OTC? REALLY!!! Contraception and the Changing Role of Medical Providers in an Over-the-Counter World
Earlier this month, the American College of Obstetricians and Gynecologists (ACOG) put forward a bold position that might seem logical: allow birth control pills to be sold over-the-counter without a prescription. The benefits are obvious. Improve access by removing financial and logistical barriers for women using the pill. No more scheduling doctor’s visits carefully in advance of the last pack of pills running out. No more buying six months at a time to decrease hassles: simply head to the pharmacy when you’re running low and throw the box of pills in with your other casual pharmacy purchases.
There is another reason it was a bold move by ACOG: Besides the fact that it’s unlikely such a thing would come to pass without a fight since it requires approval from the Food and Drug Administration (FDA) which is lobbied by religious and conservative anti-contraception groups, a group of physicians is now arguing that we no longer need their services for a specific health intervention. As CNN quoted Dr. Daniel Grossman on the decision: “‘It is a pretty bold move on the part of ACOG,’ he said. ‘I really respect that the organization decided to make this statement after reviewing all the evidence. It’s not very common where you hear a physician organization say, ‘We think there should be a change so that our patients don’t have to see us anymore.’ “
This is the change that is likely to have the biggest impact on women’s health overall if birth control does eventually go over the counter. Improved access to those contraceptives will indeed result, but I think it will mark a bigger change in how we interact with providers, particularly in the arena of women’s health and gynecology.
Obviously not everyone uses birth control pills to begin with—so this might not change a thing for those people who either use other birth control methods (IUD, Depo shots, condoms, etc) or who are not concerned with pregnancy prevention (queer people, the post-menopausal, etc). But according to the Guttmacher Institute, an estimated 11.2 million U.S. women ages 15 to 44, or 18 percent of all women, currently use oral contraceptive pills. That’s 11 million women who now will have one less reason to visit their medical provider on an annual basis. Coupled with new recommendations steering us away from annual pap smears, we’re heading into an era that might actually indicate less frequent visits to our gynecologists.