Why isn't birth control available over the counter? Turns out, it already should be
America seems to have a massive problem with women making decisions about their reproductive and sexual health, which is why there are constant battles with insurance companies about covering the costs of birth control. It’s infuriating when you think about it (well, you don’t have to think that hard to get angry about this), because really, birth control should already be available over the counter so that women have access to it whenever they want.
According to most medical research, there is no reason for hormonal birth control to not be accessible without a prescription, as it is in 102 other countries. The big difference? Culturally, America still doesn’t want young women having sex for pleasure and controlling their own reproductive health.
According to the Centers for Disease Control and Prevention, the pill is the most popular form of birth control among women, especially teenagers, with 54 percent of them using it between the ages of 15 to 19, which is also when women are at highest risk for an unintended pregnancy. We stigmatize teen pregnancy, although the rates are at historic lows, according to the CDC. “Although reasons for the declines are not totally clear, evidence suggests these declines are due to more teens abstaining from sexual activity, and more teens who are sexually active using birth control than in previous years,” the CDC explains.
But still, the American teen pregnancy rate is “substantially higher” than in other “western industrialized nations,” and there are huge disparities in teen pregnancy rates depending on where you live in the country and your ethnic background. Black and Hispanic teen birth rates are twice as high as those of white teenagers.
We make birth control so complicated, even though we know it’s safe. Even teens know how to use it properly.
A recent study from John Hopkins Medicine found that teens can adhere to taking the pill and that it’s safe for them to take without medical supervision. And there generally aren’t any medical complications with progestin-only pills (as opposed to the combination estrogen and progesterone pills) for pretty much all women, despite their age. Since taking the pill is a daily practice and not a decision made in the heat of the moment, like using a condom, lead researcher Krishna Upadhya, M.D., M.P.H. thinks that young people would be more likely to use them. “Our review strongly suggests that giving teens easier access to various contraceptives will not lead to more sex but would result in fewer unwanted pregnancies,” she said in a statement accompanying the paper.
The Food and Drug Administration makes drugs available over the counter only when they’re safe “for self-administration, effective when self-administered, treat a condition or address a concern that is self-diagnosable, and can carry labels that are easily understood and tailored for self-administration.” Birth control pills meet all of those requirements, which is why the American College of Obstetricians and Gynecologists (ACOG) recommended that it be available over the counter back in 2012. While there are always risks with any medication, progestin-only birth control pills are so safe. Safer even than, say, Tylenol, which you can actually overdose on or can give you stomach problems.
The culture of requiring a woman to have health insurance and then go see a doctor for birth control is based in fear mongering. Having birth control chosen for and prescribed to us isn’t always effective in terms of finding the pill that works best for our bodies. Women should be trusted to read up on the different kinds available and choose one that works for them, just like we do with cold medicine.
Other legislators clutch their pearls about making birth control readily available since they think it will lead to more teen sex and STDs, which, like, huh? People are going to have sex whether they have the protection they need or not, and teaching kids to use condoms and birth control along with other safe sex practices is something we should already be doing.
Making birth control available over the counter is a no brainer, but it sends a strong message to people that sex can be just for pleasure, that women’s bodies aren’t just for making babies, and that women are capable of making the decision about how they take care of their bodies.
Birth control empowers women, which is the only reason lawmakers won’t let us have it when we want it and at a price we can afford.
It takes a long time to get the FDA to approve a drug for over-the-counter use, which is another reason we haven’t seen any birth control on the shelves. Luckily, French pharmaceutical company HRA Pharma and the nonprofit Ibis Reproductive Health have partnered to walk a progestin-only pill through the long, bureaucratic process. We don’t know how long it will take to get approved for over-the-counter use and when it would be allowed on shelves. Given the issues still being debated with selling emergency contraception in drugstores, this will likely be a long, arduous battle.
With the current administration chipping away at the Affordable Care Act and making it so that employers, universities, and insurance companies can deny a woman birth control, we might be very far away from a time when you can just pop into a store and buy birth control over the counter without a doctor or pharmacist being involved. Just remember, the only reason you can’t already is because someone doesn’t like the idea of you making decisions about your body.
This story was originally published on February 19th, 2018.