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Create a new document and edit with others at the same time -- from your computer, phone or tablet. Get stuff done with or without an internet connection. Use Docs to edit Word files. Free from Google.

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- Long term health benifits
- increase access
- No insurance
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- 99% or nothing? BC is better than nothing
- Low income so no medical insurance(in the end it's less)
- Lower teen pregnancy
- YOU SHOULD USE 2 KINDS of BC
- "easier" to get bc
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- It's not hard to use bc
- The pharmacist counter is considered BEHIND the counter
- Talking about people with no insurance. Average does have it
- BC is not luxury
- Teens dont care about safe sex
- Long term = lower risk of health issues
- insurance can only pay for so much, ehh not really
- OTC would create continuase use

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Even though the pill is 99 percent effective it’s more effective than nothing
Not everyone has insurance
It’s not hard to add things to our school system
You can buy at the pharmacist counter
These people can’t go to the doctor
Studies show that teens would not have sex more they would just feel safer doing it

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Ever since the first FDA-approved contraception was introduced in 1960, women in need of hormonal birth control have always needed a physician's prescription to obtain it.

In 2015, all that is about to change.

Last week, Senate Democrats introduced a bill that would allow pharmacists to prescribe birth control to patients without a physician's oversight. In the past year, several similar bills have been introduced into the state legislatures in California and Oregon, both gaining significant bipartisan support.

Republican Representative Knute Buehler, who introduced a birth control bill into the Oregon House of Representatives in April, expressed his frustration that emergency contraception was available over the counter, while preventative contraception was not. Making birth control available over the counter, he said in one statement, would improve contraceptive access and reduce unintended pregnancies by 25 percent.

Special interest groups like the American College of Obstetricians and Gynecologists (ACOG) agree: In 2012, ACOG issued a statement that supported OTC birth control, saying that since the absolute risk for serious side effects was so low, it should be made widely available to the general population. Overwhelmingly, OTC birth control seems like a great idea.

But not every medical professional thinks so.

Dr. Poppy Daniels is an OBGYN and hormone specialist with over ten years of clinical experience. Daniels specializes in treating blood clotting disorders at her clinic in St. Louis, MO., and sees a substantial amount of patients who have developed blood clots thanks to their hormonal birth control. Most patients, she says, want to transition to another contraceptive method and have come to her for help.

"I rarely see the happy pill patients," she says.

In Daniel's experience, many of her patients suffer from undiagnosed clotting disorders that only became apparent after taking hormonal birth control. According to Daniels, blood-clotting disorders are extremely common, and are typically related to a gene mutation that affects an estimated forty percent of the population. For this reason, Daniels will only prescribe hormonal contraception-including the pill, the patch, or the NuvaRing-after she has carefully evaluated the risks for each patient, including a rundown of the patient's family history for blood clots, strokes, and heart attacks.

"Hormonal birth control is not without risk," Daniels says, who adds that she thinks over-the-counter birth control, available without a physician's oversight, is "ridiculous."

"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," she says. "Why would you take that risk?"

The absolute risk for serious side effects among large populations, Daniels says, is low-she and ACOG agree on that point. But only talking about the absolute risk "makes it seem like [complications] rarely happen," she says, which couldn't be further from the truth. When complications arise, says Daniels, they can be catastrophic, necessitating hospital stays or months of anticoagulants. "To put [hormonal contraception] on the same aisle as Tylenol and Zantac is absurd."

Proponents of over-the-counter birth control have said that putting prescriptions over the counter could improve contraceptive access as well as drive down costs, which Daniels thinks is important. But with so much emphasis on access and convenience, Daniels feels that women are losing something more important in the process. "We're losing the doctor-patient relationship," she says. "We're losing the opportunity for risk-factor assessment. We also lose the ability to know if a woman is having side effects from the birth control."

ACOG and others have suggested that pharmacists can screen patients for side effects, but Daniels considers that wishful thinking. "Pharmacists don't have the time to do the level of counseling that I think is needed and warranted. They're busy. The people picking up [the prescription] are busy. It's just not realistic."

Daniels, for the record, is not against hormonal birth control. "People think I have some nefarious, right-wing agenda," she says, "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."

Holly Grigg-Spall is no medical professional, but her experience with hormonal birth control, in some ways, rivals Daniels'. At seventeen, Grigg-Spall started taking hormonal contraception and spent the next several years battling severe side effects.

"I took four or five different brands [of birth control] over the next ten years," Grigg-Spall says, which led to "profound" side effects ranging from adrenal fatigue to extreme paranoia. "It started off like PMS at first, and then it got progressively worse," she says.

It wasn't until Grigg-Spall joined an online forum for other birth control users that she discovered she wasn't alone. Many women were going through what Grigg-Spall was experiencing, and others much worse: "I heard from people who had lost relationships, lost their jobs, had nervous breakdowns," she says. "Those cases are rare, but probably not as rare as we think."

Speaking to hundreds of women about their experiences inspired Grigg-Spall to not only ditch the pill for herself, but to write a book about her personal experience, offering what she calls a "feminist critique" of the birth control pill. Currently, Grigg-Spall has teamed up with Ricki Lake to produce a documentary based on the book.

Grigg-Spall is quick to point out that taking hormonal birth control can lead to a battery of physical and psychological problems. But medical groups like ACOG point out that taking hormonal birth control is less risky than having an unintended pregnancy or giving birth. Grigg-Spall sees this as a false dilemma.

"[ACOG] creates this dichotomy where women only have a choice between hormonal contraceptives or pregnancy," she says, and "that's misleading." Daniels agrees: "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."

Grigg-Spall isn't as opposed as Daniels when it comes to over-the-counter birth control. Pharmacists could provide a reasonable amount of counseling and risk assessment to women who get their birth control from the pharmacy, she thinks. But in order to make over-the-counter birth control safe, a lot needs to change.

"In a perfect world, women would be screened for blood-clotting disorders. They would know their medical history. We'd have full access and affordability," Grigg-Spall says. "But instead you have over the counter birth control in a context that's very different than that. And that's a problem."

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Ever since the first FDA-approved contraception was introduced in 1960, women in need of hormonal birth control have always needed a physician's prescription to obtain it. In 2015, all that is about to change. Last week, Senate Democrats introduced a bill that would allow pharmacists to prescribe birth control to patients without a physician's oversight.

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The cost of birth control would increase quite a bit.

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Birth Control Pills | The Pill | Contraceptive Pills

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Birth control pills are a medicine with hormones that you take every day to prevent pregnancy. The pill is safe, affordable & effective when used correctly

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When you're on the pill*, bleeding typically happens at the end of each pack. These are the days you take no pills or take the pills in your pack with no (or few) hormones-also known as placebo pills. This bleeding will probably be different than your period would be if you weren't taking the pill-and you may have times when you bleed very little or not at all.

Top things to know:

Your "period" on the pill is actually called withdrawal bleeding, and happens when the levels of hormones in your pills drop

Withdrawal bleeding may be lighter or slightly different than the period you had before taking the pill

Some people experience only spotting or don't bleed at all during placebo pill days

Your bleeding on the pill is likely to change over time

Do I get a "real" period on the pill?

Nope. The bleeding you get when you're on the pill is not the same as a menstrual period.

When you're taking the pill, your period is technically called withdrawal bleeding, referring to the withdrawal of hormones in your pill. The drop in hormones levels causes the lining of your uterus (the endometrium) to shed (1). This bleeding may be slightly different than the period you had before taking the pill. It also may change over time while taking the pill.

What exactly is happening to my body? Am I ovulating on the pill?*

No. If you take your pill consistently and correctly, you shouldn't ovulate. This is the primary way the pill prevents pregnancy. In a usual (no-pill) cycle, the body's natural reproductive hormones fluctuate up and down, taking your body through a process of preparing an egg for release, releasing that egg, and preparing your uterus to accept a potentially fertilized egg.

The hormones in the pill stop and prevent your ovaries from preparing and releasing eggs. They stop the usual hormonal "cycling", including ovulation, the typical growth of the endometrium, and the natural period.

[ Learn more about how contraception affects your hormones.]

Why is my bleeding different on the pill?

The pill prevents your endometrium from growing thicker, as it would in a typical menstrual cycle (2, 3). It also prevents ovulation, and the typical cycling of reproductive hormones. When you have withdrawal bleeding, the bleeding tends to be lighter than normal menstrual bleeding.

It's also possible to have no withdrawal bleeding or only spotting during the days you take inactive pills (or no pills). This is more common for people taking higher doses of estrogen, or a pill with a shorter (or no) hormone-free interval (most pill packs have seven placebo pills but check your pack's box and infosheet if you're not sure.) (4, 5).

What's "normal" bleeding while on the pill?

Your body's response to your pill will depend on the type of pill you take, and your own body's hormones. On a typical 21/7 monophasic pill (where all active pills have the same amount of hormones - check your pack), bleeding may start on day 2 or 3 of your placebo week and last 3-5 days on average. A few people may have only one day of bleeding mid-week, and others may have bleeding that extends into their next pill pack. Up to 1 in 10 have no withdrawal bleeding at all (not including spotting) (5).

Bleeding on the pill is also likely to change over time. In people using the 24/4 day pill (24 active hormone pills & 4 placebo pills), about 1-2 in 10 had no significant withdrawal bleeding by the 6th pill pack (4). Bleeding also tended to decrease over time.

No bleeding can also signal a pregnancy. Take a pregnancy test if you're unsure, especially if you haven't taken your pills correctly in the previous pack.

Unexpected spotting and bleeding on the pill

Bleeding and spotting can happen outside of your usual period time. This is called breakthrough bleeding. It doesn't mean your pill isn't working, but it can be frustrating to deal with (2).*

Up to 1 in 5 people experience breakthrough bleeding when first taking the pill (6). It is not usually a cause for concern and will often stop after a few weeks or months (7).

Others will need to try a different pill brand, with different levels of hormones. Many experts recommend choosing a pill with the lowest dose of estrogen ( ethinylestradiol/EE), and only changing to a higher dose if breakthrough bleeding is a persistent problem (7).

Spotting can also be caused by missing pills, as the drop in hormone levels can cause a small amount of withdrawal bleeding.

[ Here's everything you need to know about spotting.]

What's normal

Unexpected spotting for the first few months while taking a new pill (talk to your healthcare provider if it's still happening after 3 months)

Withdrawal bleeding that is lighter, or shorter than your period before the pill

Withdrawal bleeding that changes slightly over time while on the pill

Having little or no bleeding during your placebo week after taking your pills correctly

*This article refers to the use of combined hormonal contraceptive pills, which contain both estrogen and progestin (the most common type). Bleeding patterns will be different for people taking the progestin-only minipill. Download Clue to track when you've taken your pill.

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When you're on the pill*, bleeding typically happens at the end of each pack. These are the days you take no pills or take the pills in your pack with no (or few) hormones-also known as placebo pills.

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Birth control works by releasing hormones into a women's body. These hormones stop ovulation(when an egg is released). Because there is no egg, a pregnancy cannot happen. The pills hormones also thicken the mucus on the cervix. This thick mucus guard blocks sperm to swimming to an egg.

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Birth control is a kind of medicine that contains hormones. The hormones can differ depending on which kind you take. You take one pill everyday at the same time. Because of the way birth control works, you never actually get a real period when taking it, you actually get withdraw bleeding. Withdraw bleeding occurs when the levels of your hormones drop. This only simulates a women's "real" period and is generally a lot lighter and has less cramping or other symptoms than "real" periods.

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People may rely on birth control too much

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People may rely on birth control too much

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Birth control isn't 100% effective, even when taking at the same time everyday. Although it is up to 99.9% effective, it still will not protect people from STDs.

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When we talk about birth control, we need to remember that cis straight women aren't the only stakeholders.

I 've been on and off different types of birth control for the past 15 years. Last year, I got Mirena, an IUD that's 99 percent effective in preventing pregnancy and lasts up to 6 years.

While dating cisgender straight men in the past, I used birth control to prevent pregnancy. And although I can't get pregnant by my current sexual partner, my IUD is still a lifesaver because my periods have become lighter, shorter and less painful.
Queer and trans people of color, like myself, however, are almost never reflected in the visible fight for birth control rights. The poster child of the mainstream reproductive rights movement is usually a middle-class, cis, heterosexual white woman - everything that I'm not.
In the resistance against Pres. Donald Trump's war on reproductive rights, stories like mine aren't centered due to myths that LGBTQ+ folks don't use birth control, get abortions, or have kids. In reality, we do all of these things, and we desperately need better access to them.

Queer and trans people of color, like myself, however, are almost never reflected in the visible fight for birth control rights.

Trans, gender nonbinary,and queer folks experience barriers to culturally-competent reproductive healthcare because most doctors don't understand our bodies or our sex lives. Legislative attacks on birth control make it even harder for us to get the good care we deserve.
When we talk about birth control, we need to remember that cis straight women aren't the only stakeholders. As a pansexual nonbinary woman, birth control changed my life for the better, yet narratives like mine are missing from the media.
One of Trump's most recent attacks on reproductive healthcare happened on Oct. 6, when the Department of Health and Human Services issued new rules that allow employers to opt out of covering birth control on their health insurance plans based on moral or religious reasons.

This is a part of Trump's plan to dismantle Obamacare, which made contraception a preventative service and required employers to pay for it. These new rules open the door for future laws that allow discrimination against LGBTQ+ people based on sexual orientation and gender identity.

The erasure of LGBTQ+ folks from conversations about birth control is harmful, for a number of reasons. Here's why trans and queer voices must be centered in the fight for just access to birth control:

1. We need birth control for the same reasons as straight folks: to prevent pregnancy and to treat medical conditions.

This may be a surprise to some, but trans and queer people have the ability to procreate and to engage in sex that results in pregnancy. It's frustrating that birth control is only marketed to cis straight women when LGBTQ+ folks need it just as much.

Evana Enabulele, a Black queer parks and recreation worker living in Seattle, uses a birth control implant called Nexplanon for both pregnancy prevention and Polycystic Ovary Syndrome (PCOS), which causes irregular periods that are abnormally heavy and long.

She enjoys telling others about her birth control implant because many people think their only option is taking pills. It takes as little as 10 minutes to insert the tiny rod into the upper arm and is more than 99 percent effective in preventing pregnancy.

Being on birth control makes Enabulele's life more stress-free, not only because she can't get pregnant, but also because she now gets a regular period. When her PCOS was untreated, she worried about not ever being able to conceive because her periods were so irregular.

Enabulele feels personally attacked by the Trump administration's new rules allowing employers to deny covering birth control.

ChiChi Madu is a Black queer LA resident working in the startup industry who got an IUD for free at Planned Parenthood 6 years ago when she was low-income. She's also appalled by Trump's actions.

"I think it's downright evil to take away someone's ability to access healthcare," says Madu, who got on birth control to prevent pregnancy when she had cis male sexual partners, as well as to regulate her mood and decrease the flow and frequency of her period.

Although she now gets health insurance through an employer that holds progressive beliefs, she knows that other LGBTQ+ people aren't so lucky.

"I have to think about all these people who don't have my same circumstance and so it's aggravating and disheartening. It's tough to think about, to be honest," Madu says.

2. There are challenges keeping us from getting birth control when we need it - including fear of discrimination from medical providers and lack of access to health insurance - but not being able to get birth control can have harmful consequences for us.

Going to the doctor is not fun for a lot of trans and queer people, especially when we have to talk to them about the most intimate parts of our lives.

Lucia Leandro Gimeno, the director of Q/tpoc Birthwerq Project in Seattle, says that accessing reproductive healthcare can be an anxious experience for trans and queer people, especially trans and queer people of color.

The fear of being discriminated against by their medical provider is a major barrier. The fact is that most medical providers do not get adequate training in working with LGBTQIA+ folks.
While seeking out reproductive healthcare, LGBTQ+ people are often shamed for our sex lives or treated differently because of our marginalized identities. Even well-intentioned doctors don't know much about how we have sex and how birth control impacts our bodies.
"I think that if you're white and trans, it's not easy, but whiteness generally helps you better navigate a lot of systems, whereas if you're a trans person of color, doctors just kind of look at you sideways," says Gimeno, who's an Afro-Latinx queer transmasculine femme.

Most medical providers do not get adequate training in working with LGBTQIA+ folks.

Additionally, LGBTQ+ Americans have barriers to getting birth control because we're almost 10 percent less likely than straight Americans to have health insurance, and 20 percent of us are living in poverty.

23-year-old Enabulele's scared of what will happen if Obamacare's repealed because she could be kicked off her dad's insurance plan. Her birth control implant was only $10 under her father's insurance and would have cost $800 without it.

When trans and queer people can't access the reproductive healthcare we need, we're forced to go underground to get it. Some trans women buy hormones on the black market because they can't get them from a doctor, and they sometimes end up being toxic.

Trans and queer folks deserve access to birth control that is safe and low-cost or free. That can't happen when we're left out of conversations about contraception.

3. We're excluded from the reproductive rights movement, even though we actually have the hardest time getting adequate healthcare.

Our society loves to gender things, which led to "reproductive health" becoming synonymous with "women's health" - cis women's health, in particular.

Cis women refuse to prioritize trans women's reproductive rights because they're afraid of being forgotten about. But in reality, the reproductive rights movement isn't winning because they're ONLY representing cis women.

When we fight for barriers to accessing reproductive healthcare to be removed for trans and queer people of color (POC), everyone benefits, even cis straight women, because they face some of the same challenges.
Reproductive rights organizations should also embrace the values of reproductive justice, which centers women of color, LGBTQ+ folks and other historically oppressed groups and their right to make their own decisions about their bodies and their families.
Furthermore, trans and queer POC are currently leading countless grassroots movements to achieve social justice for us all. It's only right to center their health and well-being when they're literally putting their bodies on the line.

Gimeno says that reproductive rights organizations should include trans people of color (TPOC) in leadership and decision-making bodies, build projects that center TPOC and work in coalition with TPOC without tokenizing them.

When we approach birth control access with a reproductive justice lens, we acknowledge that certain groups, including trans and queer people, have a more difficult time getting contraception than others.

Fighting for the most oppressed to have access to birth control is the only way to ensure that birth control is one day accessible to everyone who needs it.

The state of Oregon recently achieved a huge reproductive healthcare victory, passing the Reproductive Health Equity Act of 2017 that covers all reproductive health services (including birth control) at no cost to all residents, regardless of gender identity, income or citizenship status.

It's going to take a lot of work for similar legislation to succeed in other states, but I believe it can happen if the reproductive rights movement fully embraces trans, gender nonconforming and queer people.

Birth control rights will continue being eroded if our leadership isn't centered.

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Why We Need To Talk About Queer And Trans People And Birth Control

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When we talk about birth control, we need to remember that cis straight women aren't the only stakeholders. I 've been on and off different types of birth control for the past 15 years. Last year, I got Mirena, an IUD that's 99 percent effective in preventing pregnancy and lasts up to 6 years.

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Some teens may not be able to use it properly 

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Some teens may not be able to use it properly 

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Because teens are uneducated about the product this can lead to increased pregnancy and heath issues. Usually you need tests done in order to be allowed to use birth control. Birth control also has side effects that may change women's hormones or mental thoughts.

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When buying birth control OTC, many people can see you go buy it. This decreases the changes of someone buying it because of embarrassment.

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OTC birth control pills could lower teen pregnancy rates.

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OTC birth control pills could lower teen pregnancy rates.

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Making the Pill OTC would increase continuous use, leading to long-term health benefits. 

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Making the Pill OTC would increase continuous use, leading to long-term health benefits. 

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Over-the-Counter (OTC) birth control would increase access for low-income and medically underserved populations.

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Over-the-Counter (OTC) birth control would increase access for low-income and medically underserved populations.

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Over The Counter Birth Control Should Be Available 

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Over The Counter Birth Control Should Be Available 

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Of the 72.2 million American women of reproductive age, 64.9% use a contraceptive. Of those, 9.1 million (12.6% of contraceptive users) use birth control pills, which are the second most commonly used method of contraception in the United States after female sterilization (aka tubal ligation or "getting your tubes tied"). The Pill is currently available by prescription only, and a debate has emerged about whether the birth control pill should be available over-the-counter (OTC), which means the Pill would be available along with other drugs such as Tylenol and Benadryl in drug store aisles. Since 1976, more than 90 drugs have switched from prescription to OTC status, including Sudafed (1976), Advil (1984), Rogaine (1996), Prilosec (2003), and Allegra (2011).

Proponents say making the birth control pill available over-the-counter would lower teen pregnancy rates, provide contraceptive access to medically underserved women, and ease access to a health-improving drug with decades of safe use.

Opponents say making the Pill over-the-counter would raise the cost of contraception for women, pose a danger to teens' and women's health by removing the doctor's visit requirement, and limit what options are made available. Read more background...

Top Pro & Con Arguments

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Pro 1

Birth control pills are safer than many OTC drugs and common activities.
Between 9 and 10.6 million American women use the birth control pill. 1] [3] 2] The Pill carries no risk of overdose or addiction.
4] Joe Speidel, MD, MPH, Professor of Obstetrics, Gynecology & Reproductive Sciences at Bixby Center for Global Reproductive Health explains that pregnancy has a mortality rate about the same as car accidents--one in 8,300--while the risk of dying from birth control is about one in 1,667,000, about the same as dying from being struck by lightning. 5]
According to Bedsider, a nonprofit online birth control network run by doctors, "As medications go, the pill is very safe-safer than having a baby, driving, smoking, or taking daily aspirin."
6] [6] 7] Eve Espey, MD, MPH, Professor in the Department of Obstetrics and Gynecology at the University of New Mexico, stated, "Nonsteroidal medicines kill far more people than birth-control pills."
And other OTC drugs carry more serious risks: non-steroidal pain pills (NSAIDS) like ibuprofen can cause stomach bleeding; Sudafed can raise blood pressure; Tylenol can cause liver toxicity; antihistamines like Benadryl can worsen glaucoma and kidney disease; and diet pills can cause irregular heart beats and raise blood pressure. 8] [9] The FDA has already indicated the safety of the drug by making Plan B available without prescription.
10]
Plan B One-Step and other emergency contraception pills are available without a prescription and share the same active ingredient as daily birth control pills, levonorgestrel, but in a higher dose.

Of 135 countries for which data are available, 96 countries representing 80.33% of the global population have OTC birth control access. Read More

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Pro 2

Over-the-Counter (OTC) birth control would increase access for low-income and medically underserved populations.
Twenty million women live in "contraception deserts," places with one clinic or fewer per 1,000 women who need government-funded birth control from programs such as Medicare. 11] In underserved communities, women could more easily find a local drug store for medication. 11-21% of sexually active low-income women studied were more likely to use the Pill if it were available OTC. 12] [13]
3]
Denicia Cadena, Policy Director for Young Women United in New Mexico, stated: "Our rural communities are most profoundly impacted by our state's health care and provider shortages. Patients face three- to six-month wait times for any primary care and even longer for specialty care... 11 of the state's 33 counties have no obstetrics and gynecology physicians."
3] The National Latina Institute of Reproductive Health stated: "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." 14]
Birth control can be difficult for many women to obtain, particularly teens, immigrants, women of color, and the uninsured.
15] [16]
Other medically underserved communities, such as LGBT+ (Lesbian, Gay, Bisexual, Transgender and others) people, are more than twice as likely to be uninsured (15% of all LGBT+ compared to 7% of non-LGBT+ people) and more likely to face discrimination in the healthcare industry, resulting in less or no reproductive healthcare. Read More

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Pro 3

OTC birth control could lower the rate of unintended pregnancies, saving taxpayers billions of dollars.
54% of unintended pregnancies are associated with not using contraceptives and 41% with inconsistent use. 1] Unintended pregnancies cost the US federal and state governments $21 billion in 2010, the newest numbers available at the time of publication, with the average cost-per-birth being $12,770 for prenatal care, labor and delivery, postpartum care, and 12 months of infant care ($20,716 for 60 months). 17] The Guttmacher Institute estimates that $15.5 billion dollars could have been saved if the unintended pregnancies had been prevented. 17]

Only 5% of unintended pregnancies have happened while the woman used effective birth control consistently. 1] A study found that women who received a one-year supply of Pills were 30% less likely to have an unplanned pregnancy and 46% less likely to have an abortion. 18] A study comparing Pill use between women who obtained Pills with a prescription from an El Paso, Texas, clinic and women who obtained Pills OTC from Mexico showed that the women who got Pills OTC were more likely to continuously use the medication. 19] Read More

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Pro 5

Making birth control pills OTC could lower the abortion rate.
In a survey of women seeking abortions, 72% said they were pregnant because they could not get the contraception they needed, and 32% reported an institutional reason such as the prescription requirement. These obstacles resulted in a 35% increase in contraceptives not being used. 22]

The American College of Obstetricians and Gynecologists stated: "The most effective way to reduce abortion rates is to prevent unintended pregnancy by improving access to consistent, effective, and affordable contraception... [and a] strategy for improving access to contraception is to allow over-the-counter access to oral contraceptive pills." 23] The Guttmacher Institute stated that "more and better contraceptive use" caused the 13% decline in abortion rates between 2008 and 2011. 24] Read More

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Pro 7

Women are responsible and knowledgeable enough to care for their own bodies.
Alison Block, MD, physician, said: "My main philosophy as someone who provides reproductive health care is to trust women to make their own decisions. The idea that they have to [have a] conversation with a doctor to decide which method is best for them seems overly paternalistic and unnecessary." 30]

Often, doctors will only prescribe birth control pills once a patient has visited and had a pelvic exam. However, Pap smears are now recommended every three years instead of every year, and only after a woman has turned 21. 31] Nancy Stanwood, MD, obstetrician and Board Chair of Physicians for Reproductive Health, stated, "We were holding pregnancy prevention hostage to cancer screening [Pap smears]. They're both worthwhile goals, but one should not be held hostage to the other." 31]

Women can sort out for themselves whether hormonal birth control is right for them. In one study, 98% of women matched their doctors' medical evaluations about whether they could use hormonal birth control. The women were more cautious about contraindications (medical reasons not to take a drug) such as headaches, smoking, and potential pregnancy than their doctors were. 32] The Border Contraceptive Access Study found that women who got the Pill OTC from a pharmacy in Mexico were adequately self-screening for contraindications. 33] Read More

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Pro 8

Most women want OTC access to birth control and say it would improve their lives.
62.2% of women surveyed indicated that they were in favor of OTC Pills. The same survey found that 28% of women using no birth control and 32.7% of women using a less effective form of birth control would use OTC Pills, a market of about 11 million women. 34] [25] 35] [36] 78.7% of women said it was "extremely or quite important" that birth control be easily obtained. 25]

62.5% of women surveyed said birth control reduces stress, 56.3% said it helps working women continue to work, 49.0% said it helped women get an education, and 48.7% said it led to more stable relationships with partners. 37]

Research supports these women's conclusions, because state laws that allowed early access to the Pill (17 or 18 years old, instead of 21) are linked to higher women's college graduation and employment rates, increased earning power, narrowed gender pay gap, and longer lasting marriages.

OTC birth control pills would also be more convenient, eliminating the need for a woman to make a doctor's appointment, take time off work, and rearrange her schedule. Read More

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Pro 10

Major medical and rights organizations support making the Pill OTC.
The American College of Obstetricians and Gynecologists (ACOG) 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." 41]

At least 89 major medical and rights organizations support making the Pill OTC, including the American Academy of Pediatrics, American Academy of Family Physicians, the ACLU, National Women's Law Center, and Planned Parenthood. 14] [42] [43] [44] Read More

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Con 1

Over-the-Counter (OTC) birth control would raise the cost of the drug.
Making birth control pills OTC means they would no longer be covered by insurance and women would have to pay for them on their own. With the Obamacare birth control mandate, insured women, who account for 89% of American women, can access free birth control. 45] The National Women's Law Center estimates that 62.8 million women have birth control coverage with no out-of-pocket cost. 46]

Stuart O. Schweitzer, PhD, UCLA Professor of Health Policy and Management, stated that OTC is "more expensive to consumers than a prescribed drug that's covered by insurance." 47]

Before Plan B emergency contraception went OTC, the drug cost about $12 for the brand name and $5 for the generic for women using Medicaid. After the drug became OTC, the cost increased to $50 for the brand name and $41 for the generic. [48] Kelly Cleland, MPA, MPH, Research Specialist at Columbia University stated, "When the generics [of Plan B] were about to go onto the shelves I thought there might be a price war that would push the cost down. But that really hasn't happened, and I don't see a sign that it will." 48] Read More

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Con 4

Women who take birth control pills without medical supervision can put themselves at risk.
Jennifer Ashton, MD, gynecologist, stated, "It's generally accepted knowledge that the overall health literacy of the lay population is about at the 7th-grade level," adding that even with one-on-one counseling and explanations about how the Pill works, patients are still confused. 54]

Birth control pills do have serious and sometimes fatal contraindications, meaning not every woman should take them. When a drug is OTC, 49% of people get information about the drug from mass media, and only 27% contact their doctors with questions about OTC drugs. 55] [56] This lack of communication and lack of awareness of contraindications can put women at risk.
57] [58]
Contraindications for birth control pills include women over 35 years old, women who smoke, who have a history of diabetes, heart disease, blood clots, cancer, stroke, liver disease, high blood pressure, migraines (and migraines with aura), or bladder disease. 59]

Poppy Daniels, MD, obstetrician-gynecologist, called OTC birth control without doctor involvement "ridiculous" and "absurd," and stated, "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?" 60] [61]

If the Pill is prescribed, the doctor or pharmacist can tell the patient about any possible interactions and prevent bad drug combinations. Drugs that can interfere with birth control pills include the antibiotic rifampin, many anti-HIV drugs, some anti-fungal medications, some anti-seizure drugs, the stimulant modafinil, many drugs to treat epilepsy, some medications for bipolar disorder, and many herbal remedies including flaxseed and St. John's wort. Read More

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Con 5

Tying prescription birth control to a visit with a medical professional results in additional screenings, tests, and conversations that promote overall good health.
When the Pill is available by prescription only, a doctor usually requires a well woman exam every one or three years in order to obtain or maintain a birth control prescription. The examination generally includes a pap smear (the test for cervical cancer that may be combined with HPV screening), a breast exam, and pelvic exam that, among other things, screens for ovarian cancer and STIs. Additionally, these yearly exams are a good opportunity to check in with the doctor about general wellness and other preventative screenings. 54]

Further, at least 14% of women on the Pill are using the drug exclusively for noncontraceptive reasons, such as acne and irregular menstrual cycles. 62] That's at least 1.5 million women 62] who could be self-diagnosing medical conditions in a drug store aisle without medical help. Read More

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Con 6

Over-the-counter status would decrease privacy.
If birth control pills were available on pharmacy aisles, purchases would be public and subject to the judgment and gossip of anyone in sight. Many people may prefer to keep their contraceptive use between them and their doctors.

Olivia Alperstein, Communications and Policy Associate at Congressional Progressive Caucus Center, 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 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... The list goes on." 63]

59% of sexually active teen girls would rather stop getting all reproductive health care services than have to tell their parents about their contraceptive use. 64] But, 99% of those teens would continue having sex. 64] Teens want their contraceptive use kept private and accessing birth control in the middle of a pharmacy where they might run into a neighbor or teacher could stop some teens from preventing pregnancy. Read More

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Con 7

Drug manufacturers are unlikely to make the Pill OTC, so improved access has to be accomplished through other means.
Drug makers to date have little interest in going through the process to make a drug over-the-counter because it can take a long time and the costs are significant. 30] Only the drug manufacturer can initiate this process with the FDA, who decides on the prescription or OTC status of a drug based on applications submitted voluntarily by the manufacturers. Lawmakers cannot change the status of a drug from prescription to OTC. Further, any decision involving birth control can be politically controversial. 65]

Instead, some states are making birth control available without a prescription, but not over-the-counter. In those states, a pharmacist is required to ask the patient a few questions, notes blood pressure and weight, and dispenses birth control from behind the pharmacy counter. Several states including California, Maryland, Tennessee, and Washington allow birth control without a prescription. California, Maryland, and DC even allow 12-month supplies to be dispensed at once, which has been found to reduce unintended pregnancies by 30% and the odds of an abortion by 46%. 66] [66] A study found that 68% of women would use birth control if it were available via a pharmacist and 63% agreed the pharmacist consultation was an important step. 68] 67] The birth control in these cases is covered by insurance.
69] Some services deliver the birth control to the patient, eliminating the need to stop by a pharmacy.70] [71] [72]
Women in some states can access birth control via an app or website from private companies. Insurance covers some of these prescriptions, and all that is generally required is a brief consultation to assess risks and appropriate medication, sometimes by video chat. Read More

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Con 8

OTC birth control pills would decrease birth control choice and access.
Vanessa Cullins, MD, obstetrician-gynecologist, noted that there were over 40 brands of birth control pills and "not every formulation will go over the counter." 73] By making a few choices available OTC, women are more likely to follow the path of least resistance and choose those available at a drug store rather than by prescription, even if it isn't the right variety of birth control for them.

The FDA-approved contraceptive methods that would not be available over-the-counter include IUDs (both copper and with progestin), the implantable rod, and shots such as Depo-Provera, plus sterilization procedures, all of which the FDA states are more effective than the Pill. 74]

Journalist Sarah Elizabeth Richards points out, "Women visiting their pharmacists won't have access to the most reliable forms of birth control on the market because those methods, such as implantable rods or intrauterine devices (IUDs), will still require a trip to a doctor's office." 75]

And, even within birth control pill brands, choice will be limited. Most effort is focused on making the progestin-only (also called POP or minipills) OTC, rather than the estrogen and progestin pills (also called combination pills). 76] The most recent data states that only 0.4% of American reproductive-aged women take progestin-only birth control pills, or about 2% of all women who take the Pill. 77] Read More

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Con 9

Making the Pill OTC would increase the use of hormonal drugs that may disrupt and damage the body.
The FDA notes the side effects of the Pill include changes in sexual desire, bleeding between periods, sore breasts, headaches, and nausea. 74] Some medical practitioners believe that pharmaceutical contraceptives in general are harmful because women are not as aware of their bodies or their natural cycles when taking synthetic hormones. 78]

Holly Grigg-Spall, health author, stated, "Health problems caused by hormonal contraceptives can appear a few months, a few years or longer into use as each woman processes the synthetic chemicals differently. Yet all women will be changed by these drugs. As a woman's body changes so does her reaction to the pill. The pill's repression of vital bodily functions that leads to ill health can build in such a way that years later a woman becomes very sick but can not make the connection." 78]

Lara Briden, ND, a naturopathic doctor, emphasized these concerns are bigger for teens: "Making hormones is not easy. It requires regular ovulation, and that can take a few years to become established. That's why the early years of menstruation are exactly the wrong time to take hormonal birth control." 79] Read More

Did You Know?

1. The FDA approved Enovid, the birth control pill on May 9, 1960 for contraceptive use, making it the first FDA-approved contraceptive drug and the first FDA-approved drug that does not treat an illness.

2. Typical use of the Pill results in nine unintended pregnancies per 100 women after one year and increases steadily to 61 unintended pregnancies per 100 women after 10 years of typical use.

3. 60% of American women use some sort of contraception.

4. 17.1% of American women aged 15-44 use birth control pills compared to 8.8% of women worldwide using hormonal birth control pills.

5. Plan B, the emergency contraception that uses the same active ingredient as the Pill, was made available over-the-counter in 2006.

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Should Birth Control Pills Be Available Over-the-Counter? - Birth Control - ProCon.org

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Of the 72.2 million American women of reproductive age, 64.9% use a contraceptive. Of those, 9.1 million (12.6% of contraceptive users) use birth control pills, which are the second most commonly used method of contraception in the United States after female sterilization (aka tubal ligation or "getting your tubes tied").