Over-the-Counter Birth Control Pill?

This article has been circulating around my inbox all week.  Kelly Blanchard, an op-ed writer for the New York Times, wrote about how and why birth control pills should be available over the counter.  Then, Feministing did a “quick hit” to the article, asking readers to think about whether or not they agree with Blanchard. This discussion follows the 50th anniversary of the Pill.  Some argue that the Pill has not been as beneficial for women as it was intended to be but one cannot respond to this argument without acknowledging the factors that keep birth control pills out of women’s hands.

Currently, birth control is only available with a prescription.  According to a 2010 report by NARAL Pro-Choice America, only 27 states “ensure that health-insurance plans that cover prescription drugs provide equitable coverage for contraceptives.”  Also, Viagra is still covered by more insurance plans than viagra.  For those who do not have insurance that covers birth control, the pill can be very expensive.  At one point, I was paying 76 dollars a month for the pill.  Fortunately, my parents were supportive of my decision and had enough money that they could pay for my medication.  However, what happens for the millions of women that are uninsured or cannot afford to pay for the pill?  They are less likely to use contraception and therefore more likely to have an unwanted pregnancy.

Birth control pills “meet the FDA criteria for over-the-counter medications.”  A woman does not need a doctor to tell her how and when to take the pill.  The instructions come with the package and are easy to follow.  “There’s no chance of becoming addicted. Taking too many will make you nauseated, but won’t endanger your life, in contrast to some over-the-counter drugs, like analgesics.”  In fact, the pill has many noted health benefits.  Blanchard discusses reduced risks of ovarian and uterine cancer, but there are other benefits, such as less cramping, bloating, etc.

Other forms of birth control, such as condoms and sponges, are already available over the counter.  However, these methods have higher failure rates than the pill.  Although condoms are approximately 97-98 percent effective, this form of birth control often fails because of user failure.  This includes not putting the condom on correctly, the condom breaking during use, etc.  Like other forms of birth control, there are specific instructions that need to be followed when taking the pill.  But even with proper (user) use, the condom is still not as effective as the pill.

Making it available over-the-counter will be beneficial for many women for numerous reasons.  First, you would not need a doctor’s consent or prescription.  This eliminates the cost of a doctor’s visit and travel to/from the doctor’s office.  Although this may not seem like a big issue, many women living in rural areas may not be able to afford transportation to/from doctor’s that are knowledgeable about birth control and support a woman’s right to use birth control.  Also, this gives women back (part of) their right to bodily autonomy.  A woman should not need a doctor to tell her when and how to take birth control.  (Of course there are certain risks to taking the pill if you have other medical conditions, smoke, etc. but these are explained on the package and can be detected easily.  Many other over-the-counter drugs have similar warnings about usage and urge people to contact a doctor with any questions or concerns).   The right to plan if and when to have a family is absolutely fundamental and the right to access birth control falls under this category.  Next, if birth control were more widely available, it would help unwanted pregnancies.  As dozens of studies have proven, an increase in contraceptive use leads to a decrease in unwanted pregnancies.  This is especially important considering that 49 percent of pregnancies are unintended.  Also, teenage pregnancy is on the rise.  Increasing access to  birth control would be a great way to bring down these numbers.

Women need to be able to control their own sexual health.  Unlike condoms or sponges, the pill is not something that you need to insert or put on before sex.  This is especially important considering that many abusive partners will attempt to exert control over their partners by refusing to use condoms in hopes that the female will get pregnant.  A woman can take the pill without her partner knowing but she can’t put on a condom or use a sponge in the same way.  Earlier this year, the Guttmacher Institute put out a report discussing the issue of male reproductive control over female sexual partners.  They met with 71 women who had a history of intimate partner abuse; of these women, 54 had experienced reproductive control.  Reproductive control, in this situation, means that the male partner did things that would be considered “pregnancy-promoting behaviors”, such as “verbal threats about getting her pregnant, unprotected forced sex, and contraceptive sabotage.”  Although there would still be a risk of contraceptive sabotage, the birth control pill is easier to hide from an abusive partner than other female-controlled contraceptives, such as the NuvaRing or OrthoEvra.

However, making birth control available over-the-counter does not solve all the problems we would like it to.  Once the pill becomes available, it will still cost a substantial amount of money each month.  There are many women who will not be able to afford this pill and will either use less effective methods of contraception or no contraception at all.    Also, as with emergency contraception, there will be tons of legislation trying to restrict access.  This could include parental notification and/or consent for minors, a clause which would allow specific pharmacists to deny access to customers, and enormous fees.

Unfortunately, I don’t see birth control becoming available over-the-counter anytime soon.  For now, there are ways to make the best out of the situation.  Visit your local women’s health clinic (first make sure they offer different methods of birth control) and talk to them about your options.  You can also visit your local Planned Parenthood.   If you are a student, see if your school or university’s health insurance plans covers contraceptive.  According to the report by NARAL, approximately 1/6 of colleges and universities offer coverage for contraceptives.  Next, figure out what would work best for you (logistically and financially).  There are many different types of birth control and many different factors to consider before making a decision about which method you want to use.

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