Clinic versus over-the-counter access to oral contraception: Choices women make in El Paso, Texas

In Mexico, oral contraceptives (OCs) are available from pharmacies without a prescription, while in the US, a prescription is required. The Border Contraceptive Access Study assessed the motivations for, and impact of, obtaining oral contraceptives (OCs) from US public clinics or over-the-counter (OTC) from Mexican pharmacies among women in El Paso, Texas.

To understand why some women prefer obtaining OCs at Mexican pharmacies, versus US family planning clinics, and which women take advantage of the OTC option, we asked clinic (n=533) and pharmacy users (n=515) about their recent pill use, motivations for choosing their source, and satisfaction with their OC source and brand.

We found significant differences between the groups in the types of pills used and number of packs obtained. In regression analysis, older women and those born and educated in Mexico were more likely to be pharmacy users. Cost of OCs was the main motivation for choosing their source for 40% of pharmacy users and 23% of clinic users. Approximately half of clinic users reported other health services available at clinics as an advantage, while not having to see a doctor for a prescription was the most important advantage for 27% of pharmacy users. Despite differences between the groups, over 70% were very satisfied with both their pill source and brand.

Women of different ages, parities, and varying educational levels would likely take advantage of an OTC option were OCs available throughout the US at low cost. The findings also suggest ways to improve clinic provision of OCs.