The game-changing promise of an OTC birth control pill

The U.S. appears likely to legalize over-the-counter contraception—a critical step in increasing women’s bodily autonomy and economic independence.


A committee of advisers recently recommended that the federal Food and Drug Administration (FDA) begin allowing sales of an over-the-counter (OTC) birth control pill—the first of its kind in the nation. All 17 members of the committee voted to recommend sales of Opill to the public, at a time when the Republican Party has carried out a widespread assault on reproductive health care. Although the FDA can decide whether or not to follow the committee’s recommendations, it rarely overrides it, and is unlikely to do so given President Joe Biden’s pledge to defend against “politically-driven attacks on women’s health.”

Margery Gass, one of the advisory committee members, who is an emerita professor at the University of Cincinnati College of Medicine, told the Washington Post, “I think this represents a landmark in our history of women’s health.” Not only is the expected legalization of Opill a step toward bringing the United States up to international standards—currently such pills are available in more than 100 countries worldwide—but it is also a useful political counterattack against a party leading a full-scale assault on the rights of everyone but rich white men. And, most importantly, it has the potential to buttress women’s economic independence.

By making the purchase of a contraceptive pill as easy and affordable as a trip to the drug store, birth control can become more accessible to those who are uninsured or underinsured, who may not have the time and resources to make an appointment with their OB-GYN, or who may live in rural areas where Republican officials have decimated local free abortion clinics. It is also likely to increase accessibility to the pill among young people of color.

There have been many studies in the U.S. examining the impact of access to birth control on women’s independence and educational achievements. A report by Planned Parenthood concluded that “Being able to get the pill before age 21 has been found to be the most influential factor in enabling women already in college to stay in college.”

The Institute for Women’s Policy Research reviewed the available evidence from many such studies and found that since prescription birth control pills began to be available in the U.S., they helped women stay out of poverty, enabled women to enter college and graduate in higher numbers, and empowered women to find jobs, keep them, and access more senior, higher-paying roles in their workplace.

It’s no wonder that a massive majority of women surveyed were in favor of an OTC pill being available in the U.S.—77 percent of women aged 18 to 49, as per a Kaiser Family Foundation survey in November 2022.

There was a time when Republicans were also fully in support of OTC birth control pills—in 2015 when they fought against the Affordable Care Act’s requirement that insurance companies cover the cost of the pill. Seeing an OTC pill as a weapon against Obamacare, GOP lawmakers argued that people should simply be able to buy the pill on their own. Democrats countered that it might become too expensive if insured people were forced to pay out of pocket. Indeed, the Affordable Care Act made birth control pills more affordable for insured women.

Setting aside the idea that all health care and medication should be tax-funded and cost nothing at the point of access—a radical notion that Medicare should be for all—an OTC contraceptive pill should supplement, not supplant prescription birth control, which the FDA is expected to shortly allow.

Moreover, legalizing an OTC contraceptive pill does not undo the damage of the ongoing GOP assault on abortion access. Florida became the latest state to ban abortions past six weeks into pregnancy—a stage at which pregnant people barely realize what has happened to their bodies. Governor Ron DeSantis signed the ban even before an earlier ban on abortions after 15 weeks of pregnancy could take effect while it is being challenged in court. The Associated Press explained his reasoning in plain language: “The ban gives DeSantis a key political victory among Republican primary voters as he prepares to launch an expected presidential candidacy built on his national brand as a conservative standard bearer.”

Privileging fetal cells over the autonomy of the living, breathing human hosting those cells is not the real reason for the GOP’s attacks on abortion. The real reason is to obtain the political allegiance of a reliable subsection of anti-abortion fanatics among the U.S. voting public.

How fanatical are they?

One organization peddling flat-out lies in order to pave the way for ending access to contraception is Pulse Life Advocates. On its website are claims that are so preposterous, they veer on comical, such as, “Contraception increases likelihood of divorce,” and “Contraception kills babies.”

These same sort of zealots want the GOP to attack access to prescription birth control pills, as well as Plan B, the “morning-after” pill. The popularity of such pills offers little political protection—a majority of Americans have continued to support access to abortion and yet it is no longer a right federally.

If the anti-abortionists were truly interested in protecting fetal cells, contraceptive pills would help ensure such cells were not generated in the first place. But of course, the ultimate agenda—usually couched in faux concern for women’s health—is to control women. Indeed, Pulse Life Advocates sees the birth control pill as akin to couples saying to god, “We want the physical pleasure of sex, but we want control, we want to leave you out of it.”

Um, yes. Wanting control over one’s body is a fundamental tenet of democracy. The anti-abortionists and their antiquated views on birth control represent medievalism, not modernity.

Mother Jones reported in May 2022 that such fundamentalist activists were plotting their next move against birth control pills and that one attendee at an anti-abortion conference called birth control, “Unbiblical and harmful to women’s bodies.”

Pregnancy is far more harmful to women’s bodies, education, careers, wages, and overall well-being than abortion or contraception. For those who choose to have children in spite of the disadvantages—people like me—the risks are worth the rewards. But the critical factor is choice.

This article was produced by Economy for All, a project of the Independent Media Institute.


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