Over-The-Counter Birth Control Is Finally A Reality

On July 13, 2023, the U.S. Food and Drug Administration made history by approving the country's first over-the-counter oral contraception. Opill is a 28-day supply of full prescription strength norgestrel tablets, designed to be taken at the same time every day to provide hormonal regulation and protection against unplanned pregnancy. 

While the move is unprecedented for the United States, birth control pills have been approved for over-the-counter distribution in more than 100 other countries around the world. Now, just a little over a year after the controversial overturning of Roe v. Wade, increased access to the pill may help to restore autonomy to women who have otherwise felt stifled. 

Previously, the only method of contraception available to sexually active Americans without a doctor's prescription was condoms. While condoms and birth control have comparable efficacy rates when used correctly, the Nebraska Medicine University Health Center notes that pregnancy rates are drastically reduced when two birth control methods are used. The approval for Opill to be offered over the counter will open up access and options for those looking to take control of their sexual health and autonomy. 

Over-the-counter oral contraceptives are reproductive justice

The need for oral contraceptives to be an over-the-counter drug goes beyond convenience. The previous barriers to accessing the birth control pill meant that, for some, it was never really an option. The Free the Pill movement outlined the need for improved access, as obtaining a prescription often required individuals to have a regular health care provider. They also had to find transportation to a doctor's office, take time away from school or work to make an appointment, and/or gain parental consent. These steps, which may seem simple to some, meant that many low-income or historically oppressed groups had much larger roadblocks to overcome. 

The timing of the announcement is also significant. Not only has the reversal of Roe v. Wade limited abortion access and sparked fears of contraceptive restrictions, but maternal mortality is on the rise in the United States. The rate is especially high for Black women who, according to the Associated Press, are almost three times more likely to die during pregnancy or delivery compared to other races.

Implicit bias in the healthcare system means that women, minorities, and LGBTQ+ patients may not have their reports of pain or pregnancy concerns taken seriously. Contraceptives help give sexual partners or prospective parents the ability to think through these risks and concerns.

What to expect from Opill

NBC News reported that, according to a spokesperson for the manufacturer, Opill is expected to hit the shelves in early 2024. However, "hitting the shelves" may not mean that Opill is out and ready for the taking. Retailers will be able to choose where they stock the product — whether on the shelves, behind locks, or at the pharmacy counter. These placements could require consumers to ask for assistance in order to access the drugs. 

Perrigo, the manufacturer, not only has discretion over the timeline but the price. While the announcement of the official cost may be a few months away, a press statement from the company's global vice president of women's health is encouraging. "[Perrigo is] committed to ensuring that Opill is affordable and accessible to people who need it," said global vice president of women's health Frederique Welgryn, per CNN.

Of course, Opill won't be the ultimate solution to ensuring reproductive justice and access to affordable sexual healthcare. The newfound ease of acquiring the birth control pill should not shift the responsibility of using contraceptives onto females. Costs should be shared, and discussions should be had about the side effects of birth control. No person should feel obligated or pressured by their partner to take a daily drug — condoms are still available and have the bonus of protecting against STIs.