Recently, the American College of Obstetricians and Gynecologists published an opinion that stated oral contraceptives should be available over-the-counter. The opinion cited that unintended pregnancy has consistently accounted for approximately 50% of all pregnancies over the past 20 years, and has been recently estimated to cost tax payers $11.1 billion each year. The opinion argues that one way to battle unintended pregnancy is to allow oral contraceptives to be sold over-the-counter.
However, over-the-counter access to oral contraceptives has implications for women of all ages beyond preventing unintended pregnancy. Women have always been at a disadvantage when it comes to their bodies and sexuality. The fact that women produce children has historically led the government and society to exert control over women’s lives. Women should attempt to end this historical trend by pushing for less government involvement in the regulation and accessibility of oral contraceptives.
Allowing oral contraceptives to be sold over-the-counter is an effective way to remove one aspect of the government’s paternalistic control over the reproductive lives of women. Additionally, by allowing oral contraceptives to be sold over-the-counter like condoms, it increases the accessibility to those women whose choices are the most limited when it comes to taking their reproductive health into their own hands; namely, uninsured and low-income females.
Throughout his candidacy and presidency, President Obama has continually presented himself as being the “pro-woman” politician. However, during his first term as president, Obama did nothing but limit a woman’s access to various means of contraception, most notably with emergency contraception.
When the FDA ruled the emergency contraception, Plan B, as "safe and effective” stating it “should be approved for nonprescription use for all females of child-bearing potential," as young as 11 years old, Health and Human Services Secretary Kathleen Sebelius overruled their decision, effectively stopping the Plan B morning-after pill from being placed onto drugstore shelves next to condoms and spermicides. While Obama wasn’t involved directly with Sebelius’s decision, he did come out in support of it from the perspective of a father of two daughters. As a result, instead of being offered over-the-counter, Plan B can only be obtained by women who prove they are 17 years of age or older to a pharmacist, thus limiting accessibility to emergency contraception for all women.
Additionally, while campaigning on behalf of “women” during the 2012 election, Obama highlighted his proposed mandate of health insurance coverage of birth control throughout his campaign in an attempt to capture the “women’s vote.”
However, there are economic problems with a health insurance mandate of birth control coverage that would not exist if an over-the-counter option were made available. Over-the-counter access would remove health insurance from covering contraception altogether. Thus, over-the-counter access means women would pay the actual price. However instead of having a fixed price, over-the-counter access incentivizes companies to lower prices in order to compete with one another. After all, that’s what’s happened with other over-the-counter medications, like allergy medication. In the long run, this benefits all women, but especially the uninsured, low-income women who suffer the most from the current lack of over-the-counter access to oral contraceptives.
Regardless of whether or not you agree with Obama’s politics, when women are told to look to the government to take care of their reproductive and contraceptive needs this is hardly an empowering message, let alone “pro-woman.”
Until women realize that they themselves, not the government, have a moral obligation to take care of their own reproductive health, they will continue to fall victim to the whim of politicians who may or may not be putting forth legislation that benefits their reproductive choices. No politician would be able to limit a woman’s access to oral contraception if it were sold over-the-counter.
Unfortunately, the issue of access to birth control and other contraceptives has become so politicized that it is unlikely that oral contraceptives will be sold over-the-counter anytime soon. Taking into account the administration’s decision to limit the access of emergency contraception even after the FDA deemed it to be safe, I doubt the administration’s approach to over-the-counter access to oral contraceptives will be any different.
However, I think the over-the-counter recommendation by the American College of Obstetricians and Gynecologists should be taken very seriously by all women who are in favor of making their own choices when it comes to their reproductive health. As long as politicians are involved in decisions related to women's bodies and sexuality, accessibility will always be a gamble. In the end, we all lose.