Why Isn’t the Pill Available Over the Counter?

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When a federal judge ruled that the FDA had no scientific reason to require a prescription for emergency contraception at any age earlier this month, some wondered why we should bother with birth control prescriptions at all. Oral contraceptives are basically the same drug as Plan B, but in smaller doses. The American College of Obstetricians and Gynecologists officially recommended making the pill available without a prescription for the first time in December and, as the New York Times reported over the weekend, it poses fewer dangers than Motrin and Sudafed. Making birth control pills available over the counter would remove the biggest obstacle to proper use — that thing where “you run out on a Saturday night, you lose your pills, you go on vacation, you can’t get a doctor’s appointment,” as gynecologist Daniel Grossman put it to the Times. 

In response, conservative doctors cited a study that suggests easy access to emergency contraception leads to riskier sex and a higher incidence of STDs. They also argued that over-the-counter birth control would allow women to forgo doctor's appointments and important screenings. Or is that just a conspiracy to make us get more Pap smears than we need? (The horror.) As the Times' Elisabeth Rosenthal points out, gynecologists might resist over-the-counter birth control because, with Pap smears now only advised once every three years instead of annually, refilling a birth control prescription might be the only reason young women have to visit the gynecologist. And then who will give them a pantsless pop quiz about their sexual history and drinking habits?