Birth control has long-term health benefits

The argument

The argument for over-the-counter birth control here is that a prescription requirement treats contraception as though pregnancy prevention were its only purpose, when in fact it is a medication with a wide range of health uses, and that the requirement blocks access to those uses for the women least able to pay for them. Women take birth control for several different reasons. It is effective at preventing pregnancy, but many use it to regulate their menstrual cycle and to reduce the symptoms associated with premenstrual syndrome. Beyond that it is effective in preventing iron deficiency anaemia, bone thinning, acne, ovarian cancers, cysts, and serious infections of the uterus and fallopian tubes. That is a list of ordinary conditions, some of them painful and some of them serious, and for many women the contraceptive effect is a secondary benefit rather than the reason for taking it at all. The obstacle is procedural. In many countries, including the United States, a woman must consult a doctor or an obstetrician-gynaecologist before she can obtain a prescription. Many women have no health insurance, and for them visiting a specialist and paying out of pocket is not always affordable or convenient. The requirement therefore falls hardest on those with the least money. What is being rationed by that requirement is not only contraception but the other benefits on that list, several of which concern conditions that become more serious when left alone. Making birth control available over the counter would give women more choices in preventing pregnancy and in looking after their overall health as well. Because of these long-term health benefits, the argument concludes, over-the-counter birth control should be for sale.

Premises

Counter-arguments

While it is proven that there are health benefits associated with birth control, there are also many side effects. There are a number of birth control brands that can be prescribed, but some brands are not well suited for certain women based off of their medical history. It would be irresponsible to make birth control available without the consultation of a doctor first. Birth control can come with side effects, such as headaches, vomiting, weight gain, and bleeding in between periods. There are also risk factors for women who are over the age of 35, have a history of cancer, high blood pressure, heart attacks, and blood clotting. Birth control is also risky for women who smoke. Because of these factors, it is important to consult a physician before taking any brand of birth control, no matter how healthy an individual may be. While it would be a woman’s responsibility to know their medical history before taking birth control, some women may be unaware of possible health issues, or may be uneducated on how birth control may be risky for them. Making birth control available over the counter may lead to more health problems for women, and in some cases, can be very dangerous.

Rejecting the premises

[Rejecting P1] The benefits listed are real but are not evenly distributed across products, and the argument treats hormonal contraception as a single thing. Reduced ovarian cancer risk and cycle regulation are associated principally with combined oral contraceptives — which are also the formulations carrying the risks that motivate the prescription requirement in the first place. [Rejecting P2] The premise identifies a cost barrier and then proposes a regulatory change, which does not obviously address it. Over-the-counter status removes the consultation but not necessarily the price, and in systems where contraception is covered by insurance only when prescribed, deregulation can raise the out-of-pocket cost rather than lower it. [Rejecting P3] The counter-argument on record sets out why the consultation is not a formality: combined pills are contraindicated with a history of blood clots, certain cancers, migraine with aura, uncontrolled hypertension, and in smokers over 35, and a user may not know which of these applies to her. Product choice among available formulations also depends on that history. [Rejecting C] The argument would be stronger drawn more narrowly, since the risk profile it needs to escape belongs to the oestrogen-containing products specifically, and progestin-only formulations — which is where over-the-counter approval has in fact been granted — do not carry it. As stated, the conclusion is broader than the premises support.