Now that Oregon and California have started offering hormone-based contraceptives – such as the Pill – over-the-counter, it seems like only a matter of time before this becomes nation-wide. The decision has caused no small amount of controversy, with some saying it's dangerous, and other saying it's long overdue. Many have raised legitimate questions about what over-the-counter birth control will mean for women's health. We've researched the questions and answers to the most common questions below.
Q: Does over-the-counter mean that anyone can buy the Pill?
A: No. Women technically still need a prescription for the Pill, but in Oregon and California a pharmacist can write it instead of a doctor.
Q: Isn't that dangerous? Doesn't a prescription like that need a doctor's oversight?
A: Actually, no. Buying the Pill over the counter is no more dangerous than buying restricted allergy medicine or anything else. There are potentially dangerous drug interactions that could occur, and women who smoke or are over 30 should be counseled about their increased risk of developing dangerous side effects. But similar dangers exist with all behind-the-counter medicines, and pharmacists are specially trained to recognize and warn women of any potential problems. The only difference between seeing a pharmacist and going for office visit is that women will no longer be required to undergo a yearly pelvic exam.
Q: But don't women need yearly pelvic exams?
A: No. Experts say that an annual pelvic exam is unnecessary in healthy women. Though it should always be an option for women who wish to have one, and is a good way to maintain reproductive health, since it's not a necessary medical procedure for most women, it's not a prerequisite for a birth control prescription.
Q: I've heard that over-the-counter birth control will actually make birth control less accessible. Is this possible?
A: Unfortunately this is a possibility, and we're still not sure what will happen. Women's health advocates who oppose these measures say that insurance companies won't pay for the Pill if it's available over the counter (currently hormone-based contraceptives are covered 100% under most plans). If this is the case, it means that women who do have health insurance may need to start paying for it out of pocket. And at roughly $60 per 28-day supply, this might make birth control inaccessible to many women.
Q: Would I still be able to get my preferred brand of birth control?
A: There's also the possibility that the variety of birth control will decrease. Because every woman's body is different, one brand of birth control may work very well with few to no side effects, while another will have side effects that are intolerable. If birth control is no longer covered by insurance, pharmacies may reduce the number of brands they carry, limiting the women who can afford birth control to options that don't work for them.
Q: So… is this a good change or a bad one?
A: If handled properly, over-the-counter birth control could be a godsend to women who can't afford yearly pelvic exams, or choose not to have them. It can also make reliable birth control more accessible to lower-income women who don't have health insurance. However, if there isn't enough oversight it may well lead to fewer women having access to birth control. Women's health advocates will be keeping a close eye on trailblazers Oregon and California to see what happens there.