An FDA panel has recommended that one form of birth control—the mini-pill (or progestin-only pill)—be made available over the counter (OTC). While there’s been a lot of discussion about various policy changes at both the federal and state level to improve access to oral contraceptives, today’s news represents the first time that federal officials have approved a pill for this OTC status. 

Here are a few things to know about this recommendation:

“The pill” is the most-used form of contraception in the United States (after sterilization). While some other forms of birth control, like IntraUterine Devices (IUDs), have been increasing in popularity in recent years, more people still use oral hormonal contraception. The FDA approved the first birth control pill in 1960, and today millions of women use it to prevent pregnancy or manage health conditions. Some other forms of birth control—such as condoms—are already available over the counter, but condom use isn’t as common as the pill. 

The mini-pill is safer for more women. Most of the time, birth control pills are “combined”—meaning they contain both estrogen and progestin. The “mini-pill” is progestin-only. The estrogen in the combined pill comes with a risk of blood clots, and for women who smoke or have other contraindications, the risk is higher. For example, the mini-pill has been my choice for birth control because I have rarely suffered from migraines with aura, which is a red flag. And I’ve used it when I’ve been breastfeeding; combined pills aren’t recommended in this situation.

Women have been shown to be capable of self-screening to determine if they are a good candidate for birth control when given the right tools, meaning a consultation with a doctor and a prescription may not be necessary for patients’ health. Other screenings, like regular pap tests (while important), don’t determine if someone is a good candidate for birth control. 

In fact, the added cost and time cost of a doctor’s visit often serves only as an impediment to women’s continuous, consistent use of the pill. It’s no wonder regulators want to remove this hurdle. Obviously, it’s much easier for women to walk into a pharmacy and pick up a medication from the shelf than to schedule an appointment, attend the appointment (potentially missing work or obtaining child care), fill the prescription, and pick it up when ready.

While no drug is perfectly safe, the birth control pill is safer than some other drugs that are already available for over-the-counter sale. For this reason and others, various medical organizations, including the American College of Obstetricians and Gynecologists (ACOG), support moving the pill to OTC

Importantly, the pill, while popular, is not foolproof. In fact, the “typical use” failure rate of the pill is 9%, meaning in a year of typical use, of 100 women using the pill, nine will become pregnant. Today about half of abortion patients in the United States report using birth control when they got pregnant. For this reason, (and other reasons, as I argued recently in the New York Times) women and men should still take sex seriously and choose partners carefully. 

Most people, including most conservatives and pro-life people, support safe and accessible birth control. In a 2022 poll, our sister organization, Independent Women’s Voice, found that 84% of Republicans support access to birth control. Two-thirds of pro-lifers believe that restricting access to birth control will increase demand for abortion, and 80% say that support for birth control is a pro-life position. This means that a lot of conservative and pro-life people are cheering today’s recommendation from the FDA, or at least they don’t oppose it. 

However, the political left has tried to use the issue to scare women. It is true that lawmakers in some states have limited access to (or decreased public funding for) emergency contraception or drugs that cause abortions, but no state has acted to restrict access to normal preventive forms of contraception. And there’s a fat chance any state will: If you read the poll numbers above, you can see there’s simply no meaningful political threat to birth control. It’s disingenuous to conflate opposition to abortion or abortion-inducing drugs with opposition to preventive forms of birth control. It’s political fear-mongering at women’s expense. It’s even worse when you consider the history of legislative attempts to move birth control OTC, and how much of the recent opposition has come from the political left, even from Planned Parenthood

The bottom line about today’s announcement from the FDA is good news for the millions of women who use birth control: It means the mini-pill will soon show up on shelves at our local CVS or Walgreens, making life a little easier, and entrusting women with our own health.