Beginning on January 1, Oregon became the first state to allow women to purchase birth control pills and patches without first visiting an ob-gyn for a prescription. Women in California can now do the same as of April 8. (This new law does not have an age minimum like Oregon and Washington do, which also sell over-the-counter birth control, and it also covers birth control injections and vaginal rings.) Score.)
The catch is that these birth control options still aren’t as accessible as, say, antacids or allergy medications. Despite being advertised as over-the-counter medications, which are defined as those that can be purchased without a prescription, they are not exactly that. You still require a prescription, but one from a pharmacist rather than a doctor. Therefore, it eliminates the step of scheduling a doctor’s appointment but leaves the requirement for a medical professional evaluation in place.
Having said that, you must admit that this sounds a lot simpler than scheduling a consultation with your gynecologist and then visiting your neighbourhood pharmacy. Is this the most secure method to get BCPs, though, in terms of your sexual health? And will it actually make it simpler for more women to access? We consulted four gynecologists, all of whom serve as advisors for Bedsider.org:
Less access barriers to safe, effective contraception and to refills for contraceptives allow for better adherence to these methods, which is one of the main benefits. Due of their advanced training, pharmacists can help women get access to these contraceptives. For some women, the requirement for a pharmacist will nonetheless be a barrier; ideally, these contraceptives would be available over-the-counter with suitable self-screening for contraindications. – Eve Espey, M.D., professor and head of the family planning fellowship at the University of New Mexico’s department of obstetrics
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These are great birth control options that are safe to use and shouldn’t need a doctor’s appointment to obtain. One can determine whether or not they are safe based on their own medical history by asking a few screening questions. I believe removing the requirement for obtaining health insurance or taking time off of work to attend a doctor’s appointment is a great way to increase the accessibility of these secure contraceptive options.
Cost remaining a barrier is one of the main disadvantages I see. But aside from that, we haven’t really done anything to make these techniques more approachable. – Leah Torres, M.D., a Salt Lake City obstetrician.
The American Congress of Obstetricians and Gynecologists has supported OTC access to oral contraceptives since 2012. There are numerous advantages to this. One of the most widely used forms of birth control is the pill, and availability over-the-counter removes many obstacles to initial and continued pill use.
If a woman runs out of her birth control and is unable to quickly get a refill, this could be especially helpful. My main worry is who will pay for it because I don’t think pharmacists will be willing to spend the extra time assessing and counselling women if they don’t get paid for it. This model was initially created in Washington State, but due to insurers’ refusal to pay for the pharmacist screening and women’s reluctance to pay for it themselves, it wasn’t widely adopted. Hopefully, insurance will pay for this this time.
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One of the most widely used methods of birth control is the pill, and availability over-the-counter removes many obstacles to initial and continued use.
The fact that these procedures will only be accessible when a pharmacist is on duty and the pharmacy is open is another disadvantage. It is therefore not quite as beneficial as making the Pill truly over-the-counter, which would exclude the involvement of a pharmacist. I worry that some pharmacists will refuse to provide regular hormonal birth control because we know that some have refused to provide emergency contraception. However, I don’t think this will discourage women from getting their yearly gynecological exams. We have proof from other settings where women purchase over-the-counter medications that they continue to receive advised screening for sexually transmitted diseases and cervical cancer. – Daniel Grossman, M.D., director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco, and professor in the department of obstetrics, gynecology, and reproductive sciences.
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