTC birth control pill. This should be a BIG concern, but I’m not hearing a lot mentioned about it.

Anyway, those are my thoughts. What are yours? Is it time to start making birth control pills accessible to women without a prescription? Let us know your thoughts in comments.

*cross-posted to BlogHer Health & Wellness

Update:  On Friday the FDA approved a controversial emergency contraceptive, I will be writing more about this in a separate post tomorrow…

A new drug that can prevent pregnancy after unprotected intercourse or the failure of other contraception was approved on Friday by the FDA.   The drug, ulipristal acetate (to be sold under its brand name, ella), is available only by prescription and prevents pregnancy when taken orally within 120 hours (five days) after a contraceptive failure or unprotected intercourse. Previously approved emergency contraception based on the drug levonorgestrel (Plan B) is labeled for use within 72 hours of intercourse.