Research brief: A national survey of US women's interest in over-the-counter access to a progestin-only pill

Approximately half of all pregnancies (45%) are unintended in the United States each year, including 72% among teens aged 15-17. Numerous factors contribute to these high rates, including socioeconomic inequalities, gaps in insurance coverage, cost barriers, and challenges accessing a healthcare provider. One effective strategy to better meet people’s reproductive health needs is to make oral contraceptive pills (OCs) available over the counter (OTC).

Leading medical organizations have issued statements supporting OTC access to the pill, including the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians. All OCs, including progestin-only pills (POPs) and combined OCs (COCs, which contain both progestin and estrogen), are safe and highly effective at preventing pregnancy. However, POPs are the safest OC option for the broadest population. Since POPs have fewer contraindications compared to combined OCs and progestin-only emergency contraception is already approved for OTC use, a POP may be the first pill formulation to become available OTC in the United States.

Little is known about women’s and teens’ interest in using an OTC POP in the United States. This study aimed to fill this gap by surveying a nationally representative sample of 2,026 sexually active adult women aged 18-44 and 513 female teens aged 15-17 who did not desire pregnancy in October 2015.

Key findings from the survey include:

• Thirty-nine percent (39%) of adults and 29% of teens reported likely use of an over-the-counter POP. If covered by insurance, likelihood of use increased to approximately 46% among adults and 40% among teens.
• Nearly one in four adults and teens not currently using contraception said they would be interested in using an over-the-counter progestin-only pill.