April 22, 2013 —The idea of making birth control pills available over the counter is gaining increased attention, but political and regulatory hurdles remain, according to a New York Times news analysis by Elisabeth Rosenthal, a Times reporter covering the environment and health.
Rosenthal notes that the American College of Obstetricians and Gynecologists last year released an official position paper "concluding that the time had come for birth-control pills to be sold over the counter." The paper marked "the first time the group had endorsed such sales, concluding that scientific evidence suggested that the practice was safe and calling it a 'potential way to improve contraceptive access and use, and possibly decrease the unintended pregnancy rate,'" she writes.
Despite ACOG's recommendation and expansive medical evidence affirming the safety of birth control pills, OTC access is not likely "anytime soon" because "pregnancy, prescriptions and religious politics form a combustible mix in the United States," Rosenthal writes.
Women's health groups have lauded ACOG's recommendation, but the Catholic Medical Association has "lambasted the idea," she continues. Meanwhile, gynecologists "seem divided on the issue," with a recent University of Missouri poll finding that some oppose the recommendation because of safety concerns. The researchers who conducted the poll "concluded that the fear was irrational, revealing 'a knowledge deficit' about 'the safety of oral contraceptives,'" Rosenthal writes.
"The political response had been even more topsy-turvy," Rosenthal continues. Conservative Louisiana Gov. Bobby Jindal (R) has endorsed the idea of OTC birth control pills, while FDA refused to comment on the concept because of the "'ongoing legal issues' concerning the judicial ruling on [emergency contraception]," she writes.
OTC sale of birth control pills also faces several "procedural hurdles." More extensive research would be needed on women's ability to safely take the drugs without a doctor's involvement, and a drugmaker would have to apply for FDA approval.
Although the U.S. debate "has been argued in black and white," there is a middle ground -- used in some other countries -- allowing pharmacists to sell the pills after screening "women for contraindications with a few simple questions," according to Rosenthal. Although the Affordable Care Act (PL 111-148) eliminates copayments for birth control for many women, Rosenthal concludes by noting that many doctors "think it would be even smarter to just eliminate the prescription" (Rosenthal, New York Times, 4/20).