• Wed, Nov 21 2012

Pretty Please? Birth Control Should Be Sold Over-the-Counter, Say Docs

There’s more potential for danger and abuse in a bottle of acetaminophen than a pack of birth control pills, so why is one sold over-the-counter and not the other? No good reason, really — especially considering that about half of pregnancies in the United States are unplanned. Thankfully more doctors and medical groups are recognizing that allowing Americans to prevent minor headaches without jumping through hoops but not life-changing situations like pregnancy is … kind of dumb. The latest to speak up is the American College of Obstetricians and Gynecologists (ACOG), which released a statement yesterday in support of non- prescription birth control.

The high unintended pregnancy rate in the U.S. has remained unchanged for the past 20 years, the group points out — at an estimated $11.1 billion annual cost to taxpayers. Any risks associated with OTC birth control pill sales would be outweighed by benefits, ACOG says.

The risks are pretty slim anyway. Hormonal contraception may come with a lot of obnoxious side effects for some reason, but most aren’t actually dangerous. The pill can increase women’s risk of blood clots, but this is rare (and besides, so can pregnancy). And what’s the worst that can happen if someone takes it when they don’t need to — they don’t get pregnant?  There’s just no logical reason to keep birth control pills prescription-only. Any arguments otherwise reek of paternalism, sexual prudery and moral panic.

If the powers that be would decide to declassify the Pill, however, it could take quite a while. The Food and Drug Administration would have to conduct studies showing the pill is safe for OTC use and that women could understand its purpose and side effects without a doctor’s help.

I guess that’s pretty standard procedure  but it sure sounds … insulting. Will our tiny lady brains be able to comprehend reading pill labels?!? For good measure, could we have the pills labeled: “Warning, ladies, these are NOT tic-tacs?” And maybe “This pill does not give you license to be a wanton hussy” (for the Catholics out there)? And for the conservatives, maybe small print noting that “Allowing women to take this step toward controlling their reproductive destiny with minimal hassle or interference does not tacitly imply we think women are full human beings (resales are not endorsements).” That should cover all our bases shouldn’t it?

For the record, studies show women support OTC birth control pill access, are able to self-screen whether it’s appropriate for them and able to assess the health risks, according to ACOG. Evidence also shows women will continue seeing their gynecologist for screenings and preventative care without needing to go there for a birth control script, and that women who get more than one month’s supply of the pill at a time have a higher continuation rate than those who don’t.

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  • MC

    While I fully agree that every woman (that wants it) should have access to birth control, I’m not entirely in favor of having them be over the counter. Where I live (Belgium) you need to get them from the gynecologist- when you go to ask for them you undergo an exam just to check everything and the doctor recommends the most suitable pill for you (this may take existing conditions into account (e.g. acne) and/or the strength of the pill). I think that if pills would be over the counter, this might make more women reluctant to go for their (semi)annual appointments and potentially miss early warning signs of all kinds of things. (this said, I do whatever mechanism is in place to distribute contraception, it should remain affordable)

  • Rebecca

    I’m more concerned that if BC isOTC then insurance companies won’t have to cover it any more. That’s what happened with a lot of acid reflux medications and my daughters nutrimigen formula. If you can get it OTC but it’s $25 a month a lot of women will have to pass. I think this is really just the insurance companies way of getting out of covering it.Also I’m unable to take BC because I developed a blood clot and a lot of the BC’s I tried had negative effects on my mental health, so I can see the dangers

  • Alexandra

    I wouldn’t be in favor of this, there are dozens of types of birth control pills, each with different hormone concentrations. In addition to this, the estrogen:progesterone ratio differs as well.

    There is no way you can choose the right pill for yourself. My doctor even had trouble figuring out what was going on when I needed to go from alesse to marvelon because my own hormones re-balanced and alesse was no longer strong enough!

    As MC said, certain pills are better suited for women with acne, others are great for mood swings and intense cramps.

    Some women, like my friend, are extremely sensitive to birth control and require a lot of time and effort to find a brand that works.

    Birth control also counteracts with many medicines, including antibiotics. Considering both the pill and antibiotics are prescribed to treat acne, this could be dangerous because the counteraction makes the pill less effective.

    Finally, a lot of women may be tempted to pick a higher dose so “it works better”, which is wrong! A stronger dose can cause really bad side effects for some. The best is to start with the lowest dose possible and go up if that one doesn’t work.

    Basically, I have NO idea what those doctors were thinking…
    Oh, and I live in Canada, where a gynecologist or a doctor can also prescribe the pill (which is great because when my gynecologist was on maternity leave I could still get a new prescription), however, you don’t need a checkup, you just talk to the gyno about your needs, which I find great because most teens don’t use the pill for contraception.

    • kj

      Totally. Plus, people only take OTC painkillers like acetominophen sporadically (or at least I assume that’s generally the case) whereas birth control is something that some women use for years and years. I think it’s a good idea to have that kind of long term use monitored in some way.