By the end of the summer, at least half of states are poised to ban or severely limit abortion. At least eight have already implemented bans. And there’s no guarantee that anti-abortion lawmakers are stopping at abortion, either: law experts have cited fertility treatments, miscarriage care, and even birth control as possible next targets the legislative chopping block. In fact, anything that might prevent conception might soon become illegal in some states if the decision is left up to rightwing lawmakers.
Since the draft opinion overturning Roe was leaked in early May, there’s been a dramatic spike of interest in long-acting reversible contraception such as IUDs and implants. While solely focusing on the increased use of birth control won’t stop the need for abortion access, birth control remains a critical tool to prevent pregnancies in states where giving birth is the only choice.
“There has long been a tremendous unmet need to improve access to modern, reliable contraception in the United States,” said Geralyn Ritter in a statement, a health care policy expert and executive vice president at Organon & Co. “Even worse, the United States has one of the highest maternal mortality rates in the developed world. The disparities among communities are galling; Black women are three times more likely to die than white women in childbirth. Now, more than ever, it is critical that women have access to the contraceptive method of their choice.”
Ibis Reproductive Health, a global research and advocacy organization that works to advance sexual and reproductive health worldwide, has led a coalition-driven effort called Free The Pill of more than 100 organizations for two decades to make birth control pills accessible over the counter (OTC).
In 2016, Ibis partnered with HRA Pharma to conduct the research necessary to transfer Opill from prescription to OTC, and last week, HRA Pharma submitted its application to the U.S. Food and Drug Administration to officially make the switch. Opill is a progestin-only, daily birth control pill and, if it’s approved, it would become the first OTC birth control pill in the United States.
In a statement, Free the Pill Project Director Victoria Nichols said, “Research has documented that the prescription requirement is a barrier for many people and can push birth control out of reach because it means a potentially costly healthcare provider’s visit, taking time off of school or work to get to the appointment, and more.”
According to Free the Pill, oral contraception is one of the safest and most studied medications in the world. For Elizabeth Ruzzo, the founder of adyn, which is the first test designed to prevent birth control side effects, the benefits of an OTC birth control pill far outweigh the risks.
But the need for OTC pills is also an economic one. Despite declines in unintended pregnancy rates, the annual direct medical cost of unintended pregnancy in the United States increased from $4.6 billion in 2011 to $5.5 billion in 2018. In a country where abortion is no longer accessible to many people, these costs will skyrocket, impacting those who already struggling.
“These barriers are even more challenging for people already facing obstacles to accessing essential healthcare because of systemic racism and other oppressions,” Nichols adds. “Over-the-counter birth control pills would reduce many of these barriers and advance health equity.”
OTC pills present an opportunity to reclaim our power from the hands of the state. It would mean that anti-abortion politicians would have less power to dictate what we do with our bodies and when.