Birth control’s prescription requirement is an unnecessary barrier that lies in contradiction to research. It’s time contraception be dispensed over-the-counter.
Almost 20 years ago, I started my first job as a physician at Bellevue Medical Center—a public hospital in New York City—as an ob-gyn providing reproductive care primarily to people of low incomes. In those days, there was little variety among contraceptive options. There were only two types of intrauterine devices (IUDs) available, and they were often very scarce. In addition to the lack of options in methods, options in service delivery for contraception were also limited.
Today, people have many more options available to them in both method and service delivery. These important advances should be recognized and celebrated. However, we must also acknowledge that we still have a lot of work to do to ensure that everyone, regardless of where they live, their insurance status or income level have the full range of contraception methods available to them without unnecessary barriers.
The advancements in contraceptive methods over the last two decades have been remarkable. Shortly after I began practicing, the single rod implant became available. Today, it’s one of the most popular methods among my patients who desire a long-term method for contraception. Further, along with hormonal IUDs being more available in varying formulations, there is a new year-long vaginal ring and a novel contraceptive gel which provides people with more options.
There is also significant progress in how people can access their desired method of contraception. Some medical practices teach their patients to self-administer injectable contraception and send them home with the necessary supplies to avoid the need to return to the provider’s office every three months. Access to contraception through telehealth is also more commonplace, allowing people to get their contraception delivered directly to their door without ever having to set foot in a provider’s office.
As an ob-gyn who specializes in family planning, I am grateful for the advancements in contraception and delivery options. However, there is still so much we can do to make contraception more accessible so people can achieve their reproductive desires. Presently, contraceptive pills are not available over-the-counter and require a prescription from a licensed medical provider. The prescription requirement is an unnecessary barrier that lies in contradiction to research that confirms contraceptive pills meet the safety requirements to be dispensed over-the-counter.
Contraception is basic health care that all people—including people of color, people with low incomes and people from rural areas—should be able to access without unnecessary barriers to stay healthy and achieve their reproductive desires. Contraceptive pills are the most common method of non-permanent contraception in the U.S. Every month, over 10 million people in the U.S take contraceptive pills to avoid an unplanned pregnancy and treat health concerns such as painful periods, acne, ovarian cysts and menstrual migraines. The pill’s record of safety is underscored by the low rate of complications reported over the 40 plus years that the pill has been on the market.
The data shows that people of all ages understand how to properly take oral contraception and are able to screen for the risks on their own to ensure that the pill is safe for them to take. The ability to assess a medication’s potential risks requires the same skill set people use every day to treat their allergies, cold, pain, gas, constipation and so much more with over-the-counter medications. This common medication which helps millions of people every day should not be held to a higher standard than other medications due to antiquated stigma regarding sex and the paternalistic approach to care for women and people capable of reproduction.
In response to the evidence showing the safety of oral contraception, activists, health care providers and policymakers have made some progress to expand access. Currently, 15 states permit pharmacists to prescribe contraceptive pills. Policies that allow pharmacists to prescribe contraception and provide people with a 12-month supply of oral contraception pills at one time remove unnecessary stress and worry and make accessing contraception convenient. In addition, these policies decrease costs associated with getting contraception such as the cost of a provider visit, transportation and time off from work. These policies also help to reduce gaps in coverage that can often result in an unplanned pregnancy.
While the progress for contraceptive pills has been helpful, the greatest impact on access would be to make contraceptive pills available over the counter. Free the Pill Day, May 9, was one opportunity to join a community of partners and advocates committed to ensuring all people have the ability to space out their pregnancies, plan for their futures, finish their education and more. Over 60 years in the making, it’s time to simplify access and make contraception more person-centered so that all people regardless of who they are or where they live have the power to decide if, when and under what circumstances to get pregnant and have a child.
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