The Pill Without A Prescription: It's Time

This article is more than 8 years old.

Earlier this month, the American College of Obstetricians and Gynecologists, the country’s leading professional group for ob/gyn physicians, recommended that oral contraceptives — on the market for more than half a century now — finally be available over-the-counter.

It’s about time.

Even emergency contraception — better known as Plan B One Step — has been available over the counter since 2006 for women 18 and older, and subsequently, for women 17 and older.

Contraception, as everybody knows by now, was a hot button political issue this fall. (Haven’t we fought this fight already?) But perhaps, given the election results, the time is finally nigh to come to our collective senses and do as the ob/gyns recommend – make birth control pills available to women of any age, any time, at any pharmacy, no doctor visit or prescription needed.

According to the American College of Obstetricians and Gynecologists: The benefits of making the pill more widely available vastly outweigh the risks.

Just because the ob/gyns have recommended over-the-counter availability of “the pill,” of course, does not mean that it will happen right away. A pharmaceutical company will have to take on the issue and go to the FDA for approval of an over-the-counter pill.

In the new recommendations, the ob/gyn physicians say that after reviewing numerous studies, they concluded that the benefits of making the pill more widely available vastly outweigh the risks. The benefits apply to women individually and to society as a whole.

Half of all U.S. pregnancies are still unintended and many of these lead to abortion. The best way to prevent abortion, obviously, is to prevent conception in the first place.


Admittedly, I do have a few concerns. One is that over-the-counter formulations could, depending on pharmaceutical pricing, be more expensive than the same drug bought with a prescription.

Dr. Kavila Nanda, a member of the committee that wrote the new recommendations, told me that “any plans to make oral contraceptives available over-the-counter need to address the cost issue because we are trying to remove barriers, not make it more expensive.” (Nobody knows yet what effect Obama’s Affordable Care Act will have on this question.)

Another concern — which is shared by the FDA — is that certain birth control pills (such as Yasmin and Yaz) that contain a hormone called drospirenone, similar to the natural body-made progesterone, may increase the risk of blood clots more than other oral contraceptives. The ob/gyn group, which has evaluated studies on the hormone, thinks the risk is “still very low,” Nanda said.

The solution, it seems to me, is to make oral contraceptives available to women of all ages, with lots of package inserts, posters and public education campaigns designed to help women decide if they are appropriate candidates for the pill. First and foremost, women should realize that, while oral contraceptives do protect against pregnancy, they do not protect at all against sexually transmitted diseases.

Women should also know that they should not take oral contraceptives without consulting a doctor if they are breastfeeding, if they are 35 or older and smoke, or if they have certain disorders like high blood pressure or diabetes. Women who have or have had breast cancer or who might currently be pregnant should also absolutely not take oral contraceptives.

So, let’s inform women and girls of these risks and hope that Big Pharma and the FDA will get on board. Soon. Before another generation of young women find themselves having to deal with unintended pregnancies.


This program aired on December 3, 2012. The audio for this program is not available.