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Should birth control pills be available over-the-counter?

Birth control pills.
Birth control pills.
brains the head/Flickr (cc by-nc-nd)

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The pill was first approved for oral contraceptive use in the United States in 1960. It’s one of the most studied – and some say, safest – medications on the market today. Yet, in most countries, including the U.S., women still need a doctor’s prescription to obtain them.

But there’s a growing movement underway to change that. The Oral Contraceptives Over-the-Counter Working Group is a coalition of health workers and advocates aiming to remove prescriptions as a barrier to pill access. They argue that prescription-only access to birth control is patronizing to women, limits contraceptive freedom and is ineffective against teen-pregnancy rates.

Obstetrician Malcolm Potts, who’s been studying contraceptives for decades, says not only is the pill safe, it has many health benefits such as a significant reduction in ovarian, uterine and bowel cancers and even melanomas. “The epidemiological data on pill safety are now so compelling,” Potts wrote in an op-ed in Monday’s Los Angeles Times, “that it seems likely the Food and Drug Administration would go along with such a proposal. The dose does not have to be adjusted to fit the user, and no one — not even a toddler who found her mom's pills — has ever died from an overdose.” But to date, the FDA has never approved a “chronic use” medication, a drug taken daily for an unlimited amount of time, without a prescription.

So why isn’t the pill, like aspirin, available in every pharmacy? What would it take for the FDA to lift the prescription-only regulations? What impact might this change have on the cost of birth control and the battles over who’s going to pay for it? Is the pill really safe enough to be used without doctor oversight?


Dr. Malcolm Potts, Bixby Professor at UC Berkeley, obstetrician and reproductive scientist who has studied oral contraceptives since the 1960s

Dr. Angela Lanfranchi, Clinical Assistant Professor of Surgery at Robert Wood Johnson Medical School, breast surgical oncologist