What If Birth Control Was Available On Drugstore Shelves?

A new study shows what would happen to the unplanned pregnancy rate if birth control pills were available over-the-counter. (Photo: Getty Images)

Making birth control over-the-counter could help to lower the rate of unplanned pregnancy for certain women, a new study suggests.

The findings, recently published in the journal Contraception, specifically show that making birth control OTC (and still covered by insurance, with no co-pay) could decrease the rate of unintended pregnancy among low-income women by as much as 25 percent.

University of California, San Francisco, researchers found that 21 percent of low-income women are “very likely” to use birth control pills if they are available without a prescription. And if birth control pills are offered at no cost to the consumer, an additional 11 to 21 percent of low-income women said they’d start using the Pill.

Not only could the rate of unintended pregnancy drop by as much of 26 percent as a result, but 20 to 36 percent more low-income women would begin using birth control or using a more effective means of birth control (as opposed to condoms, menstrual cycle tracking, lactational amenorrhea, abstention, or emergency contraception), according to the study.

In 2012, the American College of Obstetricians and Gynecologists recommended that all oral contraceptives be available over-the-counter.

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For the study, researchers presented 2,046 women with the following scenario: “Birth control pills would be available on a shelf at a drug store or grocery store just like cough medicine or some allergy pills. If you had a question, you could talk to a pharmacist. You would not need a prescription from a doctor or nurse. If you have insurance, your insurance may or may not cover ‘OTC’ [over-the-counter] birth control pills.”

Then, the researchers asked the women about their likelihood of using birth control pills given differing costs. 

All of the women in the study said they would use birth control pills if they were completely free of cost. But as cost went up, the percentage of women saying they would use the pills went down. For instance: 91 percent said they would use them if they cost $5 and 84 percent said they would use them if they cost $10, but 26 percent said they would use them if they cost $25 and just 4 percent said they would use them if they cost $50. 

The researchers concluded that offering birth control at no or low cost over-the-counter would greatly reduce the public costs of providing care and services for the thus-prevented unintended pregnancies. They also recommended the use of a progestin-only pill to minimize potential complications (which would also lead to greater public health costs reductions).

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Currently, the United States is one of only 45 countries to require a prescription for birth control pills. As of 2013, 35 countries provide birth control pills over-the-counter, with an additional 11 countries allowing for it after a woman is pre-screened to be eligible to receive them in this format. A 2011 study by the Guttmacher Institute found that unintended pregnancy costs U.S. taxpayers $11 billion annually — costs that could essentially be voided should birth control pills be offered at no or low cost over-the-counter.

Cecile Richards, president of the Planned Parenthood Action Fund, voiced her belief that the researchers’ findings need to be implemented into actual public policy. “We strongly support making birth control available over-the-counter, as part of our nearly 100-year history of expanding access to birth control. Every woman in America should have access to the birth control method that’s best for her, without barriers based on cost, availability, stigma, or any other hurdle,” Richards said in a statement. “Just making birth control available over-the-counter doesn’t go far enough. We have to also ensure that it’s affordable by protecting insurance coverage that is already helping more than 48 million women get birth control with no copay.”

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