Two years after U.S. regulators approved the nation’s first over-the-counter (OTC) birth control pill, new research suggests it is reaching people who previously struggled to access reproductive health care.
The study, published Monday in JAMA Network Open, analyzed data from 986 individuals ages 15 to 45 across 44 states. All participants obtained the pill — known as Opill — either online or at a pharmacy.
Researchers found a sharp shift in contraceptive use: a 31.8 percentage point increase among people who had not been using birth control previously, and a 41 percentage point increase among those who had relied on less effective methods such as condoms or emergency contraception.
Opill, manufactured by drug company Perrigo, is a progestin-only pill available without a prescription. The U.S. Food and Drug Administration (FDA) approved it in 2023, citing its potential to reduce barriers to contraception. Nearly half of the 6.1 million pregnancies in the U.S. each year are unintended, according to federal data.
“This is one of the first studies to show that over-the-counter birth control pills are reaching the very people they’re meant to help — those who face the greatest barriers to care,” said lead author Dr. Maria Rodriguez, professor of obstetrics and gynecology at Oregon Health & Science University.
The study found that people using OTC pills were more likely to be uninsured, younger (ages 15–20), and living in rural areas. The most common reason cited for choosing Opill was the ability to obtain it without a doctor’s appointment, followed closely by not having a regular physician.
Rodriguez emphasized the broader implications: “At a time when pregnancy is becoming even more dangerous in the United States — especially for people of color, those with low incomes and those living in rural communities — our findings underscore that OTC contraception is a powerful tool for reproductive autonomy.”
Independent experts agree. Dr. Jessica Shepherd, an OB/GYN and chief medical officer of the telehealth company Hers, told CBS News that expanded access is crucial but also highlights ongoing inequities.
“While greater access to contraception without prescriptions can be life-changing for women with limited resources, it also underscores how unplanned pregnancies continue to strain health systems and communities,” Shepherd said. “These pregnancies often carry higher maternal and infant health risks, financial burdens, and long-term socioeconomic consequences — challenges that weigh most heavily on women already facing barriers to care.”
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