Why Does Birth Control Require a Prescription?

California was the latest of three states this 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. People must meet with a pharmacist before taking the meds home. That said, the newfound accessibility of these methods is still helpful to those without insurance or resources to cover a doctor’s visit.

As Reason.com editor Elizabeth Nolan Brown says, over-the-counter birth control could help a variety of individuals, including ”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 states who even offer the option. The U.S. remains part of a minority 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 has not yet passed.

Furthermore, the Food and Drug Administration has deliberated over making hormonal birth control fully over-the-counter for more than 20 years. Right now, the most states can do is let medical professionals other than doctors — like pharmacists — dispense the medication.

So, what’s the holdup?

Back in 2012, the American College of Obstetricians and Gynecologists recommended the U.S. stop requiring a 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 Physicians agree.

The hesitance to change birth control’s status becomes even more puzzling when the more strongly dosed Plan B emergency contraceptive is already available over-the-counter nationwide.

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

Others add that 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 additional reproductive 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 to bad side effects. And many carry a risk of overdose that hormonal birth control doesn’t.

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

Furthermore, for those who claim a 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 make consulting a medical professional optional rather than a must.

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

And as seen with Plan B, even in the states that do allow for OTC birth control, not all pharmacies have the birth control available.

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

Even with its drawbacks, birth control accessibility is necessary for reproductive rights.

We live in a country where too many states try to deny citizens’ right to a safe, legal abortion, while restricting access to more proactive birth control methods and medically accurate sex education in school.

Socially conservative politicians celebrate cutting funding to family planning centers like Planned Parenthood, which seems counterintuitive when they claim to care about strong families. Children should always be born wanted, with parents prepared to care for them.

In fact, the nation’s refusal to remove the prescription requirement for birth control seems partly grounded in good, old-fashioned misogyny, alongside a cultural fear of sex. Too often folks act like women’s health decisions need to be managed for them, rather than letting women decide for themselves.

I, for one, find it strange that the only FDA-approved male birth control – condoms – is widely available, while the majority of female birth control methods require a doctor’s approval.

Photo Credit: Thinkstock


JoAnn Paris
JoAnn P4 months ago

Thank you for this very interesting article.

Kadir c
Kadir c.1 years ago


John B
John B1 years ago

Thanks Emily for sharing the info.

Jim Ven
Jim V2 years ago

thanks for sharing.

william Miller
william Miller2 years ago

all about control

Margaret Goodman
Margaret Goodman2 years 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 Goodman2 years 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 W2 years ago

Not in Oregon anymore.

Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing.