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Physicians: Birth control should be sold without a prescription

Physicians: Birth control should be sold without a prescription
CNN
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Tuesday, November 20, 2012 - 5:40pm

In the future, women may be able to buy birth control pills alongside ibuprofen and cough drops if the recommendation of the American College of Obstetricians and Gynecologists is adopted.

The group is recommending that oral contraceptives be sold over the counter without a prescription in an effort to reduce the number of unintended pregnancies in the United States.

Approximately 50% of all pregnancies are unplanned, a rate that hasn't changed much in the past 20 years, according to the Guttmacher Institute, a nonprofit organization dedicated to reproductive health research. Women in their 20s are most at risk.

"Access and cost issues are common reasons why women either do not use contraception use or have gaps in use," according to the American College of Obstetricians and Gynecologists.

Many developed countries still require a prescription for oral contraceptives, including Canada and most of Europe, but many other countries sell the pill without a prescription even formally or informally.

The movement to push birth control over the counter is nothing new, says Dr. Daniel Grossman, who volunteers as vice chairman for the American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice Bulletins.

In the early 1990s, a paper in the American Journal of Public Health argued that oral contraceptives should be available without a prescription.

What's different now, Grossman says, is that a large body of evidence documents the safety and effectiveness of the pill, as well as research showing that women are interested in receiving it over the counter.

"I want it between the condoms and pregnancy test kits," said Kirsten Moore, president and CEO of the Reproductive Health Technologies Project, a group advocating for reproductive freedom. "I want it there so it's giving the message: if you're sexually active, use protection."

As with any drug, there are risks associated with oral contraceptives. The American College of Obstetricians and Gynecologists acknowledges that the pill can increase a patient's risk of blood clots and stroke, especially if she is obese or smokes. And selling the medication over the counter would reduce the chance that a woman would be screened by a doctor.

But the group also says studies have shown that women may be able to self-screen for these conditions using a simple questionnaire. The physicians group argues that the risks must be put in context with the risk of blood clots or stroke with an unintended pregnancy.

"The comparison isn't taking the pill or not taking the pill," Moore said. "It's taking the pill or not taking the pill and risking becoming pregnant."

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