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Should the Pill Be Accessible Without a Prescription?

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The 15 Questions

If you answer “yes” to any of these questions, talk with a health care provider before using the pill:

1. Are you a smoker age 35 or older?
2. Do you think you might be pregnant?
3. Have you had a baby in the past 3 weeks?
4. Are you currently breastfeeding and is your baby less than 6 months old?
5. Do you have high blood pressure?
6. Have you had a heart attack or stroke?
7. Do you have heart disease?
8. Have you had a blood clot (thrombosis) in your lung or in your leg (NOT just varicose veins)?
9. Do you have diabetes?
10. Do you have migraine headaches?
11. Do you have liver disease or have you had liver cancer?
12. Do you have gall bladder disease?
13. Have you had breast cancer?
14. Do you take medicine for high cholesterol?
15. Do you take medicine for seizures or tuberculosis (TB)?

Would women buy the pill OTC?

A nationwide survey of reproductive-age women in the U.S. found that over two-thirds (68%) would buy contraceptives from a pharmacist and skip the doctor’s appointment. Women with lower incomes and women without health insurance were particularly interested in this option. Clearly, getting to and paying for clinic visits can make accessing prescription-only pills more hassle than it’s worth for some women. The majority of women surveyed agreed that the pill should be available without a prescription if a pharmacist would help women decide whether it was safe for them.

Women in other countries have been buying the pill OTC from pharmacies or community distribution centers for decades. So, are they more likely than women who get the pill by prescription to use it when it’s not safe for them? One study compared women in Mexico who got the pill from a clinic versus those who got it from a pharmacy and found no difference between the two groups—a small percentage of women in both groups (2%) shouldn’t have been using the pill. That suggests going to a clinic doesn’t guarantee that women are screened for health conditions before getting the pill.

And screening seems to be skipped in the U.S., too. A national study showed that 6% of U.S. women who use the pill probably shouldn’t. In this study, the majority of women who shouldn’t have been using the pill were over 35 and smoked heavily, or had a history of breast, cervical, or uterine cancer. Ironically, selling the pill behind-the-counter with pharmacists trained to screen women for safe pill use could ensure that fewer women slip through the screening cracks.

If this is such a great idea, why hasn’t it happened yet?

There is one potential downside to selling the pill OTC. Some women now have access to free or low cost prescription pills via Medicaid and private health insurance. Health insurance doesn’t typically cover OTC drugs like ibuprofen and cough syrup. If the pill were sold OTC, women now covered by Medicaid—who most need affordable methods of birth control—could be faced with higher prices. But there are several ways to address this problem:

  • In some states, Medicaid covers existing OTC methods like condoms, and this coverage could be expanded to OTC pills.
  • Not all brands of the pill would make the switch to being sold OTC at once, and it’s likely that at least some of the prescription-only brands would still be covered by Medicaid and private health insurance.

There is another potential downside that some people talk about, but it’s actually a red herring. The argument is that the pill should stay prescription-only because it reinforces yearly Pap tests and pelvic exams for women. The truth is that neither of these tests is required to use the pill. As Dr. David Grimes wrote in 1995, “women should not have contraception held hostage because of unrelated screening tests.” Despite that, many health care providers still require the tests before prescribing the pill, and the majority aren’t using the new national guidelines that call for less frequent Pap tests. The final nail in the coffin of this argument is that there is no evidence that women who use OTC birth control stop going to clinics or doctors for care.

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Read more: College Life, Dating, Friendship, Gynecology, Health, Life, Love, News & Issues, Pregnancy, Relationships, Sex, Sexual Health, Teens, Women's Health

Originally published on bedsider.org.

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Everyone should have the life they want, when they want it. And until someone is ready to have a baby, we believe they should have access to birth control. That’s where we come in. Bedsider makes birth control easier. How? By giving you everything you need to find it, get it, and use it well.

30 comments

+ add your own
2:04PM PST on Nov 4, 2012

Sounds like a lot of the comments refute some of the claims of the article. I'm still undecided.

12:38PM PDT on Oct 19, 2012

Depends upon what pill it is. it depends on the circumstance always.. you cant put a blanket truth on anything.

8:59PM PDT on Oct 18, 2012

I'm not sure how I feel about this. I think it would be a lot more convenient. But I also think its important to discuss with a doctor which pill you should take. Some people may be more sensitive to the pill so they need a lower dose of hormones. I think it would be a good idea if instead you could ask a pharmocologist instead on advice of which pill you should take.
I think that it would be a good idea!

6:43AM PDT on Oct 18, 2012

Intersting idea. Thanks for presenting it.

8:17AM PDT on Oct 16, 2012

I really don't see a good reason why not...

4:53AM PDT on Oct 16, 2012

TY

1:51AM PDT on Oct 16, 2012

I guess, it should be available over the counter just like so many other things are --- should be the person's choice without doctors consent!

1:26AM PDT on Oct 16, 2012

if it does not interfere in the yearly medical tests that women should take and there are no major health risks for taking too much/frequent then it can be considered. however, i would still advocate responsible behaviour from the younger generation. this cannot be the solution for them to sleep around and do as they please.

1:16AM PDT on Oct 16, 2012

Thank you for the interesting article.

11:22PM PDT on Oct 15, 2012

YES!!! OF COURSE!!! We need to do EVERYTHING possible to end unwanted pregnancies! The world is WAY overpopulated and does not need any more unwanted children.

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

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