OTC Birth Control Pills, Pro-Choice Satire, and Victory in Ohio


Ohio sees two major anti-choice bills die in the Senate. ACOG recommends that birth control pills be sold OTC. “Parks and Recreation” satirizes anti-choicers.

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Links in this episode:

Jodi Jacobson and others on worldwide contraception access

ACOG supports OTC birth control pills

Should they sell the pill over the counter?

Bill O’Reilly thinks conservatives are depressed

On this episode of Reality Cast, I’ll be interviewing Kellie Copeland of NARAL Ohio about recent pro-choice victories in her state. ACOG comes out in support of over-the-counter birth control pills and Parks and Recreation makes fun of abstinence-only.

RH Reality Check’s own Jodi Jacobson was on Huffington Post’s live show to discuss why 200 million women around the world can’t get the contraception they want and need.

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It’s about a half hour video and I highly recommend checking it out.

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The American Congress of Obstetricians and Gynecologists, known as ACOG, broke some interesting ground late November by announcing their support for over-the-counter sales of oral contraception. Not just emergency contraception, but the good, old-fashioned birth control pill. ACOG is basically the gynecologist version of the American Medical Association, so their policies and positions matter quite a bit, usually, though I suspect less than they should in this case. Here’s Vice President of Practice Activities Gerald Joseph, making the announcement.

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One thing a lot of Americans don’t know is that over-the-counter birth control pills are hardly an anomaly or a strange idea. Many countries already have this as a policy, including Mexico. In fact, Mexico’s policy on this is one of the reasons that there’s been more interest in moving towards this system in the U.S. A research study done in El Paso compared two groups of women, those who got the pill at pharmacies in Juarez and those who got their pills at public clinics in El Paso, and found that the women who went to pharmacies in Juarez to get over-the-counter birth control pills were better at using contraception. The reason is almost surely because it’s more convenient; drugstores have better hours and are often more accessible. Plus, you can buy multiple packets at a time instead of have to get one at a time, which is often how it goes at public clinics. Dr. Joseph discussed this aspect in the announcement.

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One concern that was raised in multiple corners was the cost issue. Right now, prescription birth control is available to most women with health insurance without a copay, and next year it will be available to all insured women. But ACOG addressed this issue in the report. This recommendation isn’t meant to replace prescription birth control pills at all. The assumption is most women will still go through their doctors, especially since they’re already getting well woman check-ups. But for women who can’t get pills through a doctor, this could help. Additionally, for women that are on prescription pills, having over-the-counter access could help a lot. If you’re traveling and forget your pills, for instance, you could buy some replacements. Or if it slipped your mind to make a doctor’s appointment and now your prescription has run out. Or, if you’re changing doctors or jobs or moving or any of the other life disruptions that can make it harder to keep up with a prescription, and which we know are linked with increased rates of unwanted pregnancy.

The other concern raised was, of course, safety. But the pill is actually quite safe.

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This is a reality that often gets lost in the shuffle, because there is a lot more attention paid to the negative side effects that some experience on the pill than on almost any other medication, even though it’s statistically a very safe drug. But not only should its safety be compared to other, more dangerous drugs that are sold over-the-counter, but also to the condition that the pill prevents, i.e. unintended pregnancy.

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From a health and safety perspective, clearly the answer is to make birth control pills available over the counter. But unfortunately in this country, decisions about reproductive health care policy tend to be as much, if not more, about politics than science. Already, as we were reminded in last week’s interview, emergency contraception has fallen victim to politics and has been put, for no good reason, behind the counter at pharmacies instead of on the shelves. There’s exactly zero percent chance that conservatives won’t start screaming about teenage girls getting birth control pills if any real progress towards getting this done is made. Already Janice Shaw Crouse of Concerned Women for America is trying to scare people by saying, “Any guy who is older and taking advantage of a younger girl could put her on a pill.” In reality, men that are interested in statutory rape rarely show that kind of interest or concern in their victim’s health care, which is why girls in that situation already have a higher pregnancy rate than girls with age-appropriate partners. Crouse doesn’t want to admit it, but she’s clearly more interested in punishing the majority of sexually active teenage girls, who are having consensual sex with boys their own age than she is in protecting anyone. By the way, since when it is better for a rape victim to get pregnant anyway?

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Insert interview

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I’m an on-again, off-again fan of the show “Parks and Recreation”. It used to be my favorite show on TV, but in the past couple of years, they’ve laid off the more satirical stuff they used to do and have drifted towards more interpersonal “gentle” comedy that isn’t as funny. But when they return to their roots as a show that uses the politics of small town government as a conduit for sharp political satire, they can be really funny again. So it was with this season’s episode “Sex Education”, which deftly skewered the mindless prudery of the anti-choice movement, as well as sent up the way that they get their hooks into people even as their attitudes have no relationship to the way people actually live their lives. Basically, the problems start when the city government decides to address an STD breakout in a surprising community.

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This is based on a real life phenomenon, where the combination of the rise of retirement communities and the invention of Viagra has created a lot more sexual opportunities for seniors. On the whole, this is really great news, because old people deserve to have fun and pleasure as much as everyone else. But they don’t have pregnancy concerns, so a lot of them don’t think that they need to use protection, and voila! These kinds of outbreaks actually happen, and by and large the sexual health community believes the best approach is the one that Amy Poehler’s character Leslie Knope proposes here: Simple sex education and providing condoms in places where seniors socialize. But when Leslie and her colleagues actually try to implement the plan, they run into trouble. The city manager comes in and shuts them down, and is followed by a couple of angry anti-choice nuts who found out about the program and freaked out.

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It all sounds ridiculous, but is real life any different? I mean, this is the same kind of mentality that is leading to various state legislatures to try to shut down Planned Parenthood, on the same grounds that it has this kind of abstract contaminating power that infects the entire community. What I liked about this is that by swapping out elderly people for children, you can see how ridiculous the anti-choice argument is. Teenagers and seniors are very much alike in that most of us know that they are having sex, but their age makes us blanch at it and we don’t much like to think about it. Anti-choicers are only too happy to harness our discomfort to serve their general anti-sex ends that hurt us all. But our discomfort is not as important as their right to control their own bodies and make their own choices and be educated to do so in the way that is best for them.

But what really made this episode such brilliant satire was how they sent up the media’s unwillingness or inability to expose anti-choicers for who they are, in part because we’re all so afraid of talking about sex and in part because it’s easier to cast judgment on others than deal honestly with their needs and desires.

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Genius. Sending up the way that journalists often interview people without questioning their base assumptions. It is true that conservatives take it as a given that suppressing your desires is a good thing, and are rarely asked to explain why that is exactly. By making the people they’re scolding and trying to control older than themselves, it draws home how ridiculous it is for random moral scolds to substitute their judgment for yours when it comes to sexual decision-making. Why are they the authority? Just because they say they are? But instead of asking these questions, the host just changes the topic. I also liked how he brought out a poll and immediately the 15% who want comprehensive sex education are characterized as “perverts”. This is a classic right wing technique for deflecting hard questions about their backwards policies. If you question them, or refer to the facts about health, they try to turn it around on you and shame you into silence. That’s exactly what happened to Sandra Fluke, for instance. She spoke out about contraception access, and was met with a sea of conservatives calling her a slut. Same thing.

The show was brave enough to deal honestly with the fact that overcoming these obstacles isn’t easy. The seniors demand real education and condoms, and Leslie cracks and gives it to them. She gets censured by the mayor and finds that she’s got no real choice but to campaign hard against the abstinence-only law. The moral is that these things can’t be fixed in one big swoop, and only by doing the long, hard political work.

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And now for the Wisdom of Wingnuts, sad sad Bill O’Reilly edition. O’Reilly is deeply concerned about the mental health of his fellow Americans. Well, some of them anyway.

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Of course, traditional America itself left a lot of people, especially women, depressed. Women forced to give birth against their will, especially if they were then forced to give up their babies, often suffered depression. Women who weren’t allowed to work because their husbands wanted them to have traditional family structures. And, of course, gays who were barred from marriage and society because of “tradition” suffered higher rates of mental illness for it. But hey, some people have a sad because they can’t oppress others quite like they used to. And Bill O’Reilly is definitely more concerned about them than all the people whose mental health is adversely affected by being relegated to second class status.   

Follow Amanda Marcotte on Twitter: @amandamarcotte