Pro & Con Quotes: Should birth control pills be available over the counter?
Sally Rafie, Assistant Clinical Professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California at San Diego, in a June 20, 2018 article, “Opinion: California’s No-Prescription Birth Control Expands Access for Women,” available at timesofsandiego.com, stated:
“Over-the-counter access to the pill might sound revolutionary, but it is already available without a prescription in more than 100 countries. Women don’t need the oversight of healthcare providers to determine if and when they want to have children and they should have convenient access to the tools to help them make decisions about pregnancy effectively.”June 20, 2018 - Sally Rafie, PharmD
The Center for Reproductive Rights, in a Feb. 2016 report, “Over the Counter: The Next Big Step for Birth Control,” available at reproductiverights.org, stated:
“[T]he truth is that the most common form of hormonal contraception—the pill—could be even more accessible if it became available over the counter (OTC) to all women. Whether someone needs birth control after office hours, over the weekend, while on vacation, or simply does not have the time or resources for a separate appointment, an OTC pill would offer accessibility and convenience for those unable or unwilling to visit a health care provider for a prescription.
Access to contraception is grounded in international human rights and is critical to an individuals’ [sic] ability to control his or her own life and reproduction. Moreover, making the pill more accessible is an important public health goal because more than half of all pregnancies in the United States each year are unintended.”Feb. 2016 - Center for Reproductive Rights
Colleen Krajewski, MD, Obstetrician and Gynecologist, in a Jan. 11, 2016 article, “Here’s What Gynecologists Think about ‘Over-the-Counter’ Birth Control Pills,” available at womenshealthmag.com, stated:
“OTC access for oral contraceptive pills has been supported by American Congress of Obstetricians and Gynecologists since 2012. There are several benefits to this. Pills are one of the most commonly used contraceptives, and over-the-counter access removes many barriers to pill use and continuation. I have had many patients who have had interrupted pill use because of the logistics of getting to the doctor’s office for a prescription or the inability to get back to the pharmacy for a refill. Since fertility can return almost immediately after stopping the Pill, I have seen interrupted access to the pill lead to unplanned pregnancy.”Jan. 11, 2016 - Colleen Krajewski, MD
Eve Espey, MD, MPH, Professor in the Department of Obstetrics and Gynecology at the University of New Mexico, in a Jan. 11, 2016 article, “Here’s What Gynecologists Think about ‘Over-the-Counter’ Birth Control Pills,” available at womenshealthmag.com, stated:
“The major benefits [to birth control without a prescription] are fewer access barriers to safe, effective contraception and to refills for contraceptives, allowing better adherence to these methods. Pharmacists are highly trained professionals and may assist women with access to these contraceptives. However, the need for a pharmacist will still constitute a barrier for some women—ideally, these contraceptives would be over-the-counter with appropriate self-screening for contraindications.”Jan. 11, 2016 - Eve Espey, MD, MPH
Hadley Heath Manning, Policy Director at the Independent Women’s Forum, in a July 13, 2017 article, “Yes, Birth Control Pills Should Be Available Over the Counter,” available at newsday.com, stated:
“Making birth-control pills available over the counter would greatly increase convenience and access for many women, ultimately leading to fewer unintended pregnancies. There is no reason women should have to obtain a prescription for this common, safe and effective drug that has been around since the 1960s…
Because birth control is a prescription drug, and because the Affordable Care Act requires insurance companies to provide no-copay coverage for birth control, American women typically don’t buy the inexpensive pills directly from a pharmacy — as women do in most other countries. American women typically use a third-party payer, like an insurance company, to pay for their contraception. And often, employers provide health insurance…
This pipeline of payment — among women, their employers, their insurers and ultimately their pharmacies — is inefficient and costly. Women may see no-copay birth control as a benefit, but it’s one they pay for: Since the Affordable Care Act passed, average health insurance premiums have increased by 105 percent, more than doubling. Women still pay for birth control; now we simply do it through higher insurance premiums…
And ironically, the morning-after pill or ‘Plan B’ — which includes a much higher dose of the same hormones as regular birth-control pills — is available without a prescription. It makes no sense from public health standpoint that ‘Plan A’ is harder to get.”July 13, 2017 - Hadley Heath Manning
Krishna Upadhya, MD, MPH, Assistant Professor of Pediatrics at Johns Hopkins Children’s Center, in an Oct. 30, 2017 article, “This Doctor Thinks Birth Control Should Be Available Over the Counter,” available at glamour.com, stated:
“A clinic visit doesn’t need to be a requirement for women to gain access to effective contraception…
One solution that makes a lot of sense to me? Making oral contraception available to purchase over-the-counter.
It would be a smart move. Studies show that individuals can determine whether birth control pills are right for them and whether there are any health conditions that might make taking birth control pills less safe or less effective without a physician’s guidance. The instructions are simple to follow—you take one pill each day—and you cannot overdose if you take too many.”Oct. 30, 2017 - Krishna Upadhya, MD, MPH
Jeffrey A. Singer, MD, Senior Fellow at the Cato Institute, in a Sep. 8, 2017 article, “Why Aren’t Birth Control Pills Sold Over the Counter? They Should Be,” available at newsweek.com, stated:
“If birth control pills are made available over the counter prices are likely to drop. That’s because oral contraceptives will be liberated from the third-party spending trap.
As is the case with doctor, hospital, and lab bills, the presence of a third-party payer results in higher prices for prescription drugs than would otherwise be the case if a pharmacy was dealing directly with the patient, not the third-party middleman…
Reclassifying birth control pills to over the counter can save women money in the long run. It also adds convenience, choice, and privacy. Medical science supports the move. The only remaining obstacles are political.”Sep. 8, 2017 - Jeffrey A. Singer, MD
National Latina Institute for Reproductive Health, in a Nov. 20, 2012 press release, “Over-the-Counter Birth Control Will Benefit Latina Health,” available at latinainstitute.org, stated:
“The recommendation that birth control be available over-the-counter supports what we know about Latinas and contraception: over-the-counter access will greatly reduce the systemic barriers, like poverty, immigration status and language, that currently prevent Latinas from regularly accessing birth control and results in higher rates of unintended pregnancy.
Over-the-counter birth control will enable more Latinas to plan the timing and spacing of their families, particularly immigrant Latinas who are expressly barred from accessing benefits under the Affordable Care Act.
It’s time for affordable, highly effective oral contraception to be over-the-counter and available alongside condoms and cough medicine. The National Latina Institute for Reproductive Health urges wide adoption of these recommendations for Latina health.”Nov. 20, 2012 - National Latina Institute for Reproductive Health
The American College of Obstetricians and Gynecologists, in a Jan. 4, 2016 statement, “ACOG Statement on Pharmacist Prescribing Laws,” available at acog.org, stated:
“ACOG has long supported over-the-counter access to oral contraceptives. Birth control is an essential part of women’s health care, and over-the-counter status would help more women benefit from the ability to control their own reproductive health. Of course, decades of use have proven that oral contraceptives are safe for the vast majority of women, and that they are safer than many other medications that are already available over-the-counter…
[W]e know from evidence and experience that oral contraceptives are safe enough for over-the-counter access, and do not require any prescription at all. Research has shown that women are very adept at self-screening for any potential risks. And, although some women may be at elevated risk of thromboembolism associated with hormonal contraceptives, we know that pregnancy raises that risk to a larger degree, so the ability to prevent pregnancy actually protects these women.
Quite simply, the benefit of facilitating access to birth control is extensive – from helping some women prevent pregnancy reliably for the first time to improving adherence among long-term birth control users.”Jan. 4, 2016 - American College of Obstetricians and Gynecologists (ACOG)
The American Academy of Family Physicians, in a 2014 policy, “Over-the-Counter Oral Contraceptives,” available at aafp.org, stated:
“The American Academy of Family Physicians recognizes that unintended pregnancies are a major public health concern, accounting for approximately 50% of US pregnancies. Access and cost are commonly cited reasons why women have gaps in contraceptive use or do not use contraception. While oral contraceptive pills are widely considered to be safe and effective medications, they continue to require a prescription for use, further restricting access. The AAFP recognizes that though contraindications to these medications do exist, women have been shown to correctly self-identify contraindications to use when using a standardized check-list. Over 100 countries round the world currently provide oral contraceptive pills over the counter without a prescription. The AAFP supports over-the-counter access to oral contraception without a prescription.”2014 - American Academy of Family Physicians (AAFP)
Lila Rose, Founder of Live Action, in a Mar. 20, 2018 interview on Sun News, available at youtube.com in the video, “Contraception Convenience Comes at a Cost,” as posted by Canoe, stated:
“Even the World Health Organization has called birth control, hormonal birth control a Group 1 carcinogen because of all of the health risks, including cancer and heart disease and the other physical risks of hormonal birth control. So, we’re pumping our little girls with hormonal birth control and now they’re making it available over the counter it’s even more accessible to these young girls. What these young girls need and what they deserve and what our young men need and they deserve is real formative teaching about sexual ethics, sexual restraint and respect, so that they can avoid STDs and heartbreak and physical problems and that they can really achieve their full potential. That’s what our young people need. Not dangerous and powerful hormonal drugs.”Mar. 20, 2018 - Lila Rose
Kent Sepkowitz, MD. Infectious Disease Specialist at Memorial Ketterling Sloan Cancer Center, in a Nov. 24, 2012 article, “How Over-the-Counter Birth Control Could Screw You,” available at thedailybeast.com, stated:
“One person is missing in this: you, the lowly patient, aka, consumer. Leaving aside the safety argument that perhaps the OTC pill invites less safety since doctors no longer are winnowing out people who might drop dead if they take it, here is the impact: Yes, your life is easier because you will be able to get the pill right this second, without calling my office. No, you don’t need to fill out forms and show insurance cards and wrangle over copay. But guess who is paying for the whole shabang? You. Yes, you…
So in the name of consumer independence, Big Pharma and Big Drug Store and Big Insurance have found a way to finally make Uncle Sam smile. Make you pay. You want $200 worth of the pill? Go for it—just pay up first. Looked at this way, reclassification would seem to threaten to push pill use down, not up, since women, many of them young 99 percent-ers, may opt to simply save a few bucks and hope for the best.”Nov. 24, 2012 - Kent Sepkowitz, MD
Angela DeRosa, DO, MBA, osteopathic doctor, in a July 7, 2015 article, “Over the Counter May Not Be the Best Choice for the Pill,” available at azcentral.com, stated:
“While expanding access to OCP [oral contraceptive pills] to help prevent unplanned pregnancies is a good idea, as a physician, there are many reasons I believe that making The Pill available over the counter is a bad idea.
First, as an over-the-counter purchase, it effectively throws the entire burden of cost back onto the shoulders of women.
Second, far too many women only see the doctor when they need their prescription refilled. Many younger, seemingly healthy women would skip this step. Doctors would lose the opportunity to monitor their patient, and potentially identify serious short- and long-term health risks.
Third, when choosing a birth-control method, it’s important to understand HOW it works in your body. Oral contraceptives shut down the ovaries to prevent ovulation. No egg to meet up with sperm, no issue.
Here’s the problem. Ovaries are not just about eggs. Their primary function is to manufacture hormones the body needs.
Most OCPs are a combination of synthetic estrogen and progesterone to replace what the ovaries would normally produce.
What they don’t replace is testosterone, which is 40 percent of a woman’s hormonal makeup and ovaries manufacture most of it.”July 7, 2015 - Angela DeRosa, DO, MBA
Arina O. Grossu, MA, Director of the Center for Human Dignity at the Family Research Council, and Patricia Livengood, intern at the Diocese of Allentown Office of Marriage & Family Life Foundation, in a Nov. 10, 2016 article, “Hormonal Birth Control Is Too Dangerous to Dispense without a Prescription,” available at thefederalist.com, stated:
“Women deserve to know the real health risks of hormonal birth control from their doctor in order to make an informed decision, not from a size-eight font warning label in the supermarket aisle…
First, scientists are discovering health risks that suggest dangers to women’s health and safety. Second, there is the real concern that over-the-counter contraceptives will increase unplanned pregnancies and abortion. Third, making hormonal birth control available over the counter without the oversight and care of her doctor endangers a woman and deprives her of proper informed consent.”Nov. 10, 2016 - Arina O. Grossu, MA
Robin Pierucci, MD, MA, neonatologist, in a June 15, 2017 article, “Is Over-the-Counter Contraception for Teens a Good Idea?,” available at thefederalist.com, stated:
“Given the side effects we know about, plus what we are in the process of learning, pediatricians should be questioning whether to recommend hormonal contraception [to teens] at all. Thus, increasing access while removing physician involvement is a step backwards for adolescent safety…
Bottom line: adolescent physiology is unique. Studies have not demonstrated that, in this specific population, hormonal contraceptives are safe for developing brains and bodies. I fear that physicians who genuinely want to provide what is best for their patients have acquiesced to cultural mores and overlooked our gaps in knowledge regarding the full spectrum of hormonal contraception’s complications in young women.
Making hormonal contraceptives available over the counter not only removes physicians from good medical decision-making for the teenager, it removes them from an important conversation about so many of the choices teens are making—choices that might be informed more by peers or perceived norms than by long-term consequences or a concerned adult.”June 15, 2017 - Robin Pierucci, MD, MA
Jennifer Ashton, MD, MS, obstetrician and gynecologist and Chief Women’s Health Correspondent for ABC News, as quoted in a 2017 press release, “Debate to Consider if America’s Ready for OTC Birth Control,” available at annualmeeting.acog.org, stated:
“If you remove completely the patient-doctor encounter that most women and young girls have to go through in order to be put on the pill, you’re removing a major opportunity for preventative health and wellness and STD screening and a whole host of things that women aren’t getting enough of.
It’s generally accepted knowledge that the overall health literacy of the lay population is about at the 7th-grade level, so with one-on-one counseling and me explaining how the pill works, I have some patients come back and say, ‘Well, but when I get my period on the pill…’ They don’t even understand that you don’t get a period on the pill.”2017 - Jennifer Ashton, MD, MS
Cortney Mospan, PharmD, Assistant Professor of Pharmacy at Wingate University School of Pharmacy, in an Aug. 8, 2016 article, “Should Birth Control Be OTC?,” available at contemporaryobgyn.net, stated:
“I also am not in support of OTC birth control because I believe this will likely cause another barrier in access: lack of insurance coverage. Prescription insurance does not require coverage of OTC medications, and in my experience, maybe 5% of the time are these covered by insurance companies. So the work that was done by the ACA to increase access through a lack of copays would be negated.”Aug. 8, 2016 - Cortney Mospan, PharmD
Poppy Daniels, MD, obstetrician-gynecologist, in a June 15, 2015 article, “An Over-the Counter Pill Isn’t Safe,” written by Sarah Watts, available at thedailybeast.com, stated:
“Hormonal birth control is not without risk… My concern is that you’re basically taking women who have no counseling, no family history, no risk assessment, and they’re just getting [hormonal birth control] with no guidance. Why would you take that risk?
… To put [hormonal contraception] on the same aisle as Tylenol and Zantac is absurd.
People think I have some nefarious, right-wing agenda. And that’s just not true. I’m medically responsible for the patients I see, and they deserve to know the potential risks and benefits of each medication.
We’re not talking about pregnancy. We’re talking about whether it is safe for non-pregnant women to buy birth control over the counter. And I don’t think it is.”June 15, 2015 - Poppy Daniels, MD
Olivia Alperstein, Communications and Policy Associate at Congressional Progressive Caucus Center, in a July 16, 2017 article, “From the Left: Birth Control Should Be Free, Not Over the Counter,” available at insidesources.com, stated:
“The concept of over-the-counter birth control ignores the grim reality that not all people can just go to a pharmacy and easily purchase birth control. Some face religious and social backlash for buying pills in full view of their pharmacist and people from their community. Some can’t afford to purchase the pill — if you’re counting pennies and choosing between food and birth control, food wins. Some are young and under a certain state’s law can’t purchase birth control without a parent’s consent. Some are transgender or gender-nonconforming. Some have medical conditions or allergies that place them at risk of serious side effects if the birth control they use isn’t carefully selected and the dosage modified to fit their bodies. The list goes on.
The reality is that most, if not all, people who need or use birth control have to find a specific combination of hormones that works for their body. It may shock some of the male politicians who are governing our right to access birth control, but millions of women don’t all just take one type of pill and have one giant mutual menstrual cycle. Each person’s hormones and menses are different, and getting the hormone combination in our birth control just right is just as important as being able to access birth control in the first place.”July 16, 2017 - Olivia Alperstein
Sarah Trumble, JD, MPP, former Deputy Director of Social Policy and Politics at Third Way, in an Oct. 8, 2014 article, “Republican Proposals for Over-the-Counter Birth Control,” available at thirdway.org, stated:
“Making birth control available without a prescription and at cost won’t make it easier for women to afford contraception. One in three women report having struggled to afford it before the ACA… [P]roposals to allow contraception to be sold over the counter—if we repeal its current coverage as a preventive service without co-pay—would effectively discourage using the very types of contraception that work the best… Limiting birth control to only be available over the counter will cost women more money, reduce their options, and make it harder to access the most effective methods that reduce the need for abortion in this country.”Oct. 8, 2014 - Sarah Trumble, JD, MPP