On the 50th anniversary of Roe v. Wade, the FDA should approve over-the-counter birth control 

OPINION: Millions of people choose the contraceptive pill every year, and many more would if not for unnecessary barriers presented by the outdated prescription requirement.

Birth control pills rest on a counter in Centreville, Maryland, on July 6, 2022. Public health leaders hope the FDA acts quickly on an application to make the combined oral contraceptive pill available over the counter. (Photo by JIM WATSON/AFP via Getty Images)

Editor’s note: The following article is an op-ed, and the views expressed are the author’s own. Read more opinions on theGrio.

Six months after the devastating Supreme Court ruling on abortion access — and five decades after the Jan. 22, 1973 landmark ruling in Roe v. Wade — people’s rights and access to reproductive health care are dangerously eroding. Emboldened by states criminalizing access to abortion, conservative extremists are now erecting new barriers and political attacks on contraception access. This includes bans on emergency contraception and new parental consent requirements for teens in need of contraception care, among other extremist policies.

The severe and widespread negative consequences of the Supreme Court overturning Roe v. Wade have brought a sharper focus on the U.S. Food and Drug Administration’s (FDA) role in ensuring equitable access to reproductive health. The urgent public health need to revisit unnecessary barriers to safe and needed medications finally broke through some FDA restrictions that were not firmly rooted in science and evidence.

First, last month, the FDA clarified the obvious: emergency contraception is birth control, not abortion. This came after years of contraception opponents falsely using an outdated FDA label to claim that emergency contraception is equivalent to abortion and lobbying policymakers to restrict access.

Second, just weeks ago, the FDA finally lifted its own medically unnecessary restriction that required physicians to stock a drug used in medication abortion rather than simply write a prescription that can be filled at a pharmacy. Lifting the pharmacy restriction will allow medication abortion to be dispensed at pharmacies in states where abortion access is still available, making this essential medication more available to people who need it.

The third signal from the FDA may have the most widespread impact of all, especially for those who face barriers to reproductive health: moving toward a decision on allowing the birth control pill to be sold over-the-counter, without a prescription.

Two formulations of the oral contraceptive pill are on track to be sold, without a medically unnecessary prescription, on store shelves. The birth control pill is one of the most reliable and popular forms of contraception, and after 60 years of usage, it meets the medical criteria for over-the-counter status. Leading health authorities, including the American Medical Association and the American College of Obstetricians and Gynecologists, have urged the FDA to take this action.

Millions of people choose the contraceptive pill every year, and many more would if not for unnecessary barriers presented by the outdated prescription requirement. The FDA has committed to a decision this year on the progestin-only pill, often called the mini-pill. Public health leaders hope the FDA acts quickly after that decision on the application for the birth control pill taken by 95% of pill users — the combined oral contraceptive pill — to be sold over the counter, on store shelves.

The Supreme Court’s ruling overturning Roe v Wade transformed the persistent national reproductive health access crisis into a public health emergency. Make no mistake: Contraceptive access is not a substitute for access to abortion. These rights must exist in tandem to ensure that everyone — no matter who they are or where they live — has control over their bodies and can decide if, when, and under what circumstances to get pregnant and have a child.

As we work toward restoring abortion access for all Americans, we must finally recognize that the attack on abortion has always been coupled with an attack on contraception. Both are essential and necessary for people’s ability to prioritize their reproductive well-being. We must continue to call out and fight against the political movements that undermine reproductive health, rights and justice.

In this post-Roe world, I implore the FDA to continue the recent positive momentum on women’s health and equity and move swiftly to approve access to the pill without the medically unnecessary barrier of a prescription.


Dr. Raegan McDonald-Mosley is chief executive officer of Power to Decide, chief medical adviser for Contraceptive Access Initiative and a practicing OB-GYN.

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