Over-the-Counter Birth Control Pills
If birth control pills were available over-the-counter (OTC) would you buy them? And, more importantly, should you?
Judging from the results of a study of over 1,000 women, buying the Pill OTC would likely be safe, especially for younger women....
Women in many countries can buy birth control pills over-the-counter(OTC). Not so in the US. Here a prescription (meaning a doctor's visit to screen for contraindications to Pill use) is required.
Even with the screening requirement, approximately 6% of COC [combination oral contraceptive] users in the US are contraindicated for use.
So researchers wanted to see how well women could self-screen for contraindications to Pill use. The women were given a checklist and asked to determine if they had any of the Level 3 or 4 contraindications to Pill according to the WHO Medical Eligibility Criteria. The results:
The sensitivity of the checklist to detect true contraindications was 83.2% (95% CI 79.5–86.3%) and specificity 88.9% (86.4–91.0%). 6.7% (5.3–8.0%) of women incorrectly thought they were not contraindicated when they truly were, largely due to unrecognized hypertension of >140/90 mm Hg. Using a cut-off of 160/100 mm Hg (WHO Category 4 contraindication), 2.6% (1.7–3.5%) incorrectly thought they were not contraindicated. In regression analysis, younger women, more educated women and Spanish-speakers were significantly more likely to correctly self-screen (p<.05).
The study concludes:
The percentage of women who incorrectly self-identified as not contraindicated (6.7%) is similar to the proportion of actual pill users in the US who are contraindicated for use (6%). Over-the-counter provision of COCs would likely be safe, especially for younger women and if independent blood pressure screening were encouraged.
So, what do you think; if you could purchase the Pill OTC, would you?