birth control pillsA movement have been under way for years to make the birth control pill available over the counter, and efforts have recently picked up steam. Bloggers for women sites everywhere are cheering this initiative, jumping up and down with joy. About 70 percent of all women want this. A birth control pill without a prescription! Women no longer being held hostage to a paternalistic medical establishment!

I'm not jumping on that bandwagon. As with anything, if it sounds too good to be true, it probably is. Health care reform will likely change things, but under the current system, I think making oral contraceptives available without a doctor's script is a really bad idea.

The pill being promoted by groups such as the Oral Contraceptive Over-the-Counter Working Group is the "mini-pill" or a progestin-only pill, the same drug used in emergency contraception.

Why does something as simple as the pill require a prescription in the first place? Because it's considered a chronic medication, something you take for a long time or indefinitely, and the Food and Drug Administration feels medications in this category should be closely monitored by a doctor. Drugs are drugs. They are not natural to your body, and often carry side effects. Even though lots of people take acetaminophen every day, studies show it is only safe when used for its approved short-term use.

Without the estrogen in the mini-pill, a lot of the side effects of the pill disappear, and the FDA said it would not be opposed to the idea of a non-prescription version.

I don't use the pill now, but I have in the past, and can come up with 5 good reasons why the birth control pill should remain a prescription drug that you can only get through your doctor.

1. Women will never go to the doctor for regular exams. Currently about 90 percent of all women say they get regular pap smears every 1-3 years as is recommended, and many of them only do this because they want their pills. Take that incentive away, and watch that number plummet, and the number of cervical cancer cases skyrocket.

2. It will be too expensive. Most insurance covers contraception, and since there are lots of choices, the co-pay tiers are currently quite affordable. The cost of medication often skyrockets when it moves from prescription to OTC.

3. It may not work. Most prescription birth control pills are a combination of synthetic estrogen and progesterone. The OTC would contain only progestin to lessen some of the side effects, but that means they are slightly less effective than hormonal pills.

4. Women should develop a relationship with their doctor. And if that pill does fail and a woman gets pregnant? If they have a doctor they see regularly, they have someone to turn to for advice. If they are self-medicators, who will help them through those tough decisions and offer referrals? Doctors are not the bad guys. I have several that are close friends. They care for their patients and truly want to guide and help them through their health decisions. Getting pregnant when you don't want to be is a scary thing. Strong doctor patient relationships are important in times like these.

5. It's easy to get anyway. I don't know of one person, young or old, insurance or no, who wasn't able to get a prescription for pills if they wanted one, so what's the big deal? Family planning clinics dish these things out like candy. All you have to do is show up and ask.

 

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