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Over the Counter Birth Control Pills are Coming to NC Without Age Restrictions

birth control pills on pink and blue background

In the coming months, birth control pills will be available for purchase over the counter (OTC) in North Carolina with no age restrictions and without the need for a prescription. In July of last year, the Food and Drug Administration (FDA) announced that Opill, also known as Norgestrel or the “mini-pill,” will be sold to any female of “reproductive age.” Pharmacies, grocery stores, and even convenience stores will stock the product, and it will be available for purchase online. This decision has implications on parent’s rights, religious freedom, and, of course, women’s health.

Also of importance, during the 2021 North Carolina legislative session, legislators passed House Bill 96, allowing immunizing pharmacists to dispense and deliver oral and transdermal hormone birth control without requiring a woman to visit her physician. The law does require parental consent for minors to obtain hormonal contraceptives from a pharmacist, an important step that will not exist for the purchase of Opill. Under the statute, “the immunizing pharmacist shall counsel the patient about preventative care, including well-woman visits, sexually transmitted infection testing information, and Pap smear testing.” But, because Opill birth control will be available over the counter, it will not have these important education requirements. This is a troubling issue for some parents and healthcare providers.

According to a recent article in NC Health News, over 1,300 pharmacists across North Carolina have taken the mandatory training to prescribe hormonal birth control. One thousand more have registered to participate in the training offered by the NC Board of Pharmacists in partnership with the NC Association of Pharmacists. These special immunizing pharmacists are required to screen for, and educate the user of, any health risks; something that will now be the responsibility of the Opill user to read, presumably on the package instructions and warning labels.

As a member of the medical community, I strongly believe there should be an obligation to counsel women and adolescents before they begin taking hormone birth control; particularly given the serious health risks that are of concern. With Opill, these include breast cancer, depression, ectopic pregnancy, and the possibility of Opill acting as an abortifacient.

All of these issues should be discussed with the women and girls prior to starting this medication. Additionally, women and girls need to be screened for potential health issues and possible medication interactions. The instructions and warnings that accompany many OTC medications are complicated, difficult to read, and fail to give the user an opportunity to ask questions. Proper use of these birth control pills contributes to their efficacy, and relying on box directions and warnings is not sufficient to ensure that the health and well-being of women, particularly adolescents, are protected.

It is also alarming that OTC hormonal birth control will now be sold directly to adolescents, potentially eliminating the child’s parents from the process. Parents are essential to adequately guide, direct, and educate children on the dangers of sex outside of marriage and the risks that accompany these medications. The FDA is not a substitute for a child’s parent, and we must fight back against the consistent push by our culture to eliminate parents from decision-making in the lives of their children.

It can seem challenging to stand against abortion and also raise concerns about birth control. The fact remains that the best way to avoid abortion is to not get pregnant, and the best way to avoid pregnancy is to not have sex. Abstinence is the only way to prevent pregnancy with 100% certainty. We know, however, that unplanned pregnancies do occur, and birth control plays a part in the quest to prevent unexpected pregnancies in our culture. It is imperative that we maintain safeguards, like screenings, medication education, and parental involvement before our women and girls begin OTC hormone birth control.


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