Last Updated:November 30 @ 05:03 pm

OB/GYNs back over-the-counter birth control pills

By Lauran Neergaard

WASHINGTON (AP) - 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. Earlier 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.

Wait, 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."

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.

Then there's the price question. The Obama 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.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe,Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexicoto buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

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  1. sexysadieComment by sexysadie
    November 21, 2012 @ 9:32 am

    Well, the women who want this to happen are actually shooting themselves in the foot. If bc pills can be bought over the counter, no insurance company will have to pay for them and I can guarantee the cost will skyrocket just like other former prescription medications have. But, then it won’t be the taxpayers having to foot the bill for someone else’s birth control.

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    • lynniehComment by lynnieh
      November 21, 2012 @ 10:27 am

      I was thinking the same thing..

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    • Blu OwenComment by Blu Owen
      November 21, 2012 @ 10:35 am

      Do you believe that taxpayers SHOULD have to foot the bill for someone else’s birth control?
      I believe these OB/GYN doctors are looking out for their patients. If they must prescribe birth control it means they would have more patients waiting for them to provide such services which in turn would severely limit the amount of time they can spend with other patients.
      Remember we can not just manufacture more doctors to cover more people.

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  2. gnafuComment by gnafu
    November 21, 2012 @ 11:12 am

    I’m in favor for some females to purchase OTC birth control pills. They have been doing this in Japan/Okinawa for many years. I also believe that responsible females should have yearly GYN check-ups and especially a check up before using OTC brith control pills. Young, unmarried females must remember that using the birth control pills will not prevent sexually transmitted diseases. If no protection is used, they are vulnerable to AIDS, Syphlus, and many other dibilitating and even deathly diseases. There are many doctors who prescribe bcp to help females regulate menstral cycles in hopes of reducing monthly cramps, etc. This should always be conducted through GYN prescriptions and follow-ups. Big Pharma will still make a good profit no matter if OTC or by prescription. After all, Big Pharma produces the birth control pills. OTC will reduce the amount of money paid to doctors for each prescription…

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  3. mysticComment by mystic
    November 21, 2012 @ 11:16 am

    Great comments by all. Thank you for morning brain candy! : }

    I was torn as I read the article. The birth control pill shouldn’t be taken lightly, and most certainly shouldn’t be taken without a doctor keeping track/eye’s on you. See the hormone levels can most certainly cause sever side effects…as well as sever health issues. At the same time, if a woman has been effectively taking the pill over a course of time, with no side effects, I could see perhaps a 3 to 6 month supply… but I would still feel much better knowing a doctor is available to her to monitor any and all side effects from taking the pill over a long period of time.

    The morning after pill. I have no idea where this person is from who wrote the article. Here, in not so sunny California today, a woman must, MUST have a doctor appt, prescription before attaining the morning after pill. Again, makes me very nervous to know a woman is taking a medication (prescription strength, not over the counter strength) without a doctor examining/diagnosing the issue.

    We’ve all become very comfortable with taking medication. Heck, I’d have a difficult time finding someone who isn’t taking at least one to two pills (vits including) a day who is in the 30+ age bracket. If this is the view medicine is going to take on birth control, then why not on blood pressure medication? Why not lower end prescription pain meds? Why not Thyroid and hormone replacement therapy pills? Why prescription strength gastric meds for G.E.R.D. and ulcers? (Think Tagament and Prilosec)

    See what I mean…there are reasons the above conditions need to be monitored, darn good reasons! Is a woman’s hormone level/preventive pregnancy any more or less important then say blood pressure or thyroid or high gastric acids? In my opinion, no…they are all equal in my mind. Requiring a doctors monitoring and assessing as the disease progresses or wanes.

    This is the beginning of Obama-care. Soon, people/public will be able to buy low grade strength antibiotics over the counter (Like Canada), low end pain meds (Again, like Canada with their Vicoden and T-3). I don’t want to be like Canada, or Mexico! I want to have access to my doctor for what my personal situation requires. Don’t pass us off onto over the counter as a way to keep doctor visits down…as all it will do is increase public needing appts for mis diagnosing yourself and creating a greater health risk for oneself.

    Gads…what a mess. Hang on people…it’s gonna be a bumpy ride.


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  4. susieqComment by susieq
    November 21, 2012 @ 12:06 pm

    What the docs are saying is that “you are on your own kid.” Read the side effects. Are they safe…really now? With insurance reimbursements going down they really don’t want to be bothered. They figure they’re not making a profit so let these women do as they will. No skin off of their teeth.

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  5. makesenseComment by makesense
    November 21, 2012 @ 9:18 pm

    This is a great but slow way to address Climate Change which is caused by having too many people living on Earth.

    Additionally, this seems to be the OBGYN’s answer to Sandra Fluke’s desire to have the government pay for her contraceptives.

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