FDA could approve over-the-counter birth control this summer

The era of requiring a prescription to obtain the birth control pill may be approaching its end.

Earlier this month, advisers to the U.S. Food and Drug Administration (FDA) voted unanimously in support of making Opill, a birth-control pill that was first approved by the FDA in 1973, available over-the-counter. The move would be significant, not only as an option for birth control as abortion restrictions are taking hold across the country, but also because it's a move that  "Free the Pill" advocates and organizations like the American College of Obstetricians and Gynecologists (ACOG) have long advocated for and supported.

"There are many nations around the world where you can access progestin-only and a combination of oestrogen- progestin pills over the counter, or at least by talking with the pharmacists," Dr. Anne-Marie Amies Oelschlager, a pediatric gynecologist and chair for the clinical consensus gynecology committee for ACOG, told Salon. "So our country is kind of behind the times when it comes to access to birth control pills."

In a global review of over-the-counter access to oral contraceptives, researchers found that oral contraceptives were informally available without a prescription in 38 percent of 147 countries surveyed, and legally without a prescription in 42 percent of countries surveyed. The researchers concluded that a majority of the world doesn't need a prescription to access oral contraceptives.

As mentioned, the pill that could be the first over-the-counter contraceptive available in the United States is called Opill, which has the generic name norgestrel. It was first FDA-approved in 1973 as a progestin-only medication, referring to the class of drugs it falls under. Compared to combination oestrogen-progestin pills, norgestrel carries fewer risks, such as blood clots. Opill works by thinning the lining of the uterus, which can prevent sperm from reaching an egg by thickening mucus in the cervix.

Amies Oelschlager said right now prescriptions are a barrier to access birth control in the United States.

"Whenever we introduce barriers to obtaining effective contraception, we decrease the chance that people can access it," she said. "[This] disproportionately affects people who live in poverty, people who live far away from a pharmacy, people who don't have access to health care providers who will prescribe it and it also disproportionately affects adolescents who have less autonomy over their reproductive health decisions compared to adults."

Want more health and science stories in your inbox? Subscribe to Salon's weekly newsletter The Vulgar Scientist.

Indeed, one study published in The Journal of Health Politics, Policy and Law in 2021 found that low-income people and people of color are more likely to live in contraception deserts.

'There are a lot of areas which we call contraceptive deserts in our country, and these are areas where there's very little access to reproductive health providers or healthcare providers in general," Amies Oelschlager said. "People have to drive long distances to be able to access a health care provider and then additionally, they might have to drive or somehow find transportation to go a long distance to access a pharmacy."

FDA panelists stressed that adolescents would especially benefit from over-the-counter birth control access, who have less autonomy over their reproductive decisions.

The FDA is expected to make a final decision later this summer. While the agency doesn't have to follow the recommendation of the panel, it often does.

"In a historic step forward for reproductive health, a joint FDA advisory committee voted on Tuesday in favor of moving a progestin-only birth control pill over the counter," said Victoria Nichols, Project Director of Free the Pill in a media statement. "The days of the current prescription requirement are numbered."