Before I start the real message of this post, I want to warn you that if you’re not comfortable/interested in reading about sex and reproductive health, stop here. There’s nothing graphic, but (perhaps with the potential to be even more upsetting to some) there are feminist opinions.
In yesterday’s New York Times, I read a Sunday Times opinion piece titled “Is it Time for Off-the-shelf Birth Control Pills?” in which Times writer Elizabeth Rosenthal contemplates the fact that her daughter has to pay hundreds of dollars in gynecological visits to obtain a prescription for the same birth control pills that she took a quarter of a century earlier. The piece discussed the recently adopted position of the American College of Obstetricians and Gynecologists that birth control pills should be sold without requiring a prescription from a doctor.
“Last December the American College of Obstetricians and Gynecologists released an official position paper concluding that the time had come for birth-control pills to be sold over the counter. It was the first time the group had endorsed such sales, concluding that scientific evidence suggested that the practice was safe and calling it ‘a potential way to improve contraceptive access and use, and possibly decrease the unintended pregnancy rate.'”
The piece made a number of convincing arguments about how birth control pills could be safely sold on pharmacy shelves, and how increased availability of a safe and effective contraceptive would encourage women who were using no birth control or a less-effective form to switch, thereby reducing the number of unplanned pregnancies.
“While oral contraceptives bring with them some tiny risks, especially if used improperly, they arguably pose fewer dangers than many other medicines bought freely at the pharmacy, experts say, including nonsteroidal pain pills like Motrin (which can cause stomach bleeding) and decongestants like Sudafed (which may raise blood pressure). With a simple packaging insert about proper use and precautions, women would be fully capable of using them safely, the gynecologists’ group maintained.”
However, I think that the article missed one very important argument. This is the reason why I have personally not gone on (or at least tried) hormonal birth control pills as a primary form of contraception.
Being on my parents’ health insurance, I am extremely prudent about the medical services I use, because I know that any services and prescriptions charged will appear on the bills that they receive. With conservative parents who believe that girls should remain virgins until marriage, this makes my life difficult. And as someone who considers an unplanned pregnancy the worst thing that could possibly happen right now (short of the zombie apocalypse), I am extremely (really, really) paranoid about birth control. While proper condom use can be almost 100% effective, they’re not completely immune to breaks/slips/leaks especially in the heat of the moment – and at any sign that there *might* have been any sort of accident, I completely freak out. Thanks to the struggles of feminists before me, I can stroll over to the university medical center and pay the $30 out of pocket (always cash to make my transaction completely traceless) to cover the cost of an emergency contraceptive Plan B pill – no prescription needed.
But while Plan B is available without a prescription to women aged 18 and over, it is – as it’s name suggests – not the first option and not a contraceptive meant for regular use.
Often, parents don’t want to acknowledge when their teenage (or even adult) daughters are sexually active, despite the reality that to have sex is an independent decision, not always governed by parents’ wishes or advice. Making birth control pills “off-the-shelf” not only makes a safe, reliable method of birth control more available to girls and women who value convenience or cannot afford the required gynecological visits, but increases the medication’s accessibility to those who require discretion.
Maybe in an ideal world where parents are always open-minded, understanding, and supportive, and children are always mature, responsible, and communicative, there would be more open discussion and promotion of safe sex. But in the real world, this kind of trust and communication does not always exist. And with the current situation, making responsible decisions sometimes means having to circumvent what are meant to be support systems.
Hormonal contraceptive pills have been proven to be safe (or at least as safe as most OTC-available medications) when used properly – women have reliably been taking the same pills for the last 20+ years as Rosenthal pointed out. Eliminating the need for prescriptions can only empower women and positively impact reproductive health.