The Case for Over The Counter Birth Control

Over the counter birth control has low risks and high benefits.

According to the CDC, birth control, or contraception, is one of the 10 great public health achievements of the 20th century. With it, came improved health and well-being, reduced global maternal mortality, and the health benefits of pregnancy spacing for both mothers and children. In addition, women were given a new sense of freedom and control over their lives as they were able to join the work force and become self-sufficient.

However, 20 million women in the U.S. and 214 million women around the world have trouble accessing birth control.

“There is a growing body of evidence that the safety risks [of over the counter birth control] are low and benefits are large.”
In the U.S., while non-hormonal birth control options such as condoms, sponges and spermicide sit on the shelf in between the tampons and tooth paste, you can’t access hormonal methods like pills and patches without a prescription. In recent years, states like California and Oregon have changed their laws to allow pharmacists to distribute certain types of hormonal birth control. However, in most states, women need to see a gynecologist before getting a prescription for birth control.

This can be difficult for teenagers, women busy with work or child care commitments, and those without health care coverage or nearby access to health clinics. The shifting landscape of health care in the U.S. makes the future of reliable access to prescription contraceptives uncertain. In addition, over three million women who need publically funded birth control live in “contraceptive deserts,” or counties with no public clinics.

Reports have shown that as more women use birth control, the rate of unplanned pregnancy goes down. According to the CDC, the most common used method of contraception, after the male condom, is the pill. It has been used by 79% of women between the ages of 15 and 44 who have had sex and is found to be 91% to 99% effective, depending on how regularly you take it. In addition, the pill may be used to alleviate health issues like pain and heavy bleeding during periods, acne and anemia. A study even found that in the last 50 years, oral contraception contributed to the prevention of 200,000 cases of ovarian cancer and 100,000 deaths from the disease.

“In the last 50 years, oral contraception contributed to the prevention of 200,000 cases of ovarian cancer.”
Despite these benefits, some critics believe that over the counter birth control would result in more teenage sex, less doctor visits and more health risks. But a recent review of oral contraceptive research found no evidence of more sex among teenagers or a greater safety risk.

“There is a growing body of evidence that the safety risks are low and benefits are large,” said Krishna Upadhya, the lead author of the review, in an interview with NPR.

In addition, a study of U.S. women near the Mexico border found that women who obtain over the counter birth control still see their health care provider for pap smears, STI testing, and pelvic and breast exams. In addition, making birth control easily accessible to women leads to less gaps in birth control use, resulting in less unplanned pregnancies.

According to Upadhya, “These pills are safe and effective and we should reduce barriers to using them.”

To make oral contraceptives or any hormonal birth control available without a prescription, drug companies need to apply to the FDA to have them approved for non-prescription use. However, according to Upadhya’s review, “Recent history suggests that in spite of scientific evidence and regulatory standards, policies that involve contraception and adolescents are likely to generate controversy and demands for unreasonable and counterproductive rules and standards.”

Therefore, health experts and their professional societies, who fight for evidence based policies and support equal access to reproductive health care, need to voice their support of over the counter birth control as the American College of Obstetricians and Gynecologists did in 2012 for oral contraceptives, stating, “Weighing the risks versus the benefits based on currently available data, [oral contraceptives] should be available over-the-counter.”

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Ashleen Knutsen is a science writer and editor in Los Angeles. After a decade of experience in engineering and research, she decided to pursue a career in science communications to not only spark women and girls’ interest in STEM, but to let them know that they too can change the world.

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