The Hill

Over-The-Counter Birth Control Pills Could Reduce Unintended Pregnancies By 25%

birth control
More women would use birth control pills if they were available over-the-counter and didn't require a prescription, but only if they weren't too pricey. Photo courtesy of Shutterstock">Shutterstock

A lot of women stall on getting on the pill because they lack insurance, they’re unemployed, or they don’t have access to it. Lack of proper contraceptive use, despite newly-developed birth control technologies, is a contributing factor to the fact that nearly half of all pregnancies in the U.S. are unplanned (and a large chunk of those end in abortion).

But a new study out of the University of California, San Francisco in collaboration with the nonprofit Ibis Reproductive Health claims that if birth control pills were available over-the-counter, it could reduce unwanted pregnancies by 25 percent — a pretty significant number.

“Women who are currently using methods that are less effective than the pill — mainly condoms or nothing — would use it,” Dan Grossman, the author of the study, said. “Particularly low-income women.”

The researchers estimated that if women were able to buy pills at a regular pharmacy without needing a prescription and didn’t have out-of-pocket costs, 11-12 percent more women would use the pill. This would ultimately cause a 20-36 percent decrease in the number of women who don’t use any contraceptive at all or who only use condoms, and a 7-25 percent decrease in the number of unintended pregnancies.

Strides have been made in the area of contraceptives; for one thing, the Affordable Care Act allows women to get birth control through insurance plans without any copayment. More and more women are also using long-acting birth control like intrauterine devices and under-the-skin implants, which show promise as being far more effective than pills — mainly because they get rid of the “human error” factor, like not using condoms properly or forgetting to take the pill every day.

“Once placed, the devices remain in place and active for between 3-10 years depending on the type of device,” Dr. Adrienne Bonham, an associate professor of Obstetrics and Gynecology at the University of Rochester Medical Center, writes on the Shiver Report. “As a result, continuation rates for these methods tend to be much higher than for methods that involve having to remember to refill a prescription, get to the pharmacy, or obtain the money to pay for it.”

But the rate of unplanned pregnancies remains very high — especially since these long-acting options are often far more expensive than condoms or oral contraceptives, making women less apt to buy them. So would over-the-counter BC really make a difference?

This conversation isn’t new; the idea of over-the-counter BC was discussed during the 2014 midterm elections, when Republicans got behind the notion as an alternative to Obamacare’s requirement that all insurance plans cover birth control. But having birth control be accessible without a prescription might not be as practical as it may seem. If the price is high, even as over-the-counter, women without the financial means will still avoid buying it (birth control for a month can cost up to $162 without insurance).

Still, the notion is supported by the American College of Obstetricians Gynecologists, who officially proclaimed they advocated the idea in 2012 — noting that birth control isn’t a huge health risk, and a doctor’s exam plus prescription was often unnecessary. In addition, reproductive rights groups are in support of OTC BC, arguing that it would provide greater access to minorities, and poor and immigrant communities.

Source: Foster D, Biggs M, Phillips K, Grindlay K, Grossman D. “Potential public sector cost-savings from over-the-counter access to oral contraceptives.” Contraception, 2015.

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