Attorney General Bonta Leads 21 States in Urging FDA to Approve Country’s First Over-The-Counter Birth Control Pill

If approved, the pill would be available to buy without a prescription, removing barriers to accessing safe and timely reproductive care

OAKLAND — California Attorney General Rob Bonta today announced leading a multistate coalition of 21 attorneys general in submitting a letter urging the U.S. Food and Drug Administration (FDA) to approve over-the-counter (OTC) birth control pills that meet applicable safety and efficacy standards, including a pending application for the nation’s first OTC pill. If approved, safe and effective birth control pills will become available for purchase over the counter, removing barriers that currently keep many people from being able to access safe and timely reproductive care. In the letter, the attorneys general argue that approval of the pill would allow individuals — especially those from vulnerable populations — greater control over their health, lives, and futures, and help them avoid the health and economic perils that come with unwanted pregnancies.

“California is a proud reproductive freedom state, and we continue to lead efforts to protect, expand, and strengthen access to that freedom across the nation — including by supporting efforts to expand access to safe and effective birth control,” said Attorney General Bonta. “This is not just about a pill, it’s about empowering people, especially people of color, people from low-income families or rural communities. This is about tearing down the barriers that trap them into lives they did not choose. Every individual deserves equal access to the reproductive care they need, and I remain committed to the fight to ensure that access.”

The FDA is currently reviewing an application to approve a birth control pill, named Opill, for OTC use. If approved, people in need of birth control would be able to, for the first time ever, walk into a pharmacy and buy it without a prescription.

In the open letter to the FDA, the attorneys general assert that the pill should be approved for OTC use because:

• It has been found to be safe and effective for most users: Studies show that progestin-only pills, like Opill, carry a much lower risk of blood clots than traditional combination estrogen and progestin birth control pills, because they contain synthetic progestin and no estrogen. And studies of progestin-only birth control pills show that they are over 90% effective in preventing unwanted pregnancies — more effective than methods such as spermicide, condoms, or the sponge.

• It would remove barriers to obtaining birth control faced by many: Researchers say one-third of adults in the U.S. who have ever tried to obtain prescription contraception have reported facing challenges, such as in getting an appointment, having to travel for clinic visits, or navigating restrictions on the amount they can buy monthly. Further, one-third of birth control users say they have missed taking their birth control because they could not get their next supply in time. An OTC birth control pill would remove many of these challenges and make it less likely for people to be forced to go through unwanted pregnancies due to circumstances outside their control.

• It would provide critical help to people from vulnerable populations: Barriers to accessing birth control disproportionately impact people of color, low-income families, and individuals living in rural areas, who are more often underinsured or uninsured, and thus find it harder to get the reproductive care they need. OTC options would go a long way in reducing these inequities and making the healthcare system more fair and accessible for all. The benefits of such a system include lower maternal mortality rates, less poverty, higher levels of physical and mental health, and more economic freedom and opportunity for vulnerable communities.

In the letter, the attorneys general point out that approving an OTC birth control pill is supported by the medical community. Three major medical organizations in the United States — The American College of Obstetricians and Gynecologists, the American Medical Association, and the American Academy of Family Physicians — support making birth control available without prescription. Moreover, birth control pills are already available over the counter in approximately 100 countries, including Mexico.

The attorneys general also assert that in the wake of the U.S. Supreme Court’s decision overturning Roe v. Wade earlier this year, many states have banned or restricted abortion care, narrowing the choices for those seeking reproductive care and making access to birth control even more critical nationwide, including for Californians who may be traveling, living, working, or studying in anti-abortion states. 

Supporting, expanding, and protecting reproductive freedoms is a top priority for Attorney General Bonta: In October, the Attorney General launched the California Reproductive Rights Task Force, bringing together legal and law enforcement partners to protect reproductive rights in the state and issued an information bulletin to California law enforcement on addressing out-of-state agencies who may seek to investigate, arrest or prosecute out-of-state patients seeking reproductive care in the state. He also led 23 attorneys general across the country in filing a letter supporting the U.S. Department of Veterans Affairs’ new rule establishing broader access to abortion care for veterans and their beneficiaries. In September, the Attorney General led a multistate coalition of 21 attorneys general in an amicus brief supporting a motion by reproductive rights advocates seeking to halt enforcement of several Texas anti-abortion laws, issued a consumer alert to help Californians safeguard their privacy while accessing reproductive or abortion care, and issued legal guidance on the prohibition of the extradition of individuals providing or accessing reproductive care in California. In June, he issued guidance on abortion rights and protections under California law, which remain fully intact, following the U.S. Supreme Court’s decision overturning Roe v. Wade. He also issued a consumer alert warning Californians seeking reproductive health services about the limited and potentially misleading nature of the services provided by crisis pregnancy centers, and emphasized health apps’ obligations under California law to protect and secure reproductive health information.

In filing the open letter, Attorney General Bonta is joined by the attorneys general of Colorado, Connecticut, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington.

A copy of the letter is available here.