Overwhelming evidence from across the globe has shown that access to comprehensive reproductive health information and services, including the full range of contraceptive methods, leads to both public and individual health and wellbeing.
But for the past several years, the Trump administration has sought to restrict access to high-quality care at every turn, most recently through a domestic “gag rule” that threatens to cut 4 million people off from Title X’s contraception and other preventive health care entirely, creating an urgent public health crisis.
The government’s actions mean the efforts of public health experts, researchers, activists, policymakers and individuals committed to ensuring everyone has the right and the resources to access birth control are more critical than ever.
A number of states are attempting to step in with stop-gap funding rather than expecting clinics providing Title X services within their borders to comply with the restrictions demanded by the Trump administration’s new policies. Nationally, Planned Parenthood is also using emergency funds following their decision to not comply with the policy — a decision that has forced them out of the Title X program.
These stop-gap measures are neither a long-term nor close to complete solution. People should not have to worry about whether they’ll have access to family planning resources like contraception. More than 99 percent of women of reproductive age who have ever had intercourse have used birth control and almost two-thirds of women aged 15-49 are currently using it.
Over the more than five decades since their FDA approval, birth control pills have become a routine part of life for Americans. The pill is the most popular form of non-permanent birth control, with more than 9 million currently choosing it for pregnancy prevention, helping to regulate their periods and for other health benefits (did you know that it can help to prevent certain cancers like ovarian cancer).
Despite the widespread usage of contraception, including the pill and the critical role that in plays in our lives, we know that many people face access barriers and that these disproportionately impact young people, low-income people, people of color and immigrants.
Nearly one in three adult women at risk of unintended pregnancy has experienced difficulties getting prescription birth control, including not having a regular health-care provider, the distance to visit a health-care provider, the cost for an appointment, lack of insurance and time spent away from work and family. Difficulties in accessing contraception will only get worse with reductions in Title X funding for reproductive health care.
No one should be denied access to safe and effective contraceptive methods. Each of us is an expert on our own life and health and should have the ultimate authority to make decisions about them. In addition to key safety net programs like Title X, we also need new, proactive and bold ways to make contraception easier to access for all. Evidence shows that making the birth control pill available over the counter (OTC) is long overdue.
Birth control pills are some of the best-studied medicines on the market today, enjoy longstanding support from medical and public health experts and decades of research and experience show they are safe for over-the-counter use. People in more than 100 countries already benefit from the pill being available OTC, reducing the hurdles and costs of requiring doctors’ appointments. It’s long past time we joined them.
Making an OTC pill available to people of all ages with all forms of insurance — while ensuring affordability for those without insurance coverage — would circumvent many of the accumulating barriers to access and help to address inequities in accessing birth control for those choosing the pill.
The Affordable Care Act increased access to FDA-approved methods of contraception by eliminating cost sharing. FDA-approved OTC contraceptives should be covered the same way to ensure everyone can access them.
Let’s set our sights on a future where our contraceptive options better meet all our needs. That includes just policies to ensure everyone has the full spectrum of health care they need, and a birth control pill that’s available over the counter.
Kate Grindlay Kelly MSPH, is an associate at Ibis Reproductive Health.