Should the Birth-Control Pill be sold without a prescription?

An over-the-counter version has long been called for, but it could soon be available if a group of practitioners and advocates have their way. When Kelly Blanchard advocated to make oral contraceptives over the counter in New York Times op-ed two weeks ago, she represented a decades-long movement among clinicians, researchers, and women’s-health advocates to remove prescriptions as a barrier to pill access. As early as 1993, Charlotte Ellertson—founder of Ibis Reproductive Health, of which Blanchard is now president—made a similar argument against the prescription status of oral contraceptives in the American Journal of Public Health.

Now a group of health workers and advocates are taking advantage of a mounting body of research that shows the pill could be safe for nonprescription use. They hope to have a proposal before the FDA within the year and an over-the-counter pill available in five years. And though their work focuses on female reproductive care, it offers a glimpse into what the future of American health care and medication could be. Members of the Oral Contraceptive Over-the-Counter Working Group, a women’s-health clinical and research institution funded by the Hewlitt Foundation and administered by Ibis Reproductive Health, believe that prescription-only access to birth control is patronizing to women, limits contraceptive freedom, and is ineffective against intractably high teen-pregnancy rates. Teenagers are particularly vulnerable to access problems because it is harder for them to get to a doctor without a parent’s help. Almost 20 percent of sexually active teens who do not want to become pregnant are not using contraceptives, according to the Guttmacher Institute. And teenage girls who do not use contraception during their first sexual experience are twice as likely to become teen mothers as their counterparts who use protection. “I think we see a range of problems with access today; clearly there are economic barriers to access,” says Amy Allina, program and policy director of the National Women’s Health Network and a member of the working group. “But there are also barriers that have more to do with the logistics of insurance, or the policy at the doctor’s office.”