WASHINGTON (Nov. 27, 2019) – Currently, for the majority of women in the United States, hormonal birth control can be obtained only through a three-step process that requires a physician consultation, a prescription and a pharmacy visit. So while birth control is legal and widely prescribed, it is not easily obtained, as it requires time, transportation and money.

This is an issue that has gained momentum in recent years. Congress and state legislatures have recently sought to expand access to hormonal birth control through deregulation. Hormonal contraceptives have a record of safety and effectiveness that supports authorization of alternative access models for these highly effective birth control methods. And in a new policy paper, R Street Institute Harm Reduction Research Associate Chelsea Boyd, Harm Reduction Director Carrie Wade and Commercial Freedom Fellow Courtney Joslin make the case for allowing over-the-counter access to hormonal birth control.

The authors point out that in most jurisdictions, obtaining hormonal contraceptives requires an office visit with a healthcare provider to obtain a prescription before filling it at a pharmacy. For people living in isolated or underserved areas or who have limited economic resources, this process is unduly burdensome and decreases access to contraceptive options.

In addition, a number of medical organizations, including the American College of Obstetricians and Gynecologists and the American Medical Association, have endorsed over-the-counter access for oral contraceptive pills. They cite the product’s lengthy record of safety and efficacy, as well as studies showing that patients can accurately self-screen for potential contraindications.

Emergency contraception’s transition from prescription-only to over-the-counter could create a pathway for the deregulation of other hormonal contraceptives. Since emergency contraception like Plan B—already sold over the counter in many jurisdictions—is not intended to be used as a primary method of birth control, expanding access to highly effective regular contraceptive methods may help decrease the United States’ persistently high rate of unintended pregnancy.

The authors add, “…it is vital to address the unnecessary, top-down regulatory hurdles women face when acquiring birth control. Doing so will not only greatly improve access but will also improve measures of health for women who use it, including fewer unintended pregnancies, decreased risk of cancers, management of gynecological disorders and improved regularity of menstrual cycles.”