Over-the-counter access to oral contraceptives could help increase use

Unintended pregnancy is a significant public health issue in the United States, accounting for half of all pregnancies. One significant contributing factor is that many women have problems accessing contraceptives. Additionally, women who have abortions are at high risk for future unintended pregnancy, and are therefore an important population to include when examining barriers to contraceptive access.

Making oral contraceptive pills accessible over-the-counter (OTC) may improve the availability of this effective method. OTC access could also be attractive to women who have difficulty obtaining prescriptions, including some women seeking abortion. Researchers with the UCSF Bixby Center surveyed women seeking abortions across the United States to gauge their interest in obtaining the pill OTC.

The researchers found a high level of interest in OTC access:

• 81% of participants supported OTC access to oral contraceptives.
• 42% planned to use the pill after their abortion. This increased to 61% if it were available OTC.
• 33% who planned to use no contraceptive following abortion said they would use an OTC pill, as did 38% who planned to use condoms afterward.
• Uninsured participants showed greater interest in OTC access than those with private insurance.

Oral contraceptive use among women at high risk of unintended pregnancy may increase if the pill were available without prescription. Women consider OTC access convenient and timesaving compared to clinic visits. The pill is already formally or informally available without a prescription in many countries.