Thread by @DrDGrossman

@acog has released new recommendations for birth control, calling for all forms of hormonal birth control to be over-the-counter. As vice chair of ACOG's Committee on Health Care for Underserved Women, I spoke to @NBCNews about what this means.
nbcnews.com/health/womens-…

In 2012 @acog issued a committee opinion supporting over-the-counter birth control pills. Now there are at least 2 companies doing research to support an OTC pill and may submit applications to the FDA in the next 2 years. The new recommendation is for all forms of birth control.

This new statement goes even farther to say all hormonal birth control methods, including the patch, vaginal ring, and injection, should all be made available OTC. The statement also clarifies that they should be made available without an age restriction and covered by insurance.

I think all hormonal contraceptives are safe and effective enough for over-the-counter sale, and that it would be feasible for potential users to figure out on their own whether they are appropriate candidates for the method.
nbcnews.com/health/womens-…

What would it look like? Let's say you're ready to take birth control—whether to prevent pregnancy, to help with periods, or another reason—you'd go to the store, read a checklist of types of birth control & a health conditions checklist to figure out which is right for you.

For Depoprovera there is a formulation that can be administered using a subcutaneous injection—just like insulin, which people self-administer all the time. Right now, hormonal birth control is available over the counter in more than 100 countries.
freethepill.org/where-on-earth/

Making the birth control OTC would be a big step in making sure more people have access. The reality is not everyone has insurance, and costs like for travel and child care, and co-pays make it hard for 1 in 5 women to get prescription birth control.
contraceptionjournal.org/article/S0010-…

Hormonal contraception is very safe. Like all meds, there are small risks of serious complications like blood clots, heart attack, or stroke for estrogen-containing contraceptive methods. It's possible to identify those who have a higher chance of developing these complications

The US Centers for Disease Control and Prevention have developed clear guidance about conditions that might make hormonal contraception less safe for potential users, and research has shown that women can use simple checklists to identify these conditions on their own.

Birth control pills are safe to take on your own as they have no toxicity, so no overdose & aren't addictive. People are able to determine if the pill is right for them & take it without a provider's explanation & screening. Of course, people who want appts would still get them.

While I think the science is clear on whether hormonal contraception should be OTC, I anticipate some political fights. As with Plan B, there will likely be controversy over whether adolescents should have access, despite the medical evidence indicating this is appropriate.

There will also likely be debate about insurance coverage. More and more insurances are covering some OTC medications, including OTC emergency contraception. It would really restrict access if insurances stopped covering birth control methods that went over the counter.

It is imperative that insurance coverage remains for over-the-counter birth control. If not, it will still be financially out of reach for people, like now.

Read more from @NBCNews: nbcnews.com/health/womens-…

Learn about efforts to make the pill OTC at: freethepill.org