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⬇️ 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.


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 as 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 — in July 2022, HRA Pharma announced the first-ever application to the FDA to switch a progestin-only, daily birth control pill from prescription to over-the-counter status! This submission 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.

This news brings us one step closer to #FreeThePill, but we still need your help in making over-the-counter birth control. Support the #FreeThePill Youth Council and help make birth control accessible to all by ensuring that birth control pills over-the-counter are available for all ages and covered by insurance.

📣 Let’s Take Action!

Help make #FreeThePill a reality by adding your name to our petition . Tell President Biden that we have heard his promise to “follow the science,” and we think that means birth control pills should be available over-the-counter, covered by insurance, and free of age restrictions.

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). It will probably take 3-4 years from the time a drug company begins an application process until a successful pill is available on the shelf. At this time no company has submitted an application, but we expect one will this year.

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

A: 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 after weighing the risks and benefits, 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 to oral contraception without a prescription. The American Medical Association has also recommended that manufacturers of oral contraceptives submit the required application and supporting evidence to the US Food and Drug Administration for consideration for a switch from prescription to over-the-counter status.

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 to stay consistent on taking the pill if your busy life precludes you from scheduling an appointment in time for a renewal. 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, and while that system had a number of faults, it is a good start for moving forward.

Q: Should teens be able to get on medication that has side effects without their parents knowledge?

A: 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. Teens are already capable of managing over-the-counter medications, regardless of their parents’ involvement. The available information suggests 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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