This undated image provided by Bedsider.org shows a package of estrogen/progestin birth control pills. The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms. The surprise opinion announced Tuesday, Nov. 20, 2012 could boost longtime efforts by women's advocates to make the pill more accessible. (AP Photo/Bedsider.org)
WASHINGTON • No prescription or doctor’s exam needed: The nation’s largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.
Tuesday’s surprise opinion from these gatekeepers of contraception could boost longtime efforts by women’s advocates to make the pill more accessible.
But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it’s not clear if any are considering it. Plus there are big questions about what such a move would mean for many women’s wallets if it were no longer covered by insurance.
Still, momentum may be building.Already, anyone 17 or older doesn’t need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex.
This year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.
Now the influential American College of Obstetricians and Gynecologists is declaring it’s safe to sell the pill that way.
Why would doctors who make money from women’s yearly visits for a birth-control prescription advocate giving that up?
Half of the nation’s pregnancies every year are unintended, a rate that hasn’t changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.
“It’s unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem,” said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.
Many women have trouble affording a doctor’s visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.
If the pill didn’t require a prescription, women could “pick it up in the middle of the night if they run out,” she said. “It removes those types of barriers.”
Doctor here agrees
Barriers to birth control clearly lead to unintended pregnancy, said Dr. Colleen McNicholas, a Washington University gynecologist who specializes in family planning.
“A lot of times what we unfortunately see are women coming in to initiate birth control and finding out they’re pregnant,” McNicholas said. “Some of the most common barriers to women getting birth control or using it are cost and convenience. It’s not convenient enough the way that our system works now.”
Easier access to affordable contraception is key to reducing unintended pregnancies and subsequent abortions, according to researchers at Washington University. The Contraceptive Choice Project has offered free birth control to more than 9,000 women in the St. Louis area since 2007. The abortion rate in the area declined by more than 20 percent from 2008 to 2010.
Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.What price?
Then there’s the price question. President Barack Obama’s administration’s new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.
If the pill were sold without a prescription, it wouldn’t be covered under that provision, just as condoms aren’t, said Health and Human Services spokesman Tait Sye.
ACOG’s opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month’s supply.
