Unlike women in the US, Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.
As medical organisations and other groups push to ease the prescription requirements for the Pill in the US and elsewhere, "we can start to use this information to... get a sense of the safety of women having access to this method where no prescription is required," said Kari White, a birth control researcher at the University of Alabama in Birmingham.
White, who was not involved in the new work, said some studies have shown that, without a doctor's input, women can accurately screen themselves for risk factors to steer away from using the Pill if it's not appropriate for them.
Earlier this year, the American College of Obstetricians and Gynecologists endorsed the idea of making the birth control pill available without a prescription.
How the study was done
In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries, Dr Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in 45 countries need a prescription to get birth control pills.
The group reported online in Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the pills over-the-counter.
Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.
"The patterns we saw were interesting," said Dr Grossman. "Higher income countries - western Europe, Australia, Japan and North America - generally require a prescription."
Experts couldn’t explain pattern changes
Dr Grossman told Reuters Health he couldn't explain why these patterns have emerged."Perhaps in places like China and India (having) pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs," he speculated.
Dr Ward Cates, of FHI 360, a research organisation in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.
In some countries, "healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public," said Dr Cates, who was not part of the study.
Dr Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.
"Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not," Dr Grossman told Reuters Health. "But I do think it helps to put it in perspective that this is not something revolutionary."
(Kerry Grens, Reuters Health, January 2013)
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