Have you ever opened your medicine cabinet and realized you’re out of birth control pills—only to call your doctor’s office and learn the next available appointment is in two months? Unfortunately, many of us can easily envision this frustratingly common scenario. But it doesn’t have to be like this, if the Food and Drug Administration follows scientific evidence and makes a final decision this summer to approve the first over-the-counter daily oral contraceptive pill.
In May, an expert advisory committee voted 17-0 in favor of granting over-the-counter status to the pill without restrictions. The next step is for the FDA to issue its final ruling, which could happen in the next couple of months.
“I think that it’s really an access issue,” Dr. Katalin Roth of George Washington University said at the FDA advisory committee hearing. “We know that access is even worse than it used to be given a number of socio-economic factors and disparities. I don’t see why the general population of women cannot safely have this medication available over the counter … I think that making it available over-the-counter is the right thing for women.”
As a family physician, I see firsthand the urgent need to eliminate medically unnecessary barriers to birth control. I’m also familiar with the scientific data and strongly encourage the FDA to move swiftly to take the next step and allow the pill to be sold on store shelves.
We have decades of evidence that shows people are capable of safely using birth control pills over the counter. It’s already available without a prescription in more than 100 countries. Here in the United States, the medical community has coalesced in support of making the pill available without a prescription.
Leading experts from the American Academy of Family Physicians, American College of Obstetrics and Gynecology, and American Academy of Pediatrics have all supported the change. So what’s the delay? With the advisory committee’s recommendation, the FDA is closer than ever to making over-the-counter access to birth control pills a reality.
As a family medicine physician practicing in New York City, I see people with barriers to contraceptive access on a regular basis. Many people think an urban area like New York City would have no issue with access, but that’s just not the case.
I work in a large family medicine practice with locations around the city, and it’s not unusual for a patient to have to wait months to get an appointment with their primary care provider. Wait times aside, for people without insurance, the trip to a doctor’s office can be prohibitively expensive. Others may have difficulty getting time off work or can’t afford to lose income from an hourly job to keep food on the table. Some struggle to find child care or coverage for other obligations, like tending to a sick family member.
And all these problems, along with others, are magnified for those living in rural areas, who often need to travel long distances to the closest doctor’s office, even if they don’t own a car. Of course, these issues highlight existing, systemic disparities in health-care access. They also underscore outcomes that already weigh most heavily on medically marginalized communities—like Black and Indigenous communities, recent immigrants, people with disabilities, LGBTQ+ people, and children.
I see people of all ages and genders at my practice, those with insurance and without it. Most of my patients are of reproductive age and contraception is one of the most common reasons people come into the office to see me. Some methods, like placing a long-acting contraceptive device, will always require a doctor’s visit, but people shouldn’t have to make the trek to my office just to get birth control pills. I know my patients can read the label and make a safe decision for themselves, just like they do with more dangerous medications like acetaminophen (Tylenol). The medical community already knows that this change is safe and effective, but it’s also important to recognize that this is a necessary step in ensuring reproductive freedoms in our communities.
I commend the FDA advisory committee for following the sound scientific evidence and unanimously voting to recommend over-the-counter access to the birth control pill. I strongly urge the FDA to adhere to the medical evidence in this case and make the right decision for my patients and reproductive health and equity nationwide.
To keep an eye on what’s happening, check out #FreeThePill and @ThePillOTC on social media. I look forward to telling my patients that they can pick up their birth control pills at their convenience—no office visit required.