Availability of

Hormonal Birth
Control Over the
Counter
Tasha Robinson & Ashley Sloan
WHAT IS IT?
 WHAT IS IT? cont.
● Oral contraception
○ Releases hormones that prevent ovulation
○ Makes the cervical mucus thicker (prevent fertilization)
● Two kinds: Progestin only (Mini pill)
Estrogen and Progestin (Combination pill)
● 91% effective, taken once a day
● Costs up to $50, but can be $0
● Prescription required
 WHO?
● Biosex females take the pill in order to:
○ Prevent pregnancy in sexually active users
○ Lighten the flow of menstruation
○ Ease menstrual cramps
○ Limit the effects of PMS
○ Regulate the length/timing of menstruation
○ Regulate hormone levels
○ Reduce hormonal acne
 WHEN?
● The pill has been around for 50 years
● In 1960 it was made available for public use
● On the horizon:
○ Male birth control
■ RISUG (reversible inhibition of sperm under guidance)
○ Expanded access locally and nationally
○ Online prescriptions & availability
○ Expanded insurance coverage
 WHERE?
● Widely Available:
○ Eastern Hemisphere (excluding Western Europe)
○ South America
○ Even available in countries that have otherwise very
strict policies around reproductive health
● In the US, Canada, and Western Europe, birth control is
available almost entirely by prescription only
 WHY?
● Could make it easier to start using the pill and keep using it
longer
● Reduces gaps in birth control use since there wouldn’t be a
need to schedule a medical visit to get or refill a prescription
● The cost of a medical appointment can make it hard to get
prescription birth control
● Convenience -- forgetting or running out of your pills on a
trip or vacation
 Legal Models
● Two Models:
○ Pharmacy-Access Model - Available in the U.S.
■ Prescription required
BUT
■ Pharmacist can prescribe
○ OTC-Access Model - Not yet available in U.S.
■ No prescription required
Legal Models cont.
National Legality
Global Legality
 Change on the horizon
● Legislation introduced by Senator Joni Ernst (R) from
Iowa
○ Mostly bipartisan support
● In favor of making over the counter birth control available
without a prescription
○ Conservative states are slowly coming around
● Expanded availability through pharmacy-access model
reforms
 Birth Control - General
Benefits: Risks:
⊷ Controls/reduces ⊷ Health concerns:
unplanned high blood pressure
pregnancies, teen and migraines
pregnancies, ⊷ Greater unplanned
abortions pregnancies if lack of
⊷ Reduce risk of counseling
ovarian cancer
⊷ More options for
women
⊷ Spaces out
childbearing
 Over the Counter Birth Control
Pros: Cons:
⊷ Increases ⊷ Insurance companies
accessibility for could remove OTC
women coverage
⊷ More easily available ⊷ Customers may not be
for women with counseled enough
strict-ruled or abusive ⊷ Customers may not
households understand the
⊷ Can lower costs for consequences of not
women w/o taking the pill regularly
insurance
 Over the Counter Birth Control

Short Term: Long Term:

⊷ Nausea, headaches, ⊷ Could potentially
breast tenderness, cause cancers
mood swings, etc. ⊷ Increased risk of
⊷ Most at risk (2-3 blood clots
months) ⊷ Doesn't affect
⊷ Might raise costs for fertility
some women w/o ⊷ Reliable
insurance ⊷ Can increase
accessibility
⊷ Can generate profit
for pharmacies --
lowers cost
Ethical Aspects - Financial Cost
Unethical:
● Some insurances may drop OTC coverage
● Prescriptions may be more favorable to companies
● Costs may be lower under a prescription plan
Ethical:
● Can lower the cost overall for uninsured women -- no
need for a doctor's visit
● Cheaper to get on and off a prescription
Ethical Aspects - Religious Beliefs
Unethical:
● Conservative religions:
○ Wary of promoting contraceptive use
○ Many religions believe that birth control should not
be used because it promotes sexual activity
contrary to purposes of bearing children
○ Hypothetically promotes sexual activity outside a
monogamous married partner
Ethical Aspects - Moral Code
Unethical:
● Opponents say:
○ “Anti-life”
○ A “form of abortion”
○ Contraception can be used as eugenics tool
Ethical:
● Women's choice
● Relieves a financial burden on women
Ethical Aspects - Societal Impact
Ethical:
● People want to get counseling for birth control, but it is
already safer than a lot of other OTC medications
● Decreases unintended birth
● Decreases number of children and number of abortions
● Success for women’s rights
● Progressive policy
● Globally accepted
Ethical Aspects - Future Implications
Ethical:
● Reduce unintended pregnancies and abortions
● Save money
● Easier access: no doctors appointments or follow ups
● Treatment for endometriosis could include
contraceptive pills
Discussion
● How do you think the
availability of OTC birth
control pills could affect
adolescent women?
Discussion
● How might parents react to
OTC birth control?
Discussion
● What backlash could
pharmacies potentially face if
providing OTC birth control?
Discussion
● Should religious beliefs have
any influence over legislation
pertaining to OTC birth
control?
Bibliography
- https://www.ourbodiesourselves.org/2017/01/over-the-counter-birth-control-is-on-its
-way-to-the-us/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520685/
- https://www.medicalnewstoday.com/articles/322762.php
- https://www.nurx.com/blog/is-the-pill-safe-to-take-long-term/
- http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pil
l/480/
- http://ocsotc.org/world-map/
- http://ocsotc.org/faqs/#top
- https://bixbycenter.ucsf.edu/news/over-counter-birth-control-would-reduce-unintend
ed-pregnancies-save-money
- http://www.bbc.co.uk/ethics/contraception/against_1.shtml
- https://www.plannedparenthood.org/learn/birth-control/birth-control-pill
- https://freethepill.org/the-pill/