British Women’s Right to Over The Counter Pill: Is This a Win?

A summary of women’s access to contraception worldwide

Beginning in 2024, British women will be able to access birth control pills over the counter without a prescription, it was announced by the government on the 16th of November 2023. Going forward, “the pill” can be obtained at a local chemist or pharmacy, known as ‘over the counter’ (OTC) service.

This is excellent news for British women, and as a Black-British woman I am proud to see the UK move forward with easy to obtain contraception. Still, the questions must be asked, how common is the OTC service worldwide? Do more countries need to follow suit? What are the pros and cons? And which demographics of women are left out worldwide with this movement to give women more control over when or whether they give birth? While it may appear to be a ‘win’ for British women, is it really?

The European Stance On Contraceptive Pill Access For Women

Euro News this October scored forty-six countries on providing contraceptive care, placing 41.3% percent of them are in the “green zone” that scored 60 — 96%; nineteen of the forty-six locations fell here. This is good news for women in these locations; just over a third of European countries are doing a great job.

Six countries, or 13.4%, managed to make it into the yellow zone, scoring 55 to 59% on providing contraceptive care. What this shows is that a small majority are “good” at providing care, but could do better.

The 21 remaining countries, or 45.6% (which is the majority), fell in the orange to red zone. They scored 54% and below. What this shows us is that a majority of Europe is not doing that well, with the highest cluster of locations falling in the orange to red zone — which could be called “needs improvement.”

When we look at locations, those that fall in the “needs improvement” or lower scoring locations are largely in eastern Europe. The question is then, what is happening for women in that part of Europe? Why is their access to contraception significantly lower when compared to western Europe?

The most interesting thing to be noted in the report is: most countries still don’t offer an OTC service, without a prescription. That means a visit to the doctor is still needed for most women to get the birth control pill. Women are busy people and doctor’s appointments are not always readily available. Each European country’s score on their contraceptive care is shown on the Contraception Policy Atlas. The UK, France, Luxemburg, Sweden, and Belgium scored in the top five locations. In France, girls fifteen-years-old can obtain contraception with a prescription. The legal age for consensual sex in France was made fifteen in 2021. Turkey, Cyprus, Hungary, Bosnia, and Poland came in as the bottom five locations.

This data only tracks overall access to contraception; it does not show how many countries have an OTC prescription-free service.

FDA Approve an Over The Counter Pill In the USA

It appears that in 2023, the “first ever” pill was approved by the FDA for over the counter access without a prescription in the USA. Women’s access to this will begin in 2024, in line with the UK.

Over The Counter Access Worldwide:

The Free Pill recorded in September 2023 (the latest update), that around 100 countries around the world offer OTC, prescription-free contraceptive pills for women. All of South America (apart from Guyana, as there is no data to support either a yes or no), Mexico, the Caribbean, a large majority of Africa, Russia, and the far East seem to be ahead of the game. What this shows us is that OTC access is something that women have a legal right to in a large part of the world, already.

Do More Countries Need to Act?

Looking at the world map supplied by The Free Pill, it appears that a majority of the world is already onboard with OTC access to contraceptive pills. This would make the UK a little late to the party. The Centre for Reproductive Rights, recommended in their 2012 report that countries in the EU should:

Recognize that sexual and reproductive rights, including access to contraceptives and contraceptive information, are fundamental to the achievement of gender and health equality in the EU.

They also asserted that EU member states should:

Act on the Parliament’s Resolution of 8 March 2011 on equality between women and men in the EU, which stresses that women must have control over their sexual and reproductive rights and calls for easy access to contraceptives.

Fair enough.

Currently the UK is not part of the EU anymore, however at the time of the Centre of Reproductive Right’s report they were. The UK left membership in January of 2020. The report cited above is dated 2012. So it has taken the UK government over a decade to act, when it appears a lot of the world (one hundred countries) are already honouring these women’s rights.

Women Are Demanding More Globally

While we have a majority of the world offering OTC contraceptive pills for women, giving them complete control over whether and when they have children, the demand for the pill has been steadily increasing. A study by Birth Control Around The World found that from 1994 to the present worldwide there has been an 8.3% increase in women using contraceptives.

The biggest increase has been in Asia and Africa. Why is this? In my recent story Is Feminism to Blame For Korean Women Taking Down The Patriarchy?, I note that in this part of the world, Korean women in particular are so unhappy with their quality of life that they’ve gone on a “birth-strike” and caused a dip in the overall childbirth rate for their country. And Psychology Today found in their 2022 study The Rise Of The Lonely Single Man, that women generally are raising standards in their expectations of men, and therefore less likely to give birth.

When we consider the most popular methods of birth control worldwide, Birth Control Around The World cites the contraceptive pill. While methods have shifted between 1994 to present, the contraceptive pill still is the preferred method across six continents. This shows us exactly why the OTC service is something all governments should focus on, especially in Europe where it’s reported a majority don’t offer this.

Is The New Law A Win For British Women?

It could be suggested of course that any right a woman gains to control her own body and whether or not she gives birth is a win. Especially when you have some locations revoking that, as we have seen in the USA with the overthrow of Roe vs Wade abortion rights.

However, when we look at what the world is doing when it comes to distributing the pill when we must consider that:

• A majority of the world has already opted to allow women to obtain contraceptive pills without a prescription, over the counter.
• In 2012 the Centre of Reproductive Rights gave a recommendation following their research, that EU members provide better access to OTC services.
• Women in general globally prefer the pill as a method of contraception, and have been demanding it more since 1994.

So this should have happened sooner for British women.

Moving Forward

For women who advocate and follow women’s rights, locations which don’t offer OTC access to the contraceptive pill should be placed on their watch list. This type of access is making very slow progress if recommendations were made in 2012 for the EU.

Outside of the EU, at the time of me writing Is Feminism To Blame For Korean Women Taking Down The Patriarchy, there is a “birth-strike” going on in Asia. It’s happening now, and has been for a while. There is evidence and data supplied above to confirm that Asian women are demanding the contraceptive pill more than any other demographic of women, as they had the largest increase in use from 1994 to date. The movement across Asia for women’s reproductive rights is something women’s rights advocates should be watching in this part of the world, too.

The Pros of The Law Changes

• Women now have more control over their bodies concerning when and whether they give birth.
• Improved access could reduce pregnancy in younger girls.
• Women no longer need to wait for a doctor’s appointment, which could have led to them not taking their pills. Doctors’ appointments are hard to get in the UK from my personal experience.

The Cons of The Law Changes

• Health and safety could be compromised if the pharmacist does not take detailed health records before providing the pills.
• There’s less opportunity for a medical professional to check a woman’s overall health.

While there are pros and cons to this new legislation in the UK, to counteract the cons, women should still visit the doctor regularly for gynaecology check-ups. Pharmacists also have a role to play. The onus has shifted from the General Practitioner doctors (GPs) who originally prescribed the pill to the pharmacists when it comes to correct allocation of medication and checking a woman’s medical history and suitability to take a certain brand of contraceptive pill.

While this appears as a small win for British women, based on the data and evidence, it should have happened earlier. It’s already happening in a lot of locations, and much of Europe needs to catch up.

For younger women, this change in law could be a good thing. If they are sexually active, then make the excellent decision to use birth control, this new legislation supports their decision. It also reduces fear of parents finding out, which could be an issue for younger girls. On the other hand, does it promote more sexual activity among younger girls?

What do you think? Should we have an prescription-free OTC service for contraceptive pills?

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