Accessible contraception, particularly over-the-counter (OTC) medication, has been especially controversial since the Supreme Court’s overturning of Roe v. Wade. Opponents of OTC access have viable concerns about women’s health, namely the danger of high-risk groups using OTC pills. However, those in favor of OTC access argue that women should have the resources available to them to choose whether or not they want a pregnancy. Although people worry that making oral contraception an over-the-counter drug is unsafe due to the possibilities of unclarified health risks, it is clear that OTC oral contraception is a necessity based on the lack of reproductive healthcare for women in the U.S., the steady rate of unintended pregnancies, and the health benefits gained from taking the pill.
Opponents of over-the-counter oral contraception often voice concern about how removing the barriers to birth control access may lead to a more relaxed mindset among patients who rely on the medication. Oral contraception is less effective if used incorrectly, as explained by public health experts. According to a paper in the National Library of Medicine, “the oral contraceptive pill is the most widely used method of contraception and, when adhered to perfectly, is ninety-nine percent effective at preventing pregnancy. However, adherence to the pill-taking procedure is relatively low.” The majority of women who have taken birth control pills have missed a dose or otherwise used the contraceptive incorrectly. Those in support of maintaining restrictions on access to such contraceptives worry that if taking the pill no longer requires certain guidance, like a prescription, the majority of people will not completely understand the necessary guidelines, and the rate of unintended pregnancies might therefore increase. Experts also worry that non-prescription access to contraceptives without medical guidance is dangerous for high-risk groups, especially those who are not aware of their high-risk status. An article from the National Library of Medicine states that “evidence has started to accumulate to suggest that neither the patient nor the pill is at fault in some contraceptive failures. It may be because the patient is taking other medicines, and these may be preventing the pill from suppressing ovulation.” Opponents of the newly FDA-approved OTC oral contraception, Opill, cite that the drug has been proven to be dangerous for high-risk patients. Doctors wonder if patients can be trusted to understand the risk factors and complicated instructions of the pill on their own. Pam Belluck elaborates on this in a New York Times article published in 2023: “FDA scientists who analyzed data […] raised concerns about whether women with medical conditions that should preclude them from taking the pill—primarily breast cancer and undiagnosed vaginal bleeding—would follow the warnings and avoid the product.” They raise an important question of whether the benefits of having OTC birth control pills outweigh the risks of anyone being able to buy the drug without medical supervision.
Even aside from the risks associated with these medical conditions, many women may not know or consider whether the medications they take could have their own problematic interactions with oral contraceptives. The concern is that by implementing easier access to birth control, women will not be as careful about finding medicine that is compatible with their physical health as they would have been with the help of a medical professional, and women’s health may worsen as a result.
It is undeniable that there is a serious lack of reproductive healthcare and autonomy for women in the U.S. Abortions were justified by right in the United States in the Supreme Court case Roe v. Wade in 1973. In June 2022, the decision was overturned, to the dismay of countless Americans. This was a huge step in the wrong direction; a loss of reproductive autonomy. Without resources to lead safe sexual lives or the rights to have an abortion, women are in undeniable jeopardy of adequate healthcare. Accessible contraception is a serious necessity for the more than 19 million reproductive-age women who live in “contraceptive deserts.”
When medication is accessible over-the-counter, it means that a prescription is not required. This means that one could purchase OTC medication at a grocery store in the same way that they are able to purchase a granola bar; money is exchanged without a prescription. An example of an OTC drug is Tylenol. A Washington Post article summarizes claims of numerous public health experts in favor of OTC care with statements including, “Some of the biggest beneficiaries of OTC contraceptives would be people of color and members of other underserved communities who face a constellation of barriers in getting access to prescription birth control pills.” The healthcare system in the U.S. consistently fails to provide marginalized communities, especially people of color, with comprehensive medical attention in the same way others are prioritized. Restricting access to certain aspects of healthcare is only furthering the injustice all too often inflicted upon minoritized groups. Women of color statistically have much less access to birth control. Because of systemic issues that are much more prominent in these communities, namely misinformation about the pill (most commonly fear-mongering myths like oral contraception causing excessive weight gain and even cancer) and coercion (defined in this scenario as forceful and often violent persuasion to have unprotected sex), women of color are consistently pushed away from the ability to access the care they need. Enabling women to choose their healthcare without the intrusion of an unjust industry means that women of color would have better access to contraceptive care rather than being forced to live within barriers of sexual stigma. Over-the-counter oral contraception is a step further towards reproductive justice for women of color and an opportunity for these women to access the necessary reproductive healthcare that they are all too often not given. General health for the female population in the U.S. has steadily declined due to systemic misogyny within the healthcare system. Medication traditionally concerning women has always been of the lowest priority in the medical field. According to a report from the World Economic Forum and the McKinsey Health Institute: “Women spend twenty-five percent more of their lives in debilitating health than men.” Low preference for women’s health in the U.S. is what fuels the eerily consistent health problems within the country’s female population. Those concerned about women’s health should be less interested in implementing barriers to access birth control, which would only cause women’s health to decrease even further, and should instead demand accessible oral contraception that is not as harmful for high-risk groups. Reproductive health and rights for women is a vulnerable point of attack in the United States. It is crucial to demand OTC oral contraception in order to sustain what little reproductive autonomy women in the U.S. have left.
Without accessible contraceptives, the rate of unintended pregnancies in the United States is bound to skyrocket. Women who become accidentally pregnant often attribute it to an inability to access effective birth control. Tanne, a writer for the British Medical Journal, states: “Women who were dissatisfied with their healthcare providers or considered that it was difficult to ask their provider questions were more likely to be inconsistent in using contraceptives.” For many, the healthcare system can feel daunting and is more often than not an inconvenience to access, whether that be because of one’s work schedule, financial situation, or other factors. Giving women the option to access birth control without a professional opinion would change the precedent for unintended pregnancies appreciably. For example, stocking local grocery stores or markets with OTC oral contraceptives, which carry far less potential harm than other OTC drugs like Tylenol, would save countless individuals an unnecessary and time-consuming doctor’s appointment while providing an entire population with the tools they need to have safer sexual lives.
A large proportion of unintended pregnancies is attributed to teen pregnancies. According to the World Health Organization, adolescents aged fifteen to nineteen years old in low and middle-income countries have an estimated 21 million pregnancies every year, of which around half are unintended. Even in sexual health curricula in schools across the U.S., contraceptives like “the pill” are seriously stigmatized. When something becomes so closed off, people no longer feel as comfortable asking for it. If birth control is only accessible via prescription, teenagers will certainly not feel as comfortable as they should asking for their rightful reproductive healthcare, frequently resulting in the unsafe sex that occurs all too often in high school and consequential unintended pregnancies. The fact that certain oral contraceptives like Opill no longer require a prescription to access is a step towards providing young generations with the comprehensive knowledge needed to engage in sexual activities safely while maintaining their health and academic path.
Additionally, numerous studies show that birth control pills are much more effective than other contraceptives. According to the Centers for Disease Control and Prevention: “Prevalence of any condom use at last sexual intercourse was 54.3%, and condoms were the most prevalent primary contraceptive method (43.9% versus 23.3% for birth control pills […]).” There is a belief that couples should use “easier options” like condoms when participating in intercourse because it is less complicated, which explains the notably lower number of birth control pill use in the study. Yet, the main factor that has complicated oral contraceptive use is access to it only by regular prescriptions. Birth control pills are ninety-nine percent effective when used correctly. By making oral contraceptives accessible over-the-counter, the more effective option can also be the easiest option. By increasing barriers to getting effective contraceptive care, entire generations of women will be denied the ability to accurately plan their pregnancies or even choose to have them. With increasingly widespread access to oral contraceptives, women will gain more reproductive autonomy, decreasing the rate of accidental pregnancies.
Throughout the history of oral contraceptive use, women have reported innumerable health benefits attributed to taking such medication. Countless individuals take birth control for many purposes aside from preventing pregnancy. doctor of medicine, Nivin Todd, clarified that there are “other benefits, too, including making your period less painful and more regular, clearing up your skin, and lowering your risk of some cancers.” By denying OTC access to birth control, U.S. law is not only denying women the ability to lead safe sex lives but is also discontinuing the treatment of numerous health problems for individuals in the U.S. The inability to access medication without a prescription, which is already taxing for many in regard to the cost of medical care and time taken from work or school, puts those who rely on the drug to treat certain health problems at a serious disadvantage. They would have to find alternative treatments at the risk of such solutions not being as or at all effective.
In addition to physical health, mental health among women in the United States is considerably worse than that of men. A study from the American Psychological Association “cited previous research that found women suffer more than men from depression.” It is important to consider not only the impact of birth control on one’s physical health but also the vast improvements it can provide for one’s mental well-being. Providing women with unrestricted healthcare would mean that women are closer to being treated equally within the healthcare system. Supporting widespread access to reproductive healthcare could shift the mental health of the country’s female population significantly. Taking oral contraceptives actually lowers the risk of developing many cancers. Research from the MD Anderson Cancer Center backs this claim: “Taking the pill may help cut your risk of ovarian cancer and endometrial (uterine) cancer […]The longer you take the pill, the greater the benefits. In fact, taking the pill for five years or longer may cut your ovarian cancer risk in half. That protection may last up to 25 years after you stop taking the pill, according to the National Cancer Institute. Studies even suggest the pill may protect against ovarian cancer in women with [breast cancer-inducing] genetic mutations.” The rate of these cancers is unignorable for women in the U.S. According to the American Cancer Society, almost twenty thousand women will be diagnosed with ovarian cancer in 2024. Increasing access to a drug that actively works against the development of these diseases will inevitably lead to positive health trends for the country’s female population, a change many are rightfully desperate to see. Safeguarding over-the-counter oral contraceptives not only hinders women’s reproductive freedom but also endangers the health of a significant portion of the U.S. population. Convenience of birth control access is a readily debated topic. However, there is no question of its necessity considering the void of reproductive healthcare and rights for women in the United States, the unwavering rate of unplanned pregnancies across all age groups, and the health advantages of taking such medication. Women everywhere rely on effective care to live safe and healthy reproductive lives and have suffered exponentially without access to it. Offering oral contraception over-the-counter is just the start of unifying the U.S. healthcare system for all.