Nearly a third of people using over-the-counter birth control pills previously used nothing, study finds

Over-the-counter birth control pills have been gaining popularity since the U.S. Food and Drug Administration approved the first OTC pill two years ago. A recent study published in JAMA Network Open looked at who is making the switch to this convenient form of contraception and why.

Researchers surveyed 986 individuals, aged 15 to 45, from 44 states who obtained the over-the-counter pill either online or at a pharmacy. The study revealed that a significant number of users had transitioned to the OTC pill from a less-effective birth control method or from using no contraception at all.

The survey found a 31.8 percentage point increase in usage among individuals who had previously used no contraceptive method. Additionally, there was a 41 percentage point increase in those who switched from less-effective methods such as condoms or emergency contraception.

Opill, the over-the-counter progestin-only pill manufactured by Perrigo, offers a convenient option for accessing oral contraceptives without the need for a prescription. The FDA’s decision to approve OTC birth control pills aimed to reduce barriers to access, as nearly half of the 6.1 million pregnancies in the U.S. each year are unintended.

Lead author Dr. Maria Rodriguez, a professor of obstetrics and gynecology at Oregon Health & Science University School of Medicine, highlighted that the study is one of the first to demonstrate that OTC birth control pills are reaching individuals who face significant barriers to care. Those accessing the OTC pill were more likely to be uninsured, younger (ages 15-20), and living in rural areas.

The primary reasons cited for choosing the OTC pill in the survey were the absence of the need for an appointment and not having a regular physician. Dr. Jessica Shepherd, a board-certified OBGYN and Chief Medical Officer of healthcare company Hers, emphasized that while increased access to contraception without prescriptions can be transformative for women with limited resources, it also underscores the far-reaching consequences of unplanned pregnancies on healthcare systems and communities.

Dr. Shepherd noted that unplanned pregnancies often lead to higher maternal and infant health risks, financial strain, and long-term socioeconomic challenges, particularly impacting women facing barriers to care. The study’s findings highlight both the progress made in reproductive healthcare and the persistent gaps that exist.

As the discussion around OTC birth control pills continues, it is important to recognize the potential benefits they offer in terms of reproductive autonomy while also addressing the broader issues surrounding unplanned pregnancies and access to comprehensive healthcare services.