Time to Demand All Birth Control Pills Be Sold Over-the-Counter


In all the fussing over the sale of emergency contraception over-the-counter (OTC), it’s easy to forget that there’s another contraception drug out there that should be available OTC but isn’t: the ordinary, everyday birth control pill. The American College of Obstetricians and Gynecologists (ACOG) thinks birth control pills should be sold OTC. Most other countries sell birth control pills OTC. And now, as ThinkProgress reports, nearly two-thirds of American women say they want the pill sold OTC, and about 30 percent who aren’t currently on the pill would consider going on it if this option was available.

So why can’t we have this, when the public and the medical establishment both think it’s a great idea? Part of it is no doubt the politics of it. As the furor over emergency contraception—which you only take in emergencies (and don’t need if you’re consistent with your birth control pills)—demonstrates, the idea of women being able to prevent pregnancy easily sets off all sorts of irrational reactions in this country. You should have to struggle for it to prove you deserve to be not-pregnant, because … mmmph that’s why. The religious right already believes that contraception is too easy to get, which is why they’ve been attacking it with so much vigor lately. Trying to make birth control pills available OTC would set off a political firestorm that would make the emergency contraception wars look like mere skirmishes.

Still, for women’s health, I believe that’s a fight that pro-choicers would be happy to have (though maybe not the folks in the Obama administration trying to maintain the ruse that they better understand medical risk than researchers and doctors). The problem here, however, is that there’s still a widespread belief that birth control pills need to be prescription-only in order to make sure women go to their doctors. Unlike many of the other countries that have the pill available OTC, the United States doesn’t have universal health care (yet, though in 2014, we may see this shift dramatically due to Obamacare), which means that doctors have a uniquely difficult time in this country encouraging women to go to the doctor regularly. The argument is that we need to use the pill as bait to make sure women are going to their doctor—or to a local Planned Parenthood—to get their check-ups.

It’s a tempting argument, but something that needs to be tossed out for a number of reasons. First and foremost, as pro-choicers we need to adhere closely to the principle of supporting a woman’s right to the ultimate authority over her own health care. If birth control pills are safe enough to be sold OTC, then it’s up to a woman to decide if she wants a doctor’s supervision to take them, just as we allow individuals to make that determination with other drugs, like allergy medications or pain killers.

Second of all, the science doesn’t support the claim that using the pills as bait supports women’s health better than decoupling the pill from regular exams. Increasingly, research supports the conclusion that American doctors overuse the pelvic exam and the Pap test. Forcing women to take a major health risk with unintended pregnancy in order to get them to submit to a bunch of medical tests they may not even need is not good medical practice, especially when you consider that pregnancy requires massive medical intervention whether a woman chooses abortion or to bring the pregnancy to term.

Most importantly, there’s no reason to believe that women will stop getting regular medical care just because they can buy the pills OTC. Prescription pills will be available without a co-pay for insured women under the Department of Health and Human Services (HHS) regulations, which will be plenty of encouragement for women to keep in regular contact with their doctors without taking away their right to choose. In addition, making pills available OTC could be met with creative responses to use the pill-buying experience as an opportunity to encourage women to get checked up by a gynecologist, albeit by the more relaxed new standards instead of the old, overly invasive routine.

Planned Parenthood could play a major role in all this. Planned Parenthood clinics could continue to offer pills with a deep discount by tweaking their already-existing practices slightly, but when women come to pick up their prescription-free pills, the staff could use that time to highlight other important services they offer. Knowing that they don’t actually have to come in for invasive tests every year could encourage a lot of women who are currently hesitant to come in. Perhaps some of those 30 percent of women who aren’t on the pill but would consider it if they could get it OTC would be reached. They aren’t being reached now, if they avoid family planning clinics completely out of an overblown fear of being subject to too many tests. College health centers could play a similar role, offering the pills OTC but also including information on getting inexpensive and non-invasive check-ups.

Right now, birth control pills being prescription-only means that they’re decoupled from condom use. You can go pick up pills at the pharmacy counter without even walking by the condoms in most drugstores, creating this sense that there are “pill users” and “condom users,” and that they don’t even share an aisle. But if pills were sold OTC next to condoms, as emergency contraception soon will be, that creates an association. They could even be advertised as things to be used in conjunction with each other. If you’re with a partner in a non-monogamous or non-tested relationship, it would make it much easier to think of yourself as someone who uses condoms first and the pill as back-up.

We should charge ahead on this unafraid. Standing up for OTC birth control pills would absolutely be a hard, long fight, but it would be one that demonstrates that the pro-choice community really means it when we say we trust women with their own health-care decisions. Putting more time and resources towards this also means picking another fight with the right over contraception, and history shows that’s a fight that tends to favor our side in public opinion.

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  • http://www.facebook.com/corinna.taylor.73 Corinna Taylor

    My suggestion would go one step further. All birth control should be available free and over the counter, no questions asked. Methods requiring a doctor – implants, iud, etc. should be free including the doctor’s visit, available to all ages. This would not only reduce unwanted pregnancies but also cut down on huge amounts of paperwork and administrative expenses.
    As for doctors and phamacists who object — if they aren’t willing to fulfill their entire job description they should find other professions.

    • http://www.facebook.com/profile.php?id=1130629591 Mark Youngkin

      What, exactly, do YOU do without expecting to be paid?

      • John H

        Let’s see, in the past week I spent an hour and a half chopping apart that tree that fell down across the bike path with my utility knife, I made food for our co-op grocery’s annual membership meeting and potluck, I cleaned my roommate’s crap off the dining room table so I could use it, I marched in favor of labor and immigration rights, and I worked about 6 hours of unreported time at my job in order to help students who were having trouble applying to and enrolling in our graduate programs. Not much, I’ll grant, but then your comment was also a non sequitur, and my response isn’t meant to validate it but instead point out that even were it relevant, lots of us do at least some unpaid labor, for family, friends, and even strangers.

        I mean, there’s also everything I do specifically for my own well-being for which I don’t expect to be paid, but then I figured that’s not what you were talking about.

        • http://www.facebook.com/Feral.9.Hex Carla Clark

          Also, women do TONS of work for free, without any expectation of getting paid, whatsoever. So, his comment was completely debunked, as well.

        • http://www.facebook.com/profile.php?id=1130629591 Mark Youngkin

          Exactly. Corinna Taylor wants physicians and their staffs to provide free office visits for the purposes of facilitating contraceptive devices. It’s reasonable to ask what professional services (assuming that Corinna Taylor is an otherwise productive member of society) she routinely provides at no charge. Surely she would be willing to do what she expects of others. The question is relevant; you’ll find plenty of non-sequitirs below.

          • http://www.facebook.com/corinna.taylor.73 Corinna Taylor

            Read more carefully. I never said the providers shouldn’t be paid. Only that the users shouldn’t pay directly. When is the last time you had to hand money to a firefighter or policeman who came to your aid? Do you put coins in the traffic light each time you cross the street?

      • jupitaur

        Public school is free but teachers get paid. We teach everyone for free because it’s in the public interest to do so. Preventing unwanted pregnancy falls into the same category.

        • http://www.facebook.com/profile.php?id=1130629591 Mark Youngkin

          That’s rich, truly.

        • http://www.facebook.com/ingrid.heimark.5 Ingrid Heimark

          True! I am really pissed at norwegian authorities that have done research that free contraception to women in high risk age groupd for unwanted pregnancy and abortion reduses both of these, still they won’t finance it

      • http://twitter.com/JenGStarr Jennifer Starr

        I watched my friend’s two children while she put herself through nursing school. I took them to and from school, did homework with them, cooked meals for them, did light housework, put them to bed and entertained them. She paid me when she could but I didn’t expect her to.

      • http://www.facebook.com/corinna.taylor.73 Corinna Taylor

        I wasn’t suggesting that the providers shouldn’t be paid, just that they should be paid directly by whatever Board of Health or Medicaid fund or whatever would be paying under Obamacare, just eliminating the reams of paperwork, means testing, etc. that is otherwise involved, or being limited to only specific pharmacies that accept them.
        And yes, I do a lot of things without being paid, or without being paid directly by the recipient.

      • http://www.facebook.com/corinna.taylor.73 Corinna Taylor

        I’m an artist. I often donate my services to non-profit groups, I also give free demonstrations and workshops.

    • ljean8080

      You would give BC TO an 8 year old?

      • http://www.facebook.com/profile.php?id=1017522898 Karki Meade

        Don’t see why not. It’s not permission to have sex, but entirely about avoidance of pregnancy. I wouldn’t want a pregnant 8-year-old, would you?

        I immunized my children, but that doesn’t mean I took them to places with outbreaks of whooping cough. It just meant I had one less thing to worry about.

        • http://www.facebook.com/Nightsky.Sam Alisha Wolford

          My mother had an usual story, she had her period at 5 years old. Nothing was done because they were too poor to get help. She came from a family of 7.

          • http://www.facebook.com/Feral.9.Hex Carla Clark

            Alisha, Lina Medina was the youngest person to ever get pregnant, at five years old.

          • http://www.facebook.com/Nightsky.Sam Alisha Wolford

            I can’t fathom dealing with either periods or pregnancy at 5years old. Just mind-blowing. My mom was picked on a lot I know that much, can’t imagine how horrible it had to be for the pregnant girl Lina or how her body could have sustained that.

        • HeilMary1

          I do wonder if there isn’t some descreet third party monitoring system (staffed by employees) that could be set up in pharmacies to look out for such children and make sure they’re not crime victims?

      • http://twitter.com/JenGStarr Jennifer Starr

        You would force an 8 year old to give birth, ljean?

        • HeilMary1

          Especially if the fetus had Down Syndrome.

      • HeilMary1

        Let’s not forget that you are the other extreme: still a virgin at nearly 60. I’d rather an eight-year-old be spared a dangerous pregnancy by accessing EC, and whoever had sex with her be sent to jail or a juvie detention center. Funny how the people who most oppose molested children accessing EC also oppose turning in the priests and anti-choice activists who molested them.

        • ljean8080

          Where have I ever said I WOULD NOT TURN these creeps in?

          • http://twitter.com/JenGStarr Jennifer Starr

            But you’d force an 8-year old kid to carry a pregnancy.

          • http://www.facebook.com/Feral.9.Hex Carla Clark

            Where did she say you would not? Seriously, people, can’t you READ? She said those who oppose doing such and such also oppose doing such and such. It’s very true. Because we have seen many Pro-‘life’ people do exactly that. Kthx.

          • HeilMary1

            Thank you! Pedophile priests and half-age trophy wife collectors like looksist Randall Terry are the flip side of the anti-choice coin.

          • colleen2

            The question is: would you force a pregnant child to carry to term? Your pathetic attempts to avoid answering that question provide an answer anyway. I can see why you would be too ashamed to answer directly.

          • ljean8080

            No,but like the Obamas until my child was 14 or 15,they would be on a very short leash with me knowing where they were at all times.

          • HeilMary1

            Not only are short leashes no guarantees (because pedophiles are often trusted family friends like one of my parents’ “married friends” and many priests in our eight+ parishes), but also what about the 100 million homeless kids worldwide? Who is looking out for those street kids? — the pedophile missionaries endorsed by “Mother” Teresa?? You haven’t even gone through motherhood, and real mothers, especially those disabled by childbirth like my mother and my friend with lethal face cancer, don’t have the physical ability to monitor their kids 24/7. I believe my parents’ good friend, Mr. S., who sometimes babysat us, molested my sister.

          • colleen2

            That wasn’t the question.

          • HeilMary1

            Jean, while you probably would turn in pedophile priests, most extremists with fetal idolatry derangement would justify not turning them in because of their “important holy mission” to keep all sex dangerous for women’s health. Perfect examples are “Mother” Teresa, who vehemently demanded that pedophile priest Donald McGuire be returned to his “mission”, and sex hater Judie Brown of American Life League who ignored Human Life International’s “Father” Tom Euteneurer’s sexual assault “exorcisms”.

      • http://www.facebook.com/corinna.taylor.73 Corinna Taylor

        I would give birth control to any woman capable of becoming pregnant, regardless of age. Of course an 8-year-old shouldn’t be having sex, but getting pregnant would only compound the disaster.
        An 8-year-old should also not be driving a car, but if she did I would want her to use a seat belt!

  • driveswift

    The common argument is that the risk of blood clots is raised when taking hormonal birth control, which is a silly argument considering how much higher the risk of clotting is when actually pregnant – yet we don’t require women to get a doctor’s permission before getting pregnant.

  • http://oatc.livejournal.com/ oatc

    There are many other countries where the birth control pill is sold without prescription, or is supposed to be prescribed but pharmacies ignore the requirement (India being the prime example of that), so there is plenty of precedent. Unfortunately the US tends to be always pressing those countries to adopt US-type rules; this proposal would be greatly beneficial in ending that too.

    The restrictions on The Pill were initial forced by the Catholic Church which otherwise intended to stop it being manufactured at all. The rule that a gap had to be recommended in order that women still experience menstruation was one of their rules, without any clinical justification. Their malign influence on women’s lives needs to be swept right away.

  • http://www.facebook.com/ingrid.heimark.5 Ingrid Heimark

    An interesting discussion…. Here in Norway, EC is available without presciption, whilst the Pill is not. Nurses though are allowed to prescribe a few of the different pills. My suggestion would be that the EC comes with a two month prescription of low dose, but efficient BC-pills. Then the woman has time to get to the doc. Most women are not stupid, but given that people dies from usingan entire pack of Tylenol at once based on ignorance, I truly believe that unless such a pill are prescribed by a physician for long-term use, Pharmacist counselling should be mandatory at first buy. After all, the pill carries risks, such as blod cloths and are risky with breast cancer. Women should have access to the full range of contraceptives, a woman that can’t use the pill might be able to use the IUD.
    So emergency contraception and a few months of BC should be OTC, but long term use should require at least the first prescription being after a health test, lifestyle test (smoking, obesity) and counselling on all contraceptive options. And I am saying that because not all women know all the options. I know women having abortions because of failure on the pill, without realizing the patch was available all the time