Expand access to birth control pills

Promisingly, the FDA may allow sales without a prescription.

By the Editorial Board of the St. Louis Post-Dispatch

May 21, 2023 at 11:00PM
This illustration provided by Perrigo depicts proposed packaging for the company’s birth control medication Opill. Federal health advisers said May 10 that the decades-old birth control pill should be sold without a prescription, paving the way for a likely U.S. approval of the first over-the-counter contraceptive medication. (Associated Press/The Minnesota Star Tribune)

The U.S. Food and Drug Administration is considering allowing birth control pills to be sold without a prescription. Some conservatives are raising predictable objections, but others appear to grasp the obvious: If the anti-abortion-rights movement truly is motivated solely by a desire to prevent abortions, without a broader agenda of imposing religious dogma or subjugating women, its adherents should be the loudest voices for making reliable birth control as easily accessible as possible.

The start of the sexual revolution is often pegged to a single date — May 9, 1960 — which is when the FDA approved sale of the prescription oral contraceptive Enovid, over fervent objections of religious leaders and political conservatives. The Pill, as society quickly dubbed it, was initially illegal in many states, and even where it could be sold, prescriptions were generally available only to married women.

The specter of separating sex from procreation was viewed by many as a harbinger of moral decay. In reality, it would usher in vast new opportunities for women to pursue personal and professional lives free of the ever-present threat of unplanned pregnancy.

After 63 years, the FDA is finally giving its first-ever consideration of approval for an over-the-counter birth control pill (the French-made Opill). It's late in coming by global standards. More than 100 countries already allow over-the-counter oral contraceptives.

America's continued prescription requirement is less the result of medical necessity than political trepidation. When a Supreme Court justice officially muses, as Clarence Thomas did in his concurring opinion in last year's reversal of Roe v. Wade, that perhaps contraception, too, should lose its constitutional protection, it's clear that at least some of the culture remains mired in the misogynist past.

But unlike the continuing debate over abortion rights, there are encouraging signs that the re-emergence of birth control pills in the national conversation won't spawn the same entrenchment from the right that it did generations ago. While a statement from the U.S. Conference of Catholic Bishops "strenuously" opposing easier access to the pill was predictable enough, others who are fully engaged in the fight to end abortion rights appear to be sitting this one out.

The National Right to Life organization told the Washington Post it "does not take a stance on anything that prevents fertilization." Even as red states like Iowa and Indiana are passing draconian new abortion restrictions, they are simultaneously expanding birth control availability.

We would argue that abortion rights and easily accessible birth control share a common imperative: allowing women to make their own reproductive choices, free of governmental coercion in this most private of topics. But those who seek to end abortion rights should at least recognize their own special obligation to expand rather than close off other avenues of choice. To the extent that's happening, it's a bright spot in this otherwise darkening era for women.

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the Editorial Board of the St. Louis Post-Dispatch