Birth Control

Tennessee Latest State to Consider Over-the-Counter Birth Control

States are moving to make contraception more accessible, with the charge being led by Republican men.


M. Markus/Flickr

More encouraging signs from the states on the over-the-counter contraception front. Tennessee state Sen. Steven Dickerson (R-Nashville) introduced legislation Wednesday to allow birth control pills and the contraceptive patch to be accessible to anyone 18 and older without a prescription. 

"Requiring a physician's prescription can be an obstacle to access and effective use, especially among low-income women," Dickerson said. "One of the barriers for women is the fact they need to go to a doctor's office to get a prescription. Often, this burdens them with missing work or takes them away from their family." 

Dickerson, who is also an anesthesiologist, is one of many in the medical profession who think women should be able to access certain forms of birth control without a doctor's permission slip. The American College of Obstetricians and Gynecologists backs the idea, pointing out in a 2012 statement that "access and cost issues are common reasons why women either do not use contraception or have gaps in use," and this is a large driver of unintended pregnancy. "Weighing the risks versus the benefits based on currently available data, [oral contraceptives] should be available over-the-counter," ACOG concluded. "Women should self-screen for most contraindications to [oral contraceptives] using checklists."

Oddly enough, the biggest supporters of over-the-counter contraception on the political front have been conservatives. Last May, Republican Sens. Cory Gardner (Colorado) and Kelly Ayotte (NH) co-sponsored a bill to spur action on over-the-counter oral contraception—though it didn't go anywhere. The subject was also a big one during Gardner's 2014 Senate campaign, a response to allegations from Democratic opponent Sen. John Udall that Gardner was opposed to contraception and women more generally. 

That whole season was a topsy-turvy one for birth control, with liberals and women's rights groups—those most traditionally in favor of expanding access to contraception—denouncing over-the-counter birth control proposals as attacks on reproductive liberty. Many viewed the idea as an attack on Obamacare's contraception mandate, which requires employer-sponsored health insurance plans to offer a wide range of "free" contraception to enrollees. In a particularly ugly period of partisan hackery, Democrats denounced all efforts to decouple birth control from doctor's visits as part of the Republican "war on women."

But with a little distance from the 2014 midterm elections and the Supreme Court battle over the contraception mandate, liberal furor over giving women more options has died down, and some state legislation to this effect has been able to proceed.

In both Oregon and California, patients can now walk into a pharmacy with no prescription and walk out with birth control pills. While the pill is not technically prescription-free, both states allow pharmacists to write such prescriptions after a simple screening—a system the Tennessee measure might also rely on. While details of the legislation are still being worked out, Sen. Dickerson said it might include providing pharmacists with a "risks list" with which to screen patients before doling out the drugs. 

I'd prefer to see birth control pills sold alongside aspirin and acid-reflux meds,  but proposals like these are a major, major step in the right direction—and the majority of Americans agree. The 2014 Reason-Rupe poll found 70 percent of Americans favor legalizing over-the-counter birth control pills and patches. Support was high among both men and women, and also showed bipartisan appeal, with 65 percent of self-identified Republicans, 69 percent of Democrats, and 74 percent of political independents in favor. 

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  1. In a particularly ugly period of partisan hackery, Democrats denounced all efforts to decouble [sic] birth control from doctor’s visits as part of the Republican “war on women.”


      1. So who is paying off these legislatorsd that oppose making birth control OTC?

        1. Planned Parenthood?

          The reality is that Cory Gardner’s proposal would actually cost women more by forcing them to pay out of pocket for the birth control that they are getting now at no cost thanks to the ACA.


          With their baby-organ-selling profits, probably.

          Also, note that their oppo to this is couched almost entirely in terms of who is proposing it – those evil Teahadists who are trying to repeal St. Obama’s gift to the nation, ObamaCare.

          1. “they are getting now at no cost thanks to the ACA”

            Hmm either somebody else is paying for it or it is going on their premiums

            1. It’s FREE, Frankjasper1. FREE!!! What don’t you understand about FREE BIRTH CONTROL? Are you some sort of retrograde TEATHUGLIKKAN or something?

            2. No cost except for the copay or pre-deductible cost of getting an OB appointment.

              1. Studies have revealed that a certain income group is not getting visits for birth control, thus, increasing their need for abortions! The visits are never free. Either, they are poor enough for Medicaid, or they can afford private insurance, and the deductibles. Even with private insurance, many cannot afford the deductibles being charged. Free is the best.

                Although I am very conservative, I understand that anyone depending on abstinence is crazy as a darned loon! “Saved” or not, there are kids (yes their, sweet, innocent, little girls) who are going to give in to the feelings! Since it is the girls who will go into the pregnancy with not support, most of the time, they should be smarter than thinking theirs will be an exception! Sadly, the girls will likely be limited from buying it, by age restrictions. Somebody has to get smarter about it. This only solves part of the problem. But, it will help. And, I got payed for many a PAP smear women were forced into getting for yearly renewal of birth control. There is actually no scientific reason to get them yearly, you know!

                Sadly, my mother, who was 75 was not given a PAP smear, for her vaginal bleeding, and died from the cancer of the cervix , last year. There was a big scientific reason to get hers! Too bad no one seems to care about it. No malpractice lawyers seem to care. She was old anyway. Only had another 20 years to live, at the most, anyway!

          2. St. Obama’s

            I usually go with Barack H. Christ

            1. Hallowed be Teh Lightworker’s Name!

      2. You’re welcome.

  2. “Oddly enough, the biggest supporters of over-the-counter contraception on the political front have been conservatives….

    “That whole season was a topsy-turvy one for birth control, with liberals and women’s rights groups?those most traditionally in favor of expanding access to contraception?denouncing over-the-counter birth control proposals as attacks on reproductive liberty. Many viewed the idea as an attack on Obamacare’s contraception mandate”

    Both sides realize that making contraception over the counter would pretty much destroy any remaining rationale for the contraception mandate. It would be like forcing employers to buy aspirin for their employees. Not even “women’s rights groups” will be able to argue with a straight face that there’s a compelling interest in forcing part of a worker’s compensation to be paid in the form of contraception not money.

    But if it’s prescription-only, the groups can wring their hands about expensive contraception is, and how dare these top-hatted bosses (and nuns) deny women their free contraception? What a wonderful opportunity to screw over those fundies!

    Not to mention that this sort of thing keeps women dependent on the government, the Democratic Party, and the “woman’s rights groups.”

    So there’s nothing odd or topsy turvy about it at all.

    1. “wring their hands about *how* expensive contraception is”

    2. It’s all about power, captured markets, and handing out favors to preferred interest groups. That’s pretty much standard operating procedure.

    3. Look, women should have the same right to free birth control as men. Whether by prescription or OTC, it must be free to be equal. Free condoms, after all, are widely available to men in many gas-station bathrooms. Well, “free” assuming you have a crowbar, and since most women don’t carry around crowbars in their purses and – let’s face it – lack the upper-body strength to pry off that steel bar padlocked across the front, it’s not fair that women should be denied their right to free birth control just by the accident of being born a crowbar-less, upper-body-strength-less woman.

    4. “Both sides realize that making contraception over the counter would pretty much destroy any remaining rationale for the contraception mandate.” How so? The costs still remain to be assigned.

  3. Falling back-asswards into a liberty position is better than nothing at all.

    1. You say that about everything!

      What else have fallen into ass-backwards?

      1. Swimming pools, lakes, the ocean–Atlantic and Pacific, a tractor tire, and your mom.

        1. She still talks about that.

          “His ass was like a large, gentle field of adipose, jiggling in the majestic wind.”

      2. Hitler?

    2. I can’t understand why non-Catholic conservatives would be opposed to such a thing in the first place. It’s not like birth control uniquely protects fornicators instead of married couples, and it’s not like the promiscuous can’t already get it at any rate, so it shrinks government and saves money.

      1. I actually think you’re likely to get more pushback from evangelicals than Catholics. Sure, the Church is opposed to contraception but in many ways it seems like the “testify!” crowd is much more pushy regarding telling folks how to lead their lives. They also seem to actually be much more prudish than the Church regarding sex generally. The Church wants you to fuck like rabbits and make lots of Catholic babies. Evangelicals often seem to regard sex as inherently sinful.

        1. Do you have some cites for this?

          1. Not at all. Should’ve included the “completely anecdotal, personal experience” marker on that. My own experience as a Catholic (wayward though I may be) was actually very pro-sex, with the obvious preconditions of being married and no contraception (the whole discussion of the acceptability of the rhythm method seemed a bit of a contradiction I’ll admit). My experiences as a Southerner around more evangelical-raised folks was much more socially straight-jacketed, as if certain strains of Christianity really would prefer if babies were born immaculately or, at the very least, sex was treated as something to not be discussed in polite company.

            Could be more cultural than religious and again, completely anecdotal.

            1. Does not match my experience!

  4. “I’d prefer to see birth control pills AND testosterone sold alongside aspirin and acid-reflux meds”

    So I am assuming this would be acceptable? Since both are simply hormones, and equality and everthing.

    1. #AllHormonesMatter

    2. “I’d prefer to see birth control pills AND testosterone sold alongside aspirin and acid-reflux meds”

      Ideally, I’d like to see all drugs legalized and available to whomever wants to buy them without the intercession of a medical cartel. But if we can get the camel’s nose under the tent, it’s a step in the right direction.

      1. Chant with me, folks: “NO OTC HEROIN, NO PEACE!”

        1. What’s this “OTC” business? I want it in vending machine across the street from elementary schools all over the country.

          1. At the very least, the ATF and the DEA* should be privatized, repurposed, and franchised as convenience stores.

            *Drug Enablement Administration

            1. ATF: now I only have one stop to make on a Friday evening.

              1. C’mon, guys. Its BATFE. You’re leaving out the funnest part of their inventory.

                1. Is that a Chipotle reference ?

        2. Screw that. I want my Ludes back, man.

        3. I’m holding out for OTC amphetamines, personally

          1. Mmmmmm…dexadrine…

          2. You said it. My house will never have been so clean, and anyway, who needs sleep? Or teeth?

        4. Heroin takes too many accessories.

        5. Heroin = diacetyl-morphhine. Pure, it is much safer than the the street version. It is used as pain medicine in South Africa! But otherwise, let’s keep fighting the drug war in the same fashion. It has helped so much so far!

    3. I’d prefer to see birth control pills, rings, testosterone, oxycodone, marijuana, mushrooms, cocaine and MDMA sold alongside aspirin and acid-reflux meds.

  5. But its not accessible unless someone else pays for it, and if its OTC, its probably not covered.

    See, the Teahadist Rethuglikkkans are actually making birth control less accessbile. #WarOnPrescriptions

    1. Well, duh. They cost $3,000 a month!

    2. OTC was covered by HSA plans until Obamacate killed that.

  6. In a particularly ugly period of partisan hackery, Democrats denounced all efforts to decouple birth control from doctor’s visits as part of the Republican “war on women.”

    So, if women are required to visit a doctor and receive counseling and the doctor’s approval before getting something, that’s a “war on women”. If something is available OTC so that women don’t have to go to the doctor, that’s a “war on women”. Got it.

    1. It’s Wars on Women all the way down…

      That meme never get’s tired.

    2. Change birth control to abortion and they would be freaking out about required visits and such.

      1. …pretty sure that was JD’s point.

        1. Yeah. Just read it again.

    3. Unless that something is an abortion, then it’s the opposite.

      1. Ah, never mind.

    4. It is as if they lack principles,. but not principals.

    5. The irony, of course, is that only a doctor or a pharmacist is actually able to “deny access” to birth control.

  7. Who was it that was pointing out that the left’s support for “reproductive rights” are pretty damn odd when you consider that what’s being discussed isn’t “the right to reproduce” but “the right not to reproduce”? Kind of funny that the same people who most strongly insist reproductive rights naturally include the negative right to not reproduce are the same ones who insist freedom of association does not include the negative right not to associate. Don’t try arguing that freedom of association in any way connotes a freedom to not associate with a gay couple who wants you to bake them a cake.

    1. J, I had not thought of that angle, and plan to use it without attribution to you in any way. So, thanks.

      1. Go right ahead, just when you use it make sure you change the “left’s support for reproductive rights are” to “left’s support for reproductive rights is” so Sevens doesn’t have to chase you around correcting you’re grammar.

        1. Dang it. That should be “you’re grammer”, not “you’re grammar”. And check your spellin. And Type-O’s. And malapropisms.

  8. So all these Tennessee Republicans are really left-wing hippies?

    1. That was, oddly enough, sort of true in 1950 when V. O. Key wrote his classic Southern Politics in State and Nation. Tennessee Republicans were in the eastern part of the state and basically Republican because they had opposed secession. (TN-01 and TN-02 have voted Republican every election since then.) The mountain folk Republicans who opposed slavery have long provided some of the more libertarian Republicans.

  9. What made the opposition loony is that plenty of drugs are available *both* OTC and prescription, and plenty of insurance (including Medicaid!) will reimburse for OTC drugs when you have a doctor’s prescription to get it. On top of that, for people who work hourly, OTC costs are still cheaper than forgoing pay in order to get a doctor’s visit.

  10. Meanwhile, prescriptions required for Sudafed to combat a phony meth crisis.

  11. Im making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do,


  12. The contraception mandate has initiated a creeping zeitgeist among conservatives. Some are finally realizing that if you remove barriers to contraception, the numbers for abortion go down! Who’da thunk! Unfortunately Liberals believe their own propaganda, so are convinced that this is some sort of Anti-Obama care plot they haven’t quite figured out yet, but must be fought.

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