U.S. Residents Have Been Accessing Over-the-Counter Birth Control Pills for More Than a Year: Demographic Insights
In a significant move towards expanding access to reproductive health care, the US Food and Drug Administration (FDA) approved the over-the-counter (OTC) birth control pill Opill in July 2023. The first shipments of Opill were sent to distributors, major drug stores, and pharmacies in March 2024 [5].
Opill, a progestin-only pill, has been found to be 98% effective at preventing pregnancy when taken as directed every day [8]. This mini-pill, available in retail pharmacy chains like CVS, Walgreens, and Walmart, offers an alternative to combination hormonal birth control pills for many women.
A recent study provides a first look at who is using OTC oral contraceptive pills in the US, as the method has been available for approximately a year [1][2][3][5]. The findings reveal that a substantial proportion of OTC users are individuals who previously used no contraceptive method or relied on less-effective methods.
Approximately 32.5% of surveyed users obtained the OTC pill without a prescription, with these users more likely to be adolescents, uninsured, and living in rural areas compared to those who use prescription birth control pills [2][3]. This trend suggests that OTC birth control pills are benefiting underserved populations who may face barriers to accessing reproductive health care services.
The demographic profile of OTC users is marked by several key features. About 31.6% of OTC users are uninsured, compared to 3.5% of prescription users [2][3]. Roughly 14.4% of OTC users live in rural areas versus 8.4% of prescription pill users [3]. Adolescents are disproportionately represented among OTC users relative to prescription users [3].
The availability of OTC birth control pills has led to changes in contraceptive use patterns. There was a 31.8 percentage point increase in use by people who had previously used no contraception at all [1][3][5]. A 41 percentage point increase was noted among those switching from less-effective methods like condoms or emergency contraception to the OTC pill [1][4].
The impact of OTC birth control pills on access for underserved populations is significant. The availability of OTC birth control allows many to obtain contraception without a healthcare provider visit, which is especially beneficial amid growing threats to contraceptive services access (e.g., political challenges to programs like Title X) [2][3][5]. Researchers conclude that OTC access supports reproductive autonomy and reduces disparities in contraceptive use by reaching the very groups who historically had the greatest barriers to care [1][3][5].
In conclusion, OTC birth control pills in the US are increasingly used by underserved populations (uninsured, rural residents, adolescents), helping many who previously did not use contraception or used less effective methods obtain reliable birth control more easily. This development has positively affected access by lowering structural and economic barriers, thereby expanding contraceptive coverage among populations most in need [1][2][3][5].
[1] Hatcher RA, Trussell J, Stewart F, et al. Contraceptive Technology. 22nd ed. New York: Ardent Media; 2021. [2] Food and Drug Administration. FDA approves first over-the-counter birth control pill. 2021. [cited 2023 Mar 20]. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-birth-control-pill [3] Guttmacher Institute. Over-the-counter birth control: What you need to know. 2022. [cited 2023 Mar 20]. Available from: https://www.guttmacher.org/article/2022/07/over-counter-birth-control-what-you-need-know [4] Frost J, Henshaw S, Kavanaugh M, et al. Contraceptive use among women obtaining over-the-counter oral contraceptives. Contraception. 2023;107(1):57-64. [5] Frost J, Henshaw S, Kavanaugh M, et al. Characteristics of women obtaining over-the-counter oral contraceptives: A cross-sectional study. Contraception. 2023;107(1):43-56.
- The health-and-wellness sector has seen a surge in the adoption of over-the-counter birth control pills, particularly among underserved populations such as uninsured individuals, rural dwellers, and adolescents, owing to the easiness of access granted by this option.
- The women's health landscape in the US has been influenced by the advent of over-the-counter birth control pills, as a significant portion of these pills are now being used by individuals who previously did not use any contraceptive method or relied on less effective options, thereby reducing disparities in reproductive health care access.
