Largest OB-GYN organization urges over-the-counter birth control

The American College of Obstetricians and Gynecologists issued a call Tuesday for birth control pills to be sold over the counter. Currently oral contraceptives are available only with a doctor’s prescription.

In a policy statement, the organization argues that making birth control pills easier to get will translate into fewer unwanted pregnancies. These unplanned pregnancies remain a major problem in the United States, they write, accounting for approximately 50% of all pregnancies. And such pregnancies, they argue, do not just interrupt lives -- they also cost a fortune, with a price tag of approximately $11.1 billion per year, according to an analysis published in the academic journal Perspectives on Sexual and Reproductive Health.

According to the obstetricians and gynecologists, one major reason women at risk for unintended pregnancies don’t use birth control is that they don’t have regular access to a doctor, either for practical reasons or because they are uninsured. And in a 2004 telephone survey conducted by an Oakland based nonprofit, 47% of the uninsured women who currently do not use birth control say they would use it if it were available over the counter, like Tylenol or Benadryl. Another recent survey, conducted by public health experts in Texas, found that 60% of women not on birth control pills would use it if they could buy it without a prescription. Such statistics, they argue, make plain the need to increase access.

One argument commonly used to argue against making hormonal contraceptives like the pill available over the counter is that they can harm patients if they are not properly screened for contraindications. But the obstetricians and gynecologists point to several studies showing that individuals can successfully screen for such potential problems -- and that pharmacists, rather than physicians, can also successfully fill that role.

Another argument the doctors seek to debunk is that women who receive their contraception over the counter will forego other health screening services, such as pap smears to check for cervical cancer and screening for sexually transmitted infections, because they only see their doctor when necessary to acquire birth control. But the group argues that “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating [oral contraception] use and should not be used as barriers to access.” What’s more, studies show that such fears are unfounded, they write.

One issue that the group concedes is a real hurdle is the potential for increased costs. Currently, birth control is covered by health insurance; whether that would continue if the pills were available over the counter is unclear.

Nevertheless, the group writes, “Weighing the risks versus the benefits based on currently available data, [oral contraceptives] should be available over-the-counter.”

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