In this Q&A, Contraceptive Technology Update asked Sarah E. Baum, MPH, a senior research scientist at Ibis Reproductive Health in Oakland, CA, about her new study on interest among Black, Indigenous, and people of color (BIPOC) in an over-the-counter (OTC) birth control pill. Baum and colleagues found that 45% of respondents had experienced at least one challenge accessing contraception in the past year, and 67% said they would be likely to use an OTC oral contraceptive pill.1 The following transcript has been lightly edited for length and clarity:
CTU: Please describe your study, its findings, and implications.
Baum: Despite their popularity and decades of safe use and research, people still face barriers to birth control pills. These barriers fall hardest on young people and BIPOC.
This study is unique because we partnered with communities on the ground — groups such as Black Women for Wellness, Bold Futures, California Latinas for Reproductive Justice, Native American Community Board, and National Asian Pacific American Women’s Forum — to survey more than 700 BIPOC in the United States.
We found that interest in an OTC birth control pill was high in these communities, with two-thirds saying they would be likely to use an OTC pill. Interest was particularly high among young people and people who faced barriers to birth control, such as challenges getting to an appointment, cost, privacy concerns, and fear of judgment. Our findings suggest that making birth control pills available over the counter can help bridge gaps in access among people of color who are facing barriers and give people greater control over their reproductive health and lives.
CTU: Your findings say that the survey’s results can be used to inform future OTC implementation tactics to ensure OTC access. What is an example of how OTC pill access could be made equitable for BIPOC?
Baum: This year, the FDA is reviewing an application from HRA Pharma to bring a progestin-only birth control pill over the counter, which could improve access. Our research confirms that any OTC pill needs to center the experiences and preferences of those who may be most likely to use it, including BIPOC, young people, and those who face barriers. These include barriers that are deeply rooted in systemic racism and have been made much worse by the pandemic. For an OTC birth control pill to be made equitable, it must be affordable, fully covered by insurance, and available to people of all ages, identities, and backgrounds.
CTU: What are some challenges to OTC access that could arise considering the Dobbs decision and the looming potential for some states to ban other forms of contraception? Could a chilling effect also affect access to OTC oral contraception in some abortion-ban states?
Baum: Both contraception and abortion care are part of a full range of sexual and reproductive healthcare. The reality is that access is limited to both contraception and abortion, and the barriers to access fall harder on people of color and Indigenous peoples, young people, immigrants, LGBTQ+ folks, and those working to make ends meet.
We’ve already seen states like Texas move to restrict birth control access for young people months after banning abortion care. That’s why it’s crucial that any OTC birth control pill be available to people of all ages, fully covered by insurance, and priced affordably.
REFERENCE
- Key K, Wollum A, Asetoyer C, et al. Challenges accessing contraceptive care and interest in over-the-counter oral contraceptive pill use among Black, Indigenous, and people of color: An online cross-sectional survey. Contraception 2023 Jan 11;109950. doi: 10.1016/j.contraception.2023.109950. [Online ahead of print].
In this Q&A, Contraceptive Technology Update asked Sarah E. Baum, MPH, a senior research scientist at Ibis Reproductive Health in Oakland, CA, about her new study on interest among Black, Indigenous, and people of color in an over-the-counter birth control pill.
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