Women's experiences with contraception and their interest in over-the-counter access

In addition to concerns about side effects and partner opposition, barriers to access may deter use of contraceptives. The prescription requirement for hormonal contraception is one barrier that might restrict access and consistent use. We explored women's experiences with contraceptives and opinions about over-the-counter (OTC) access to oral contraceptives (OCs). We conducted 5 focus group discussions and 10 in-depth interviews with low-income English speaking women in Boston from March 2007-January 2009. Participants cited efficacy, ease of use, and non-contraceptive benefits (i.e. lighter periods and improved acne) as advantages of their method. Many participants reported that insurance issues restricted access, including allowing only one pack of pills per month, having to pay first and apply for reimbursement, lack of clarity on covered brands, and not having health insurance. Participants also noted that travel, losing a job, or moving made it difficult to access their method. In addition, women voiced concerns about perceived side effects of hormonal contraception, including negative emotional effects, breakthrough bleeding, nausea, and weight gain. Women supported OTC access to OCs for themselves, but were concerned about whether “other” women could use OCs safely without advice from a clinician. Insurance issues, life events and perceived side effects can be barriers to consistent contraception use. Women supported OTC access to OCs to make accessing their own method easier; more information about safety and non-contraceptive benefits of hormonal methods might increase general support for OTC access.