Divya Hoytron’s experience with birth control in her religious community in conservative McAllen, Texas was less than ideal. When she expressed concerns about her pregnancy and wanted to access hormonal birth control at 16, her parents tied her up instead. Despite being prepared for a backlash, she didn’t expect that years later, at age 19, she would still not have access to reliable birth control. During this time, some of her friends ended up getting pregnant, highlighting the need for better access to contraception.
At the FDA’s two-day hearing on the contraceptive drug norgestrel, dozens of reproductive health care providers and advocates shared their experiences and concerns. The drug, marketed as Opil and approved for prescription-only use by the FDA decades ago, was being reviewed for over-the-counter use. Many public commenters highlighted the lack of access to effective contraception among marginalized groups, emphasizing the need for better reproductive healthcare.
The FDA advisory panel agreed with advocates that improving access to contraception was a public health need. The evidence presented by HRA Pharma convinced the panel that Opil was safe and effective as an over-the-counter drug. The panel voted unanimously in favor of immediate FDA approval of Opil for over-the-counter marketing.
While this is the first time oral contraceptives have been made available without a prescription, there are concerns that access to healthcare, especially for adolescents and those with low literacy, could still be an obstacle. Despite this, advocates believe that the potential for over-the-counter contraceptives to expand health equity and advance reproductive justice is significant. The FDA is expected to approve the drug for over-the-counter use this summer.
While opposition to over-the-counter access to birth control is limited to some conservative Christian anti-abortion groups, the anti-abortion voice is still strong in the US when it comes to contraceptive access. Some anti-abortion groups erroneously conflate certain forms of contraception with abortion pills and oppose premarital sex.
Better efforts to promote pregnancy prevention, starting with the over-the-counter approval of Opil, are needed, especially for marginalized groups who face barriers to healthcare. Preventing unwanted pregnancies is a recommendation of world leaders and science-based health promotion, yet there is still much work to be done to improve access to reproductive healthcare.