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We’re one step closer to getting birth control pills without a prescription

Dr. Elizabeth Yuko is the Health Editor at SheKnows. She is a bioethicist and writer specializing in sexual and reproductive health and the intersection of bioethics and popular culture. She is an adjunct professor of ethics at Fordham ...

The real reasons birth control pills aren’t available over the counter (yet)

Emergency contraceptive pills like Plan B have been available without a prescription for years, so why isn’t that the case for preventative oral contraceptive pills too?

Last week, Vox reported that America may be getting one step closer to over-the-counter birth control pills thanks to Paris-based pharmaceutical company HRA Pharma and their partnership with Ibis Reproductive Health, a nonprofit research organization. Together, the corporation and organization will take the first steps toward making some types of birth control pills available without a prescription in the United States.

More: Pass on the pill: Alternatives to birth control pills

So what's been the holdup? We know that that accessibility to birth control options decreases the rate of unplanned pregnancy and the birth control pills are relatively safe and effective (when taken correctly). We also know that not all women have access to affordable health care (and things aren’t looking great for us post-Jan. 20) — in other words, the doctor’s visit required in order to get a prescription for the pill may be another obstacle for some. So wouldn’t it be easier and more cost-effective (not to mention preventative of countless unplanned pregnancies) if birth control pills were available over the counter?

Unfortunately, it’s not that easy. Yes, there are political stumbling blocks (we are talking about women’s bodies, after all), but surprisingly, making birth control pills available over the counter has actually gained bipartisan support — in theory, at least. In practice, we’re nowhere close to a solution agreeable to both sides, particularly in regard to whether or how insurance plans would cover it. But politics are just one part of the equation.

More: Birth control pills: Facts you need to know

From a medical standpoint, some argue that the potential side effects of birth control pills are significant enough to require a doctor’s visit in order to ensure the woman understands the risks and benefits of the pill. The thing is, a lot of over-the-counter medications have side effects, but don’t require a prescription or doctor’s visit. But then again, other over-the-counter medications aren’t an integral part to many women’s autonomy, so there’s not the same urgency to regulate it.

Politics and medical safety aside, Vox points out that the real problem has been finding a pharmaceutical company willing to go through the incredibly long process of getting FDA approval for over-the-counter use of one of their own birth control pills.

More: Women tweet #MyPillStory to share birth control woes

In a statement to Vox, HRA Pharma said that "oral contraceptives are some of the best-studied medicines on the market today and enjoy longstanding support from medical and public health experts.”

Although it is unclear how long this process will take or the specific composition of the pill, Ibis president Kelly Blanchard told Vox that the plan is to submit the application to the FDA within a few years and that some components of application and research are already underway.

What we do know is that the first over-the-counter birth control pill will be progestin-only, rather than a combined pill of estrogen and progestin. This is because although both types are effective, progestin-only pills have fewer side effects and have already gone through the approval process with the morning-after pill (which is also a progestin pill).

Despite the inevitable challenges to women’s health coming from the incoming administration, Blanchard told Vox that she hopes that the FDA “will follow their process and judge it on its merits. And we think the merits are strong.” 

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