In a new study published in the journal Contraception, researchers aimed to discover what the impact would be on unintended pregnancies and associated pregnancy costs among low-income women if oral contraceptive pills were available without a prescription. In the U.S., the percentage of unintended pregnancies has remained at about 50% in the last 20 years, with lack of contraceptive use or inconsistent use being the leading cause. In 2012, the American College of Obstetricians and Gynecologists had recommended oral contraceptives become over-the-counter products based on previous research showing their general safety, particularly progestin-only pills. In this study, researchers created two different scenarios (low vs. high OTC use) using published national and state data to predict the proportion of at-risk low-income women who would likely switch to an OTC oral contraceptive taking into account the distribution method used, reported interest in OTC use, and out-of-pocket costs.

Using these estimates, the researchers came to the following conclusions:

  • 21% of low-income women would very likely use oral contraceptives if they were available OTC
  • Use varied widely depending on the out-of-pocket costs
  • If there were no out-of-pocket costs, an additional 11–21% would use the pill; this results in a 20–36% decrease in the number of women using less effective birth control or none at all, as well as a 7–25% decrease in unintended pregnancies (depending on level of use)