OTC birth control: A moral imperative

Why it is both immoral and impractical to require a prescription for birth control

The+case+for+over-the-counter+birth+control+as+a+moral+and+practical+practice.

Brent Gelick/Talon

The case for over-the-counter birth control as a moral and practical practice.

Over-the-counter (OTC) access to birth control for women of all ages is supported by The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Physicians (AAFP). As of 2017, 74% of American women aged 18-44 support OTC access to birth control. Yet, American women are still required to have a prescription to access hormonal birth control.

Proponents of OTC birth control face a number of arguments on both ethical and health-based grounds.

A common health-based argument against OTC birth control is that prescription birth control incentivizes women to seek other forms of health care. If women have to go to their doctor anyways, this argument states, then they typically will also get other forms of care, such as breast and pelvic exams.

But, this attitude is not only paternalistic in that it implies women aren’t able to take care of their bodies without restrictions imposed on them, but it is a violation of basic freedoms, akin to the government forcing people to visit farmers markets to incentivize them to buy healthier food. And, this violation of freedom is drawn along a gendered line. If this argument is truly valid, men should need to get a prescription for condoms to incentivize them to get physical examinations.

Another widespread health-based argument for requiring a prescription is that hormonal drugs may pose dangers to women. However, hormonal birth controls are deemed safe by the ACOG and AAFP. They are among the most well-studied drugs on the market, and they are considered safer than many other OTC drugs, like aracetamol (i.e. Tylenol). They are also proven to be safer than carrying a child. 

There are certainly risks, but there are risks to every OTC drug, and yet they are available anyways. These risks also seem to primarily affect women in certain health-related demographics, such as smokers 35 and older. A screening tool, where women fill out a computerized questionnaire when buying birth control and are informed if it may pose a risk to them, can help ensure women make a decision that is their own, but that is also informed.

Besides health-based arguments, many objectors to OTC birth control cite moral concerns about birth control encouraging sexual behavior. A 2007 poll found that 46% of Americans believe that providing teens with birth control would “encourage sexual behavior.”

Firstly, doctors and the government should never have the power to determine what women (or people in general) choose to do with their lives. Attempts by these agents to alter anyone’s behavior, including sexual behavior, regardless of whether their efforts are sex-positive or sex-negative, are wrong (unless they are immediately relevant to the health and safety of the person involved). We don’t have a government to push the moral or religious views of one group of people onto another group. It is abhorrent that people feel entitled to make personal choices for other people.

Secondly, birth control has countless uses besides contraception. Even if it were morally permissible for the government to regulate people’s personal choices, birth control isn’t only used by people who rely on it as a contraceptive. Hormone-related mood disorders, like Premenstrual Dysphoric Disorder (PMDD), which affects 8% of women, can be treated with birth control, and it can alleviate the effects of Premenstrual Syndrome (PMS). Hormonal birth control can be used to treat migraines, acne, period pain, period irregularity, endometriosis (pelvic pain caused by tissue growth), the symptoms of polycystic ovary syndrome and anemia.

Finally, birth control does not actually increase sexual behavior. So, even if it were permissible for the government to intervene in citizens’ personal lives, and even if birth control was solely a contraceptive, this argument still wouldn’t have merit. In fact, a study by Washington University in St. Louis, involving women aged 14 to 45, found that even giving women free birth control does not increase the frequency with which women have intercourse nor the number of partners they engage with. 

Opponents of OTC birth control may claim that it decreases the age of sexual initiation, and thus increases sexual behavior later in life. Those making this argument believe that giving a woman birth control who is already sexually active won’t have any effect, but that making birth control widely available would encourage people to become sexually active at a younger age. However, studies show that increased contraceptive use over a period of time can result in fewer adolescent pregnancies without increasing or decreasing the frequency of adolescent sexual activity.

The arguments against OTC birth control simply don’t stack up against the benefits. Birth control reduces unwanted pregnancies and can be used as treatment for many health issues. Persistent objections are a symptom of a larger problem with the way our society treats women and young people.