• Over-the-Counter Oral Contraceptives

    The American Academy of Family Physicians recognizes that unintended pregnancies are a major public health concern, accounting for approximately 50% of US pregnancies.1 Access and cost are commonly cited reasons why women have gaps in contraceptive use or do not use contraception.2 While oral contraceptive pills are widely considered to be safe and effective medications, they continue to require a prescription for use, further restricting access. The AAFP recognizes that though contraindications to these medications do exist, women have been shown to correctly self-identify contraindications to use when using a standardized check-list.3,4 Over 100 countries round the world currently provide oral contraceptive pills over the counter without a prescription.5 The AAFP supports over-the-counter access to oral contraception without a prescription. Under the Patient Protection and Affordable Care Act, private insurance must cover all contraceptive methods approved by the FDA. The AAFP supports insurance coverage of oral contraceptives regardless of prescription status in all insurance plans.


    1. Finer LB, Zolna MR. Shifts in intended and unintended pregnancies in the United States, 2001-2008. American Journal of Public Health. 2014. 104(S1): S44-S48.
    2. Frost J, Singh S, Finer L. U.S. women’s one-year contraceptive use patterns, 2004. Perspect Sex Reprod Health. 2007; 39:48-55.
    3. Grossman D, Fernandez L, Hopkins K, Amstae J, Garcia S, Potter J. Accuracy of self-screening for contraindications to combined oral contraceptive use. Obstec Gynecol.2008; 112:572-578.
    4. Doshi JS, French RS, Evans HE, Wilkinson CL. Feasibility of a self-completed history questionnaire in women requesting repeat combined hormonal contraception. J Fam Plann Reprod Health Care. 2008. 34;51-54.
    5. Grindlay K, Burns B, Grossman D. Prescription requirements and over the counter access to oral contraceptives: a global review. Contraception. 2013. Jul:88(1):91-96.

    (2014 COD) (2019 COD)