If You Take Birth Control While Your Pregnant Will It Kill the Baby

Of the 72.2 meg American women of reproductive age, 64.nine% use a contraceptive. Of those, 9.1 one thousand thousand (12.vi% of contraceptive users) use birth control pills, which are the second most commonly used method of contraception in the Us after female sterilization (aka tubal ligation or "getting your tubes tied"). The Pill is currently bachelor past prescription but, and a debate has emerged about whether the birth command pill should be available over-the-counter (OTC), which ways the Pill would be available along with other drugs such as Tylenol and Benadryl in drug store aisles. Since 1976, more than ninety drugs have switched from prescription to OTC status, including Sudafed (1976), Advil (1984), Rogaine (1996), Prilosec (2003), and Allegra (2011).

Proponents say making the nativity control pill available over-the-counter would lower teen pregnancy rates, provide contraceptive access to medically underserved women, and ease access to a health-improving drug with decades of safe utilize.

Opponents say making the Pill over-the-counter would enhance the price of contraception for women, pose a danger to teens' and women'southward wellness by removing the md's visit requirement, and limit what options are fabricated available. Read more background…

Pro & Con Arguments

Pro i

Birth command pills are safer than many OTC drugs and mutual activities.

Between 9 and 10.6 million American women use the birth control pill. [i] [2] The Pill carries no adventure of overdose or habit. [3]

According to Bedsider, a nonprofit online birth control network run by doctors, "As medications go, the pill is very safe—safer than having a infant, driving, smoking, or taking daily aspirin." [4] Joe Speidel, Medico, MPH, Professor of Obstetrics, Gynecology & Reproductive Sciences at Bixby Center for Global Reproductive Health explains that pregnancy has a mortality rate about the same as car accidents–ane in eight,300–while the hazard of dying from nascency command is about one in one,667,000, almost the aforementioned as dying from beingness struck by lightning. [v]

And other OTC drugs comport more serious risks: non-steroidal pain pills (NSAIDS) like ibuprofen tin crusade stomach bleeding; Sudafed can raise blood pressure; Tylenol can cause liver toxicity; antihistamines like Benadryl can worsen glaucoma and kidney disease; and diet pills tin can cause irregular center beats and raise blood pressure. [6] [7] Eve Espey, MD, MPH, Professor in the Department of Obstetrics and Gynecology at the Academy of New Mexico, stated, "Nonsteroidal medicines kill far more people than birth-command pills." [6]

Program B 1-Step and other emergency contraception pills are available without a prescription and share the aforementioned active ingredient as daily nascency control pills, levonorgestrel, but in a college dose. [viii] [9] The FDA has already indicated the safety of the drug by making Plan B available without prescription.

Of 135 countries for which information are available, 96 countries representing 80.33% of the global population have OTC birth control admission. [x]

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Pro ii

Over-the-Counter (OTC) birth command would increase admission for low-income and medically underserved populations.

Twenty million women live in "contraception deserts," places with one clinic or fewer per 1,000 women who need government-funded nascence control from programs such as Medicare. [11] In underserved communities, women could more hands find a local drug store for medication. 11-21% of sexually active low-income women studied were more than probable to apply the Pill if information technology were available OTC. [12] [xiii]

Denicia Cadena, Policy Manager for Immature Women United in New Mexico, stated: "Our rural communities are nigh greatly impacted by our country's health care and provider shortages. Patients confront 3- to vi-month wait times for any chief care and fifty-fifty longer for specialty care… eleven of the state'due south 33 counties take no obstetrics and gynecology physicians." [three]

Birth command can be difficult for many women to obtain, especially teens, immigrants, women of color, and the uninsured. [three] The National Latina Institute of Reproductive Health stated: "over-the-counter access volition greatly reduce the systemic barriers, like poverty, clearing status and language, that currently prevent Latinas from regularly accessing birth command and results in higher rates of unintended pregnancy." [fourteen]

Other medically underserved communities, such equally LGBT+ (Lesbian, Gay, Bisexual, Transgender and others) people, are more than twice as likely to be uninsured (fifteen% of all LGBT+ compared to 7% of non-LGBT+ people) and more likely to face discrimination in the healthcare industry, resulting in less or no reproductive healthcare. [15] [16]

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Pro 3

OTC birth control could lower the rate of unintended pregnancies, saving taxpayers billions of dollars.

54% of unintended pregnancies are associated with non using contraceptives and 41% with inconsistent use. [1] Unintended pregnancies price the United states of america federal and country governments $21 billion in 2010, the newest numbers available at the time of publication, with the boilerplate cost-per-nascence being $12,770 for prenatal care, labor and delivery, postpartum care, and 12 months of infant intendance ($twenty,716 for sixty months). [17] The Guttmacher Establish estimates that $15.five billion dollars could have been saved if the unintended pregnancies had been prevented. [17]

Only 5% of unintended pregnancies take happened while the woman used effective nativity control consistently. [1] A report found that women who received a one-year supply of Pills were 30% less likely to have an unplanned pregnancy and 46% less likely to have an ballgame. [18] A report comparing Pill apply betwixt women who obtained Pills with a prescription from an El Paso, Texas, dispensary and women who obtained Pills OTC from United mexican states showed that the women who got Pills OTC were more than likely to continuously apply the medication. [nineteen]

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Pro 4

OTC nativity control pills could lower teen pregnancy rates.

From 2007 to 2013, the nationwide teen pregnancy rate dropped 36% among fifteen- to 19-year-olds because of improved contraceptive utilize. [20]

Teens may be more than likely to use OTC nascence command because taking the Pill is a daily routine and is not tied to the emotional pressure attached to sex the way using a prophylactic is. [21]

Krishna Upadhya, MD, MPH, physician, stated: "Decades of research prove that a majority of adolescents initiate sex activity before the age of 18 and that earlier use of contraception reduces the risk of teen pregnancy. Our review strongly suggests that giving teens easier access to various contraceptives volition non lead to more than sexual activity but would consequence in fewer unwanted pregnancies… [and] any future over-the-counter pill has the potential to benefit teens." [21]

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Pro 5

Making birth control pills OTC could lower the abortion rate.

In a survey of women seeking abortions, 72% said they were pregnant because they could not get the contraception they needed, and 32% reported an institutional reason such as the prescription requirement. These obstacles resulted in a 35% increase in contraceptives non being used. [22]

The American College of Obstetricians and Gynecologists stated: "The about effective way to reduce abortion rates is to prevent unintended pregnancy by improving access to consistent, effective, and affordable contraception… [and a] strategy for improving access to contraception is to allow over-the-counter admission to oral contraceptive pills." [23] The Guttmacher Institute stated that "more and better contraceptive utilise" acquired the 13% turn down in ballgame rates between 2008 and 2011. [24]

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Pro 6

Making the Pill OTC would increment continuous use, leading to long-term health benefits.

A majority of American women–54%–agree that having access to birth control has health benefits. [25]

According to the National Cancer Institute, using the Pill long-term was associated with a 30% to fifty% lower risk of ovarian cancer, a 15% to xx% lower risk of colorectal cancer, and at least a 30% lower chance of endometrial cancer. [26]

Hormonal nascency control pills as well reduce or forbid anemia, irregular or heavy menstrual cycles, os thinning, endometriosis, fibroids, acne, ectopic pregnancies, breast and ovarian cysts, premenstrual syndrome (PMS), menstrual migraines, pelvic inflammatory disease, and infections in the ovaries, fallopian tubes, and uterus. [27] [28] [29]

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Pro 7

Women are responsible and knowledgeable enough to care for their ain bodies.

Alison Block, MD, physician, said: "My primary philosophy as someone who provides reproductive wellness intendance is to trust women to make their ain decisions. The idea that they have to [accept a] conversation with a doctor to decide which method is best for them seems overly paternalistic and unnecessary." [thirty]

Often, doctors will only prescribe birth command pills once a patient has visited and had a pelvic exam. However, Pap smears are now recommended every three years instead of every year, and only subsequently a adult female has turned 21. [31] Nancy Stanwood, Md, obstetrician and Board Chair of Physicians for Reproductive Health, stated, "We were holding pregnancy prevention earnest to cancer screening [Pap smears]. They're both worthwhile goals, but one should not be held hostage to the other." [31]

Women can sort out for themselves whether hormonal birth control is right for them. In one report, 98% of women matched their doctors' medical evaluations about whether they could use hormonal birth control. The women were more cautious about contraindications (medical reasons not to accept a drug) such as headaches, smoking, and potential pregnancy than their doctors were. [32] The Border Contraceptive Access Written report plant that women who got the Pill OTC from a chemist's shop in Mexico were adequately self-screening for contraindications. [33]

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Pro 8

About women want OTC access to nascency command and say information technology would improve their lives.

62.2% of women surveyed indicated that they were in favor of OTC Pills. The aforementioned survey found that 28% of women using no nascence command and 32.7% of women using a less effective form of nascence command would use OTC Pills, a market place of about eleven million women. [34] [35] [36] 78.7% of women said it was "extremely or quite important" that birth command be easily obtained. [25]

62.5% of women surveyed said birth command reduces stress, 56.3% said it helps working women continue to work, 49.0% said it helped women get an education, and 48.seven% said information technology led to more than stable relationships with partners. [25]

Inquiry supports these women'due south conclusions, because state laws that allowed early access to the Pill (17 or eighteen years old, instead of 21) are linked to college women's college graduation and employment rates, increased earning power, narrowed gender pay gap, and longer lasting marriages. [37]

OTC nascency command pills would likewise be more convenient, eliminating the need for a adult female to make a md's engagement, accept time off work, and rearrange her schedule.

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Pro 9

Over-the-counter nativity control would be more affordable.

Moving the Pill over-the-counter would eliminate the insurance companies as heart-man betwixt women and the Pill, thus making the drugs less expensive. Jeffrey A Singer, MD, Senior Fellow at the Cato Institute, noted that moving birth command to OTC status could make the Pill less expensive past selling the drug direct to consumers rather than through third-party insurance companies that inflate the prices. [38]

Getting nascency control by prescription has several associated costs that would be eliminated with OTC status, including co-pays for dr.'southward visits and time taken off piece of work to go to the doctor. [38]

Uninsured women may also save money by eliminating the insurance companies as middle-man. Uninsured women, well-nigh 11% of United states women ages nineteen to 64, paid $370 on average for a year's worth of Pills (about $thirty.83 per month), which was 68% of their total healthcare spending for the year, and most 51 hours of piece of work for someone making the federal minimum wage of $seven.25 an hour. [39] [twoscore]

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Pro 10

Major medical and rights organizations support making the Pill OTC.

The American College of Obstetricians and Gynecologists (ACOG) stated: "ACOG has long supported over-the-counter access to oral contraceptives. Birth command is an essential part of women's health care, and over-the-counter status would aid more women benefit from the ability to command their ain reproductive health." [41]

At least 89 major medical and rights organizations support making the Pill OTC, including the American Academy of Pediatrics, American Academy of Family Physicians, the ACLU, National Women's Constabulary Center, and Planned Parenthood. [14] [42] [43] [44]

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Con one

Over-the-Counter (OTC) birth control would raise the cost of the drug.

Making birth control pills OTC ways they would no longer be covered by insurance and women would have to pay for them on their own. With the Obamacare nascence control mandate, insured women, who account for 89% of American women, can admission free nativity command. [45] The National Women's Law Heart estimates that 62.8 million women accept nascency command coverage with no out-of-pocket cost. [46]

Stuart O. Schweitzer, PhD, UCLA Professor of Wellness Policy and Management, stated that OTC is "more expensive to consumers than a prescribed drug that's covered by insurance." [47]

Before Plan B emergency contraception went OTC, the drug price about $12 for the brand proper noun and $5 for the generic for women using Medicaid. After the drug became OTC, the cost increased to $50 for the brand proper noun and $41 for the generic. [48] Kelly Cleland, MPA, MPH, Research Specialist at Columbia University stated, "When the generics [of Programme B] were almost to go onto the shelves I thought there might be a price war that would push button the toll down. Merely that actually hasn't happened, and I don't come across a sign that it will." [48]

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Con 2

OTC status for birth control pills could result in more unwanted pregnancies.

The birth control pill is non the most effective form of birth control. Amid nativity command methods, the Pill ranks seventh in effectiveness. Typical use of the Pill results in nine unintended pregnancies out of 100 women subsequently one twelvemonth of utilize and increases steadily to 61 unintended pregnancies out of 100 after 10 years of typical use. [49]

Meanwhile, typical use of copper IUDs results in eight unintended pregnancies per 100 women after ten years of typical employ, female sterilization results in five, the Levonorgestral IUD and male person sterilization result in two, and hormonal implants upshot in just one. [49]

Robin Marty, health writer, noted that because the more than constructive options "would require a physician's visit and the Pill would just require a trip to the store, women may exist inclined to use less effective contraception for the sake of convenience." [50]

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Con 3

Teens are non knowledgeable enough to have access to OTC birth control pills.

The American College of Obstetricians and Gynecologists stated, "adolescents need special attention at every visit for contraceptive services, including comprehensive counseling about sexuality, sexually transmitted affliction and emergency contraception." [51]

Some teens may mistakenly believe that they are at a lower hazard of pregnancy but because they have admission to OTC nascency control, fifty-fifty though they may be taking it incorrectly. [52] This lack of knowledge, combined with increased sex due to mistaken conviction in the inability to become meaning, could lead to more teen pregnancies.

Peter Arcidiacono, PhD, Professor of Economic science at Duke University, and his co-authors found that "increasing access to contraception may actually increase long run pregnancy rates even when short run pregnancy rates fall" considering teens accept readily-available contraceptives for granted and are therefore more than likely to ignore availability and have sex without contraceptive protection. [53]

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Con iv

Women who accept birth control pills without medical supervision tin can put themselves at risk.

Jennifer Ashton, Medico, gynecologist, stated, "It's generally accustomed knowledge that the overall health literacy of the lay population is about at the 7th-class level," adding that even with 1-on-i counseling and explanations about how the Pill works, patients are yet confused. [54]

Nascency control pills practise have serious and sometimes fatal contraindications, meaning non every woman should take them. When a drug is OTC, 49% of people get information about the drug from mass media, and only 27% contact their doctors with questions almost OTC drugs. [55] [56] This lack of advice and lack of awareness of contraindications can put women at risk.

Contraindications for nascence control pills include women over 35 years old, women who fume, who accept a history of diabetes, center disease, claret clots, cancer, stroke, liver disease, high claret pressure, migraines (and migraines with aura), or bladder disease. [57] [58]

Poppy Daniels, Doc, obstetrician-gynecologist, called OTC birth control without doctor interest "ridiculous" and "absurd," and stated, "My concern is that you lot're basically taking women who have no counseling, no family history, no risk cess, and they're just getting [hormonal birth control] with no guidance. Why would you have that gamble?" [59]

If the Pill is prescribed, the doctor or pharmacist can tell the patient about whatever possible interactions and forbid bad drug combinations. Drugs that can interfere with nascency control pills include the antibiotic rifampin, many anti-HIV drugs, some anti-fungal medications, some anti-seizure drugs, the stimulant modafinil, many drugs to treat epilepsy, some medications for bipolar disorder, and many herbal remedies including flaxseed and St. John's wort. [60] [61]

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Con 5

Tying prescription nativity command to a visit with a medical professional person results in additional screenings, tests, and conversations that promote overall good health.

When the Pill is available by prescription only, a doc usually requires a well woman exam every one or iii years in lodge to obtain or maintain a birth control prescription. The examination by and large includes a pap smear (the examination for cervical cancer that may exist combined with HPV screening), a breast exam, and pelvic exam that, amidst other things, screens for ovarian cancer and STIs. Additionally, these yearly exams are a skilful opportunity to check in with the doctor most full general wellness and other preventative screenings. [54]

Farther, at least 14% of women on the Pill are using the drug exclusively for noncontraceptive reasons, such as acne and irregular menstrual cycles. [62] That's at to the lowest degree i.5 million women [62] who could be cocky-diagnosing medical weather in a drug store aisle without medical assist.

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Con 6

Over-the-counter status would subtract privacy.

If nascence control pills were bachelor on pharmacy aisles, purchases would be public and subject to the judgment and gossip of anyone in sight. Many people may prefer to keep their contraceptive utilise between them and their doctors.

Olivia Alperstein, Communications and Policy Associate at Congressional Progressive Caucus Center, stated "The concept of over-the-counter birth command ignores the grim reality that not all people tin can just go to a pharmacy and easily purchase birth control. Some face religious and social backlash for buying pills in full view of their chemist and people from their community… Some are immature and under a certain state'southward police force can't purchase nativity control without a parent'southward consent. Some are transgender or gender-nonconforming… The list goes on." [63]

59% of sexually active teen girls would rather cease getting all reproductive health care services than have to tell their parents about their contraceptive use. [64] But, 99% of those teens would continue having sex. [64] Teens want their contraceptive apply kept individual and accessing nascence command in the middle of a chemist's shop where they might run into a neighbor or teacher could terminate some teens from preventing pregnancy.

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Con 7

Drug manufacturers are unlikely to make the Pill OTC, and then improved access has to be accomplished through other ways.

Drug makers to appointment accept little interest in going through the procedure to make a drug over-the-counter considering information technology tin have a long fourth dimension and the costs are significant. [30] Only the drug manufacturer tin initiate this process with the FDA, who decides on the prescription or OTC status of a drug based on applications submitted voluntarily by the manufacturers. Lawmakers cannot modify the condition of a drug from prescription to OTC. Farther, any decision involving birth control can be politically controversial. [65]

Instead, some states are making nascency control available without a prescription, but not over-the-counter. In those states, a pharmacist is required to inquire the patient a few questions, notes blood pressure and weight, and dispenses nascence control from backside the pharmacy counter. Several states including California, Maryland, Tennessee, and Washington let birth control without a prescription. California, Maryland, and DC fifty-fifty allow 12-month supplies to exist dispensed at one time, which has been found to reduce unintended pregnancies by 30% and the odds of an ballgame by 46%. [66] [67] The birth command in these cases is covered by insurance. [66] A report found that 68% of women would apply birth control if it were available via a pharmacist and 63% agreed the pharmacist consultation was an of import stride. [68]

Women in some states can admission birth control via an app or website from private companies. Insurance covers some of these prescriptions, and all that is generally required is a brief consultation to assess risks and appropriate medication, sometimes by video chat. [69] Some services deliver the nascence control to the patient, eliminating the need to stop by a pharmacy. [seventy] [71] [72]

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Con 8

OTC birth control pills would decrease birth command choice and admission.

Vanessa Cullins, Md, obstetrician-gynecologist, noted that there were over xl brands of nascence control pills and "not every formulation volition go over the counter." [73] Past making a few choices available OTC, women are more likely to follow the path of least resistance and choose those available at a drug store rather than by prescription, even if it isn't the right variety of nascence control for them.

The FDA-approved contraceptive methods that would not exist bachelor over-the-counter include IUDs (both copper and with progestin), the implantable rod, and shots such as Depo-Provera, plus sterilization procedures, all of which the FDA states are more effective than the Pill. [74]

Journalist Sarah Elizabeth Richards points out, "Women visiting their pharmacists won't have access to the near reliable forms of birth command on the market because those methods, such every bit implantable rods or intrauterine devices (IUDs), volition still require a trip to a doctor's office." [75]

And, even within birth control pill brands, choice will be limited. Most effort is focused on making the progestin-only (also called Popular or minipills) OTC, rather than the estrogen and progestin pills (also called combination pills). [76] The near recent data states that just 0.four% of American reproductive-aged women have progestin-only birth control pills, or well-nigh 2% of all women who take the Pill. [77]

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Con 9

Making the Pill OTC would increase the use of hormonal drugs that may disrupt and damage the body.

The FDA notes the side effects of the Pill include changes in sexual desire, haemorrhage between periods, sore breasts, headaches, and nausea. [74] Some medical practitioners believe that pharmaceutical contraceptives in general are harmful considering women are not as aware of their bodies or their natural cycles when taking synthetic hormones. [78]

Holly Grigg-Spall, health writer, stated, "Health problems caused by hormonal contraceptives can appear a few months, a few years or longer into use as each adult female processes the synthetic chemicals differently. Yet all women will be changed by these drugs. As a woman's body changes so does her reaction to the pill. The pill'due south repression of vital bodily functions that leads to ill health can build in such a way that years later a woman becomes very ill but can not brand the connection." [78]

Lara Briden, ND, a naturopathic doctor, emphasized these concerns are bigger for teens: "Making hormones is non easy. Information technology requires regular ovulation, and that tin can have a few years to become established. That's why the early years of flow are exactly the wrong time to have hormonal birth control." [79]

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Did You Know?
1. The FDA approved Enovid, the nativity control pill on May 9, 1960 for contraceptive use, making it the start FDA-approved contraceptive drug and the first FDA-approved drug that does not care for an disease. [xc]
2. Typical utilize of the Pill results in 9 unintended pregnancies per 100 women subsequently i twelvemonth and increases steadily to 61 unintended pregnancies per 100 women after 10 years of typical apply. [49]
iii. 60% of American women use some sort of contraception. [1]
4. 17.i% of American women aged fifteen-44 use nativity control pills compared to 8.8% of women worldwide using hormonal nativity command pills. [2] [116]
five. Plan B, the emergency contraception that uses the aforementioned active ingredient as the Pill, was made available over-the-counter in 2006. [101]

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