Over-the-counter birth control pills are closer than ever this Free the Pill Day

May 2022

Following last week’s leaked Supreme Court draft opinion rolling back abortion rights, access to the full range of reproductive health care – including abortion and birth control – is crucial. Over-the-counter (OTC) birth control pills provide one way to expand access during this time.

May 9 marks the 4th annual Free the Pill Day, commemorating 62 years since birth control pills were first approved in the United States. It’s expected that HRA Pharma will submit an application to the FDA for the first-ever OTC progestin-only birth control pill later this year — a potential groundbreaking expansion for reproductive health access. This submission is the culmination of decades of coalition-driven work and campaign efforts to raise awareness about the barriers people face to accessing birth control and the need for more equitable access to contraception, including OTC birth control pills. 

More than 99% of women ages 15-44 in the US who have ever had sex have used some form of birth control and 60% are currently using birth control. OTC birth control pills have broad support among a range of groups, including health care providers, policymakers, people across the political spectrum, parents, and birth control users themselves, with 70% of women of reproductive age supporting making birth control pills available OTC. With a submission to the FDA anticipated this year, advocates and champions are elevating the barriers people face to birth control pills and the need for OTC access. This includes:

Advocates for Youth, alongside nearly 300 young people across the country, launched a campaign to leave fake birth control pill boxes with QR codes on the shelves at local drugstores and student stores to help people imagine what it would look like if birth control pills were available OTC.  

Last month, over 60 coalition members, including advocates, researchers, and provider organizations, submitted a letter to FDA commissioner Dr. Robert Califf urging the agency to follow the science when it considers any application for an OTC birth control pill.

Members of the House Pro-Choice Caucus, led by Rep. Barbara Lee, Rep. Diana DeGette, Rep. Ayanna Pressley, and Rep. Judy Chu, submitted a letter to the FDA calling on the agency to advance public health and follow the science as it reviews upcoming applications for OTC birth control pills.

Organizations are taking to social media to voice their support for why birth control pills need to be available OTC by using the hashtag #FreeThePill.

“Equitable access to birth control gives us the freedom to make decisions about our health, bodies, and lives with dignity and respect,” said Victoria Nichols, project director of Free the Pill, a campaign to educate and engage in support of OTC birth control pills in the US. “For more than 15 years, advocates across the country have voiced their support for bringing birth control pills over the counter, and now – at this pivotal moment for reproductive health access – we’re closer than ever to that being a reality.” 

Birth control pills are one of the best-studied medicines on the market and are about 99% effective when used exactly as directed and 91% effective with typical use. People are able to determine if birth control pills are right for them by using a simple checklist.

“Now more than ever, we must be vigilant in our efforts to expand access to affordable and effective birth control,” said Belle Taylor-McGhee, who serves on a national steering committee working to bring oral contraceptives OTC in the US. “It’s time we make the pill an over-the-counter product for people who need it. Eliminating unnecessary barriers to the birth control pill is not only good science, it’s a commonsense approach to sound reproductive health care policy.”

Despite its proven safety and efficacy, people still face barriers to getting a prescription for birth control pills. One-third of adult women in the US who have ever tried to obtain prescription birth control reported barriers to access. These barriers include the cost of a visit with a health care provider, lack of insurance coverage, time away from work or school and other disruptions, transportation, and finding childcare. These barriers fall harder on people of color and Indigenous peoples, young people, immigrants, LGBTQ+ folks, those working to make ends meet, and people with disabilities because of systemic and structural inequities. The same communities who face barriers to birth control access bear the brunt of abortion restrictions and can find themselves with a lack of options when it comes to reproductive health care.

"Young people, in particular, need the pill available without a prescription because we struggle to find transportation and time away from class or work to get to a doctor's appointment, and some even face stigma from parents or doctors who don't think we should be in charge of our own sexual health,” said Bex Heimbrock (they/them), Free the Pill youth council member. “Young people are imagining a world where people with uteruses can have easy and affordable access to the birth control pill, where someone can simply go to their local drugstore and purchase the pill right off the shelf. This is already a reality in over 100 countries, so why isn’t it a reality here in the US?"

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Free the Pill, operated by Ibis Reproductive Health, is a campaign to educate and engage in support of over-the-counter (OTC) birth control pills in the United States that are affordable, fully covered by insurance, and available to people of all ages. Campaign activities are driven by a coalition of more than 100 reproductive health, rights, and justice organizations, research and advocacy groups, youth activists, health care providers, prominent medical and health professional associations, and other professionals, who have been working since 2004 to build the evidence in support of OTC birth control pills in the United States.