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What is #FreeThePill?

We know birth control pills prevent countless unintended pregnancies a year, but only if you have the means, insurance, and time to get a prescription at the doctor first. For young people, especially low-income and marginalized youth, the obstacles to gaining and filling a prescription for birth control can be insurmountable. 

Young people shouldn’t have to jump through unnecessary hoops to gain access to the contraceptive care they need. Like condoms and emergency contraception, the pill should be available over-the-counter in the United States, just like it is in over 100 countries around the world. Emergency contraception, like Plan B, used to only be available with a prescription as well. It’s only available over-the-counter today because people organized, educated their community, and demanded it.

We know we can make #FreeThePill possible — on May 9th, 2023, the FDA will hold the first hearing on whether to switch a progestin-only, daily birth control pill from prescription to over-the-counter status! This marks the culmination of decades of work by providers, researchers, and reproductive justice organizers (including young people!) to bring a birth control pill over the counter in the United States.

⬇️ Behind-The-Counter: The 2022 Oral Contraceptives Access Survey ⬇️

Over the Summer of 2022, Advocates for Youth surveyed 243 people from 43 different states about their experiences trying to access birth control pills as young people and young adults. The findings paint a concerning picture that we believe every policymaker should read.

Read the report.


For the 55% of respondents who couldn’t get on birth control due to the constraints of the current prescription-only system, one in five experienced an unintended pregnancy. Many more suffered unnecessary stress, lost wages, and more.

It is time the United States join more than 100 countries around the world and bring The Pill over-the-counter and onto the shelves for all ages, covered by insurance. If you’d like to help us spread the word, please use this social media toolkit to do so.


📣 Let’s Take Action!

The FDA is looking to hear from you! Now that there has been a formal application, the FDA scheduled a hearing to review evidence and hear testimony from experts and consumers. We proudly mobilized nearly 300 young people to submit written testimony last November, and we still need your help in making sure the FDA (and the Biden Administration) see a groundswell of young people demanding safe and effective over-the-counter birth control pills available to all ages.

Here’s what you can do now:

  • Add your name to our youth sign-on letter that will be delivered to the FDA. Imagine the power of a letter being delivered with more than 1,000 young people signed on! It takes just 3.4 seconds to help us get there (yes, we timed it).
  • Use this social media toolkit to share with the world how limited access to birth control pills affects young people in particular. In fact, our survey found that 88% of young people struggle to access birth control under the current prescription-only system.
  • Stay tuned for actions we’re hosting this year to call on the Biden Administration to keep their promise to follow the science. By adding your name above, you’ll join our email list where we’ll send updates and the latest actions.

Q: How would a pill move over-the-counter?

A: For a pill to go over the counter in the United States, a drug company will have to submit an application to the US Food and Drug Administration (FDA). Over the Summer of 2022, HRA Pharma did just that, submitting a progestin-only daily oral contraceptive for approval. The FDA held an open comment period in October, and is expected to schedule another one alongside an Advisory Committee (AdComm) hearing about it this year. At that hearing, they will hear from expert witnesses, review scientific evidence and safety data, and then vote on whether to recommend granting over-the-counter status and if any restrictions should be placed on access.

Q: What do medical professionals think about over-the-counter birth control?

A: Doctors across the country have vocally supported allowing people to buy birth control pills over-the-counter (OTC) without a prescription. Most recently, the American Medical Association (the largest, most powerful group of doctors in the country) stated, "Providing patients with OTC access to the birth control pill is an easy call from a public health perspective... Access is one of the most cited reasons why patients do not use oral contraceptives, use them inconsistently, or discontinue use. Expanding OTC access would make it easier for patients to properly use oral contraceptives, leading to fewer unplanned pregnancies.” The American College of Obstetricians and Gynecologists (ACOG), reviewed much of the published evidence documenting the safety and effectiveness of over-the-counter access to the pill, and also concluded that it should be available over the counter in the US to all ages. In addition, the American Academy of Family Physicians (AAFP) supports over-the-counter access as well, saying that oral contraceptive pills are "widely considered to be safe and effective medications," but lamenting that requiring a prescription is "restricting access" to safe and effective birth control.

Q: Will this make BC more expensive for young people who previously had it covered by insurance?

A: First of all, having an OTC option does not preclude someone from still using the prescription system and having insurance cover it, but it would provide a low-cost option for young people unable to go to a doctor. We know form our survey linked above that 88% of young people struggle to find the time or means to get to a doctor's appointment. Especially with policymakers increasingly limiting confidential options for young people to seek care, an OTC option is beocming more and more necessary. That said, cost is one of the most important barriers to care for young people, which is why we are supporting both state and federal policy solutions to expand insurance coverage to over-the-counter methods, even without a prescription. Some states have already enacted such legislation, and we are working with the federal government to determine how we can ensure insurance coverage for OTC birth control. For example, OTC COVID tests were recently covered by insurance, as were OTC hearing aides. While that system has had a number of faults, it is a good start for moving forward.

Q: Should teens really be able to get medication without going to a doctor first?

A: Teens are already capable of managing over-the-counter medications on their own. Emergency Contraception, such as Plan B, has been available over-the-counter for years without issue, and all ages can buy it. And oral contraception is safer than Tylenol or aspirin. The research done in the leadup to this moment shows that people of all ages are able to self-screen for side effects and contraindications when it comes to oral contraception.

Q: So if this is an FDA decision, what are we asking the Biden Administration to do?

A: We’re asking the Biden Administration to let the FDA do its job, and follow the science, which clearly shows that birth control pills are safe and effective and should be made available over-the-counter. We also know that the Biden Administration trusts the expertise and decision-making power of the FDA to determine that making birth control pills available over-the-counter is safe and would remove barriers to access for people all over the country.

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