No over-the-counter OCs, say family planners
When it comes to making oral contraceptives (OCs) available over the counter, the majority of Contraceptive Technology Update readers stand firm in their opposition. More than 75% responding to the annual pill survey say OCs should remain prescription-only, a number slightly above the 72% of the past two years.
"We see a high-risk adolescent population," says Mary Anne Baker, CNM, a clinician at Health Quarters Reproductive Health Care Services in Beverly, MA. "Pap smears, chlamydia, and other STD screenings wouldn't get done without prescriptions."
There already is enough abuse and error in the use of oral contraceptives, says Steven Eisinger, MD, professor of family medicine and associate professor of obstetrics and gynecology at the University of Rochester (NY)/Jacob W. Holler Family Medicine Center. "I wouldn't object to a short dose being available over the counter for emergency contraception," he says. "But for long-term use, I think it would greatly increase the risk of error and confusion, and the efficacy would go way down if OCs were available over the counter."
Not all readers, however, believe OCs should remain as prescription-only items. Randall Whitney, MD, medical director of Family Plan ning, a private practice in Daytona Beach, FL, says he favors making 20 mcg pills exempt from prescription. The low dose of estrogen makes those pills safe, even for smokers, he says.
For readers such as Shellie Johnson, BSN, RN, public health nursing supervisor, and Katrina Susi, BSN, RN, public health nurse III, both at the Umatilla County Public Health Division in Pendleton, OR, the question bears further study.
"We believe in universal access to birth control," say the two clinicians in a written follow-up to their survey responses. "However, we have concerns about the need for empowerment of women through education necessary to understand how to use oral contraceptives effectively and how to negotiate all changes to accommodate for various side effects."
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