The FDA approves the first-ever non-prescription birth-control pill

If the decision was sobering, the concurring opinion was chilling. When the Supreme Court overturned Roe v Wade, making states the new arbiters of abortion policy, Justice Clarence Thomas laid out a blueprint for what could come next. Harnessing the same legal logic that the court used to topple Roe, he called on his colleagues to do away with a trio of other precedents. Among them was Griswold v Connecticut, a 1965 case that established a married couple’s right to buy contraceptives without government restriction. Wide-eyed progressives braced for abortion battles to morph into a war over birth control.

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Pro-lifers have been mulling going after the contraceptive pill, but an organised offensive to purge pharmacies of it has yet to materialise. Doing so will soon become harder. On July 13th the Food and Drug Administration (FDA) approved Opill, the first-ever non-prescription birth-control pill. Come early 2024, women will be able to order Opill online or pick it up from drug stores without a doctor’s sign-off.

Liberals see this as an antidote to abortion restrictions. Making contraceptive pills more readily available should result in fewer unplanned pregnancies. But for this to be a practical option for women, Opill needs to be affordable. Perrigo, the company that makes it, has yet to disclose its price and private health insurers are not required to cover it (though an executive order issued in June suggests that President Joe Biden may try to change that).

At the right price, non-prescription pills could increase liberty. Claudia Goldin of Harvard University found that when contraceptives became widely available in the 1960s, women stayed in school longer, boosting the economy. Today, 12% of sexually-active women, and 14% of poor ones, do not want to get pregnant but do not use contraceptives. Though the impact will be smaller now, it could still be significant.

Kristan Hawkins, the boss of Students for Life, an anti-abortion outfit, thinks the pill will give women a false sense of security, leading to more, not fewer, abortions. She points to a 2014 analysis by the Guttmacher Institute, a pro-choice research group, that found that 51% of abortion patients used birth control in the month they got pregnant, as evidence that women misuse contraceptives. Yet to get FDA approval, Perrigo proved that consumers use Opill safely and effectively without doctors’ instruction. Still, Ms Hawkins says the proliferation of the pill will empower rapists to slip it into their victims’ drinks to cover up their crimes and will lead to higher rates of sexually transmitted infections and depression among girls. (There is some evidence for the latter two claims.)

The impact of Opill will be dulled if women are wary of it. In places where abortion is taboo, conspiracies are particularly potent. The nurse practitioner at Woman’s New Life Clinic in New Orleans warns patients that the pill is linked to cancer and says condoms disrupt vaginal pH-levels. More than three-quarters of American women of reproductive age favour making birth control available over the counter. But those who need it most may be least likely to bring it to the till.

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