Ending the Conflict Over Contraception

Virginia Postrel suggests an easy way to expand access to contraception without risking any imposition on religious institutions: Make oral contraceptives available without a prescription.

True, making the pill available over the counter could reduce the amount of outrage and invective available for entertaining radio audiences, spurring political fundraising and otherwise amusing the American public. But the medical risks are quite low.

Partly because birth-control pills are available only by prescription, people tend to think they’re more dangerous and less well understood than they actually are. In fact, “more is known about the safety of oral contraceptives than has been known about any other drug in the history of medicine,” declared an editorial in the American Journal of Public Health back in 1993. That editorial accompanied an article arguing for over-the-counter sales.

Unlike most medications, the article noted, birth-control pills require no medical diagnosis: “A woman herself determines her need for oral contraception; she assesses her own risk of pregnancy … and the costs and benefits of both pregnancy and alternative contraceptions.” Nearly two decades later, birth- control pills look even safer than they did then, and recent research indicates that women are both able and eager to manage their own purchase decisions.

This approach won’t satisfy those who want others to pay for their contraception, nor will it please those who believe the widespread availability of contraception is a cause of cultural decay.  For the rest of us, however, this would seem like a reasonable way to make it cheaper and more convenient for those who wish to use oral contraception to obtain it without any risk of imposing on the religious  beliefs of those who believe contraception to be immoral — and for these reasons the likelihood of such a policy being adopted is small.