Why Isn’t Birth Control Offered Over the Counter?

Women’s History Month is here. For those of us in the liberty movement, I’d like to suggest we revisit concepts central to both – individual autonomy and freedom, particularly the idea that people should be free to make their own choices about their bodies and healthcare. 

I’m not trying to lure you into an abortion debate but rather something that should unite both sides of that polarizing issue – over-the-counter contraceptive pills. 

I first became enlightened about this issue in 2021 during the 81st Nevada Legislative Session where proposed legislation sought to empower pharmacists with the ability to prescribe birth control to women such as oral contraceptive pills. 

It was a surprise to learn that in the majority of world (more than 100 countries), women were already empowered to make informed decisions about their reproductive health and had access to the pill without government interference. Thanks to the U.S. Food and Drug Administration, however, America lags in basic reproductive freedom.

Currently, most forms of contraception require a prescription, which can create significant barriers for women, particularly those who lack access to healthcare or live in areas with limited medical resources. 

Making birth control pills available over the counter would give women greater autonomy over their reproductive health by enabling them to obtain contraception more easily and without the need for a healthcare provider’s permission.

Research has shown that over-the-counter access to birth control pills would have numerous benefits, including reducing unintended pregnancy rates and improving contraceptive use. 

A 2017 study published in the Journal of Adolescent Health reviewed decades of studies and the researchers from John Hopkins found that over-the-counter access to birth control pills increases access to contraception and reduces unintended pregnancy rates among young women without compromising safety or effectiveness. 

Another important benefit of over-the-counter birth control pills would be the potential cost savings for both individuals and society. A recent study estimated the move would result in a 5 percent to 8 percent decrease in unintended pregnancies in the United States. 

This would likely translate into millions, if not billions, of dollars saved in healthcare costs since unplanned-pregnancy rates are highest among low-income women who are more likely to be reliant on public services. In addition, removing the out-of-pocket costs of doctors’ visits for prescriptions and the introduction of over-the-counter contraceptive pills would drive increased market competition that would bring down the price of all forms of contraceptives, as occurred with allergy medication.  

Central to liberty is the idea that individuals have the right to make their own choices and decisions, as long as they do not infringe upon the rights of others. There can be no doubt this includes the right to make choices about our own bodies and healthcare. 

We know ourselves best and the evidence proves consumers can make these decisions. As the Cato Institute noted, “a 2006 report from Seattle found women’s self evaluation regarding whether or not they should take the pill matched those of doctors about 90% of the time – and the 10% of the time they didn’t match was mostly because the women were more cautious.” 

Preventing women from greater bodily autonomy is just one in a long list of issues with the FDA. The reality is that the agency has repeatedly failed us. Through its slow and lengthy approval process, it has increased the cost of our prescription drugs and denied millions of life-saving medication over the course of its existence. 

As Milton Friedman once noted, the FDA has caused “more harm by retarding progress in the production and distribution of valuable drugs than it has done good by preventing the distribution of harmful or ineffective drugs.” 

This is why it was such a big deal when the Trump Administration passed the Right-To-Try Act. Allowing patients who have been diagnosed with terminal illnesses and with no other options the opportunity to try something that could save their lives was the right thing to do. 

For far too long government intervention in our healthcare system has caused disruptions and prevented patients from getting the treatments they deserve. Thankfully there are those who want to get the government out of the way. 

Earlier this month U.S. Rep. Nancy Mace (R-S.C.) introduced The Greater Access to Contraceptive Options Act, which would urge the FDA to give priority review for applications of self-administered contraceptives, including birth control pills, patches, vaginal rings, and injections or shots while waiving FDA application fees. If enacted, it would be a positive move for women everywhere.