Access to birth control is front and center in the post-Roe world [Video]


Permission to distribute over-the-counter birth control pills in the United States has quickly become a pivotal battle, especially following the Supreme Court’s decision to overturn Roe v. Wade, who legalized abortion nationwide.

However, the hope of the campaign remains bright for many activists.

“The prescription barrier, in particular, is something that keeps safe and effective birth control pills out of reach for many – often because you have to go to a doctor or a provider’s office to get a prescription and that can be hard for people to do,” Victoria Nichols, project director for Free The Pill, a campaign that focuses on getting birth control pills to market, told Yahoo Finance. “Getting them over the counter would really reduce and eliminate a lot of the barriers that people face when trying to get access that are really rooted in systemic inequity.”

Limited access to abortion has sparked a debate about decreasing access to abortion drugs. According to the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, the states rather than the federal government have the power to regulate abortion. And with that authority, state governments could target drugs more directly.

A map showing disparities in access to birth control across the United States (Map: Power to Decide)

According to Power to Decide, an organization that promotes sexual health and wellness, more than 19 million women of childbearing age in the United States live in “contraceptive deserts,” meaning they don’t have access to a health center in their county that offers all methods of contraception. What’s more, according to the data, about 1.2 million of these women “live in a county without a single health center offering the full range of methods.”

In addition to the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe and ended the constitutional right to abortion, Judge Clarence Thomas suggested that the right to contraception should also be considered.

In July, the House passed legislation to protect access to contraception nationwide. The measure, which was increased from 228 to 195, would protect the authority to purchase and use contraceptives without government restriction. However, it has yet to pass the equally divided Senate.

“Systemic Inequalities”

Access issues include the need to travel to an appointment for care, the cost of an appointment, and transportation, among other barriers, Nichols explained.

“Often people have to miss school or work to get to appointments and these barriers fall harder on black people, indigenous people, other people of color and young people,” he said. she stated. “Often, people working to make ends meet and people in rural communities face these barriers because of systemic inequities.”

Dr. Shelly Tien gives a patient medication to start a medical abortion at Planned Parenthood in Birmingham, Alabama March 14, 2022. REUTERS/Evelyn Hockstein

Dr. Shelly Tien gives a patient medication to start a medical abortion at Planned Parenthood in Birmingham, Alabama March 14, 2022. REUTERS/Evelyn Hockstein

For example, being insured is associated with a greater likelihood of receiving family planning services. According to 2019 data from the Kaiser Family Foundation, only 7.8% of white Americans are uninsured compared to 20% of Latinos, 21.7% of American Indians and Alaska Natives (AIAN), and 11.4% black Americans.

Overuse of over-the-counter oral contraceptives would remove many of these barriers and allow these underserved communities to gain better access.

Similar to the morning after pill (which is currently available over-the-counter), the contraceptive uses levonorgestrel to prevent ovulation, making it harder for sperm to reach the egg when ovulating. However, emergency contraception is only 95% effective, while the birth control pill is 99% effective.

Oral contraception became legal in the United States in 1960 and has been used safely by millions of women ever since. Although blood clots in the veins remain a primary health problem, they are extremely rare and occur in less than 1 in 1,000 people who take the pill per year.

Last month, French pharmaceutical company HRA Pharma filed an application with the US Food and Drug Administration (FDA) to authorize an over-the-counter (OTC) birth control pill. If approved, the pill would be the first oral contraceptive available in the United States without a prescription, giving women wider access to birth control.

The routine time frame for the FDA to respond to such requests is generally 10 months. That means it could take until mid-2023 for the drug to finally hit the shelves. However, Nichols is confident that there is strong evidence that supports the safety and effectiveness of over-the-counter birth control pills for people of all ages.

Two US companies have won FDA approval to produce and sell mifepristone, the first of two separate drugs used to terminate a pregnancy during medical abortion: brand name maker Danco Laboratories and generic maker GenBioPro. Another drug, misoprostol, also used to treat ulcers and other conditions, is used in the second stage of the two-pill regimen.

The FDA process is product-by-product, which means they have to review the data and science for each product. Nichols said the process is squarely science- and data-driven.

“I know there are people working and exploring what might come next, including other hormonal methods for birth control pills,” she said. “Who knows what the future holds for us?”

Sandra Salathe is editor-in-chief at Yahoo Finance. Follow her on Twitter at @srsalathe.

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