

Buying birth control pills over the counter

The unintended pregnancy rate in the United States is abysmal, and doesn’t appear to be improving with time. Incredibly, half of the pregnancies in this country are unintended, and half of those result in abortion.  The American College of Obstetricians & Gynecologists (ACOG) released a statement this month recommending that birth control pills be sold without a prescription. I am all for any change that might increase my future patients’ access to contraception, so naturally I am excited about this recommendation.

One of the most feared side effects of the birth control pill is forming a blood clot, which can be fatal if it travels to the lungs. The risk of a blood clot is very low, less than one in five thousand for healthy women, and most of the time they are not life-threatening. It just so happens that my current research project is examining the underlying reason behind this elevated risk, so I am keenly aware of this side effect of the pill. At first, upon reading the new recommendation that pills be sold over the counter, I was hesitant. But I like ACOG’s suggestion of providing a check list with the pills so women can be alerted to the contraindications. For example, women who are over 35 and smoke have an unacceptably high risk of blood clots, so should not take the pill. (Not to mention, the risk of pregnancy-associated blood clots is many fold higher.)

Many other over the counter medications have their own health risks. Did you know ibuprofen can impair kidney function? Or that taking too much acetaminophen can cause damage to the liver? Doctors are able to warn those with preexisting kidney or liver disease that they should stay away from these medications, and I believe they would be able to do the same with birth control pills. We can trust women to make their own health care choices, along with their physicians. I support any measure that improves access to contraception and decreases unplanned pregnancy.

What are your thoughts about over the counter birth control pills? Do you think it’s about time, or it’s too risky?

Marianne DiNapoli