Why Does Birth Control Require a Prescription?

California was the latest of three statesáthis year to make hormonal birth control available over-the-counter.

But birth control methods like the pill or patch haven’t reached Tylenol status yet. Peopleámustámeet with a pharmacist before taking the meds home. That said, the newfound accessibility of these methods is still helpfuláto those without insurance or resources to cover a doctor’s visit.

AsáReason.com editoráElizabeth Nolan Brownásays, over-the-counter birth controlácouldáhelp a variety of individuals, includingá”an undocumented immigrant, a sexually active 19-year-old whose parents disapprove, a woman in an abusive marriage, [or] a woman who forgot to pack her pills while on vacation.”

Too bad California, Washington, Washington D.C. and Oregon are the only statesáwho even offer the option. The U.S. remains part ofáaáminority of countries that still require a prescription to use hormonal birth control, according to a study published in Contraception.

A handful of other states recently proposed similar legislation, which hasánot yet passed.

Furthermore, the Food and DrugáAdministration has deliberatedáoverámaking hormonal birth control fully over-the-counter for more than 20 years.áRight now, the most states can do is let medical professionals other thanádoctors — like pharmacists — dispense the medication.

So, what’s the holdup?

Back in 2012, theáAmerican College of Obstetricians and Gynecologistsárecommendedáthe U.S. stop requiringáa prescription for birth control, calling unintended pregnancy a “major public health problem” — about half of American pregnancies are unplanned. The American Medical Association and American Academy of Family Physiciansáagree.

The hesitance to change birth control’sástatus becomes even more puzzling when the more stronglyádosedáPlan Báemergency contraceptive is already available over-the-counter nationwide.

Critics say that hormonal contraceptives carry a host of potential side effects,álike blood clots, that can be life-threatening. They argueáthat doctors need to screen for conditions that put patients at risk and educate them.

Others addáthat requiring a doctor’s visit to re-up a birth control prescription gives providers the opportunity to talk about other methods of contraception, as well provide additionaláreproductive health services, like screening for STIs.

While these arguments do have some merit, their rebuttals are pretty convincing. As Brown argues, plenty of OTC drugs can also lead toábad side effects. And manyácarry a risk of overdose that hormonal birth control doesn’t.

For some perspective, Brown offers,ápeople get blood clots from their birth control at half the rate they get blood clots from pregnancy.

Furthermore, for those who claimáa doctor needs to screen patients for susceptibility to side effects: Research indicates that most women are just as adept at screening themselves for risk factors related to taking birth control. That fact should makeáconsulting a medical professional optional rather than a must.

To be sure, over-the-counteráhormonal birth control isn’t the end-all, be-alláto access. As the Guttmacher Institute notes, drugs can becomeámore expensive when they don’t require prescriptions. Furthermore, insurance companies might stop funding birth control if people buy it off the shelf.

Andáas seen with Plan B, even in the states that do allow for OTC birth control, not allápharmacies have the birth control available.

Los Angeles Times reporter Sarah Elizabeth Richardsáalso makes a good point when she notes that the most reliableáforms of birth control, besides abstinence,ástill require a doctor’s visit in all 50 states — implantable rods or intrauterine devices.

Even with its drawbacks, birth controláaccessibilityáis necessary for reproductive rights.

We live in a country where too many states try to denyácitizens’ right to aásafe, legaláabortion, while restricting access to more proactive birth control methods and medically accurate sex education in school.

Socially conservative politicians celebrateácuttingáfunding to family planningácenters like Planned Parenthood, which seems counterintuitive when they claim to care about strong families. Children should always be born wanted, witháparents preparedáto care for them.

In fact, the nation’s refusal to remove theáprescription requirement for birth control seems partly grounded in good, old-fashioned misogyny, alongside a cultural fear of sex. Too often folks act likeáwomen’sáhealth decisionsáneed to be managed for them, rather than letting women decideáfor themselves.

I, for one, find it strange thatáthe only FDA-approved male birth controlá– condoms –áis widely available, while the majority ofáfemale birth control methods require a doctor’s approval.

Photo Credit: Thinkstock


Kadir c
Kadir c.3 months ago


John B
John B6 months ago

Thanks Emily for sharing the info.

Jim Ven
Jim Ven9 months ago

thanks for sharing.

william Miller
william Millerabout a year ago

all about control

Margaret Goodman
Margaret Gabout a year ago

Susan T. wrote, " ... Don't screw someone unless you a READY to have a CHILD. ... " Whew! So a married woman who has had as many children as she and her spouse can afford should stop having intercourse with her spouse??

Margaret Goodman
Margaret Gabout a year ago

For Nicole P. of Canada, going to the doctor once a year is no big hardship. But for an uninsured/underinsured woman in the United States it can be prohibitively expensive, not to mention the loss of any income while she goes to the doctor.

Marie W.
Marie Wabout a year ago

Not in Oregon anymore.

Siyus Copetallus
Siyus Copetallusabout a year ago

Thank you for sharing.

Christine V.
Christine Vabout a year ago

I think a doctor should prescribe it