It's occurring to me that "a post-Dobbs world" might ring a little US-centric to some.
Wait, so women have always had to stand in line for a pharmacist to dispense them birth control? For something that's been near-standard for two generations? That's fucked up.
Even Plan B has been OTC for about 10 years now! Although I wonder how routinely stocked it is.
you had to make a doctor's appointment to get a prescription! Then wait in line at the pharmacy.
To be fair, it's not crazy to have medical supervision. It's just that it comes with a lot of barriers currently.
Maybe we need to require pharmacies to let people get OTC birth control or Plan B without having to ask anyone for it. (Like, push a button and it's readied at the register.)
You have to high five the pharmacist to buy condoms.
I'm a little confused about how people choose *which* birth control pill without a doctor's involvement. Or are we about to see a bunch of branding and advertising for specific birth control brands? Having just tracked down an article, it looks like only one formulation is approved so far, but presumably once you have one then others will get approved as well? Or was there something special about this particular one that allowed it to get OTC approval?
It looks like this OTC-approved version contains just one hormone and was approved in 1973. So I can't imagine generics won't follow hard upon.
Maybe the ideal path will be, people talk it over with their doctors, then if the OTC version makes sense for them they start getting that?
JAMA talking a bit about what sets this formulation apart.
A progestin-only pill seems like a logical first step toward a broader array of over-the-counter contraceptives because such pills are highly effective, have a strong safety profile, and don't require an examination or testing to determine eligibility.
...Only a small minority of oral contraceptive users in the US take a progestin-only pill, typically people who have contraindications for a combination pill that contains estrogen as well as progestin.
Physicians may be less likely to prescribe progestin-only pills because they think they're less effective than pills containing estrogen and progestin, a recent review article noted. However, based on 54 studies, the authors concluded that only 2 pregnancies are expected to occur for 100 people who used progestin-only contraceptive pills for 1 year. This failure rate is much lower than the currently accepted estimate of 7%.
University of California San Francisco obstetrician and gynecologist Daniel Grossman, MD, attributes the country's low use of progestin-only pills in part to a lack of marketing of off-patent products. Another factor could be that progestin-only pills are supposed to be taken at the same time every day and are associated with irregular menstrual bleeding, Grossman said in an interview.
8: Once you talk to a doctor it's probably cheaper to get a prescription, but there's still advantages to OTC in that setting (traveling, moving, switching doctors, etc.). But I'd expect OTC is mostly for people who don't want to talk to a doctor.
10: I think birth control is among the preventive services supposed to be paid by insurance copay-free whether it's OTC or not. Actually getting them to honor that might be more complicated. (See Plan B.)
I get some OTC medications by prescription because that means I can use HSA money for it (ACA is partially funded by not letting you use HSA money for OTC medication, thanks Obama!).
OTC medications in general, yes, but I think being on the preventive list is supposed to take precedence over that. I found one company's coverage list saying they're required to cover birth control both prescription and OTC.
*huge* benefits to those still living with parents (& therefore not able to confidently access bc from their regular doctor), those who are older/independent but without health insurance or the funds to get a rx, & every fertile person who doesn't want to be pregnant but is traveling & forgot rx/dr demands impossible to schedule appt before will approve rx/etc etc etc ... just a measurable increase in autonomy & dignity during an otherwise horrendous time.
Huge for teenagers for whom getting to the doctor and dealing with parents is prohibitive. (That's why Rs oppose it.)
Anyhow there is no way bcp are more dangerous than Tylenol.
14/15: It is definitely huge for those groups. But condoms do exist. This makes it more invisible for the guy, but it's not the first OTC thing that prevents births.
For people with insurance or Medicaid, it could be more expensive.
Because of the risk of blood clots in the combined pill, it's the progestin only mini pill which is slightly less effective. I think you have to be more careful about taking it at the same time each day, because it is not quite as effective as the one with estrogen.
Usually, The Atlantic doesn't forget that poor people exist to quite the same degree as they manage here.
17: huge gain in autonomy for all the teenagers who won't have to rely on their partners 1) acquiring, and 2) consenting to use condoms. are barrier methods essential for disease prevention? yes! but it is immense that teens have a few less horrible worries.
I'm really not disagreeing. Technically girls can buy condoms, though.
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[drawing on reserves of goodwill]
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Is that a really long URL or are you just glad to see me?
Some people say that Jewish people created covid so that it would target them less, but when we're all stuck at home with covid, it wasn't a gentile that brought us ice cream.
24: I'm seeing a lot of Vote No yard signs around my neighborhood.
26: it was the Jews and Chinese collaborating presumably to get revenge for the quotas at Ivy League schools.
And they brought me ice cream because I couldn't even get into Brown regardless.
Brown didn't want me either! What did they have against the future lazy driftless underachievers of America?
I had no idea my theory was so right, but just now a family of Asian Americans brought me some wine.
NMM to Jane Birkin
Surely we can make one exception to the rule
Pictures of Jane B
Made my life so wonderful
Pictures of Jane B
Helped me sleep at night
36. On condition that you do it in Xinjiang, where the temperature was recorded as 52.2°C (126°F). You need real commitment.