American women who live along the U.S.-Mexico border frequently buy over-the-counter oral contraceptives from Mexican pharmacies because they don't need a prescription and can send a friend to pick up the pills, according to a study by researchers from two University of Texas campuses and Ibis Reproductive Health.
The research, conducted in the El Paso-Juarez area, suggests there is demand in the United States for over-the-counter birth control pills and that many U.S. women would buy such contraception without a doctor's prescription if given the option. The findings are being published in the American Journal of Public Health.
"The fact that many women in El Paso make use of the cross-border option suggests a substantial latent demand for an over-the-counter option at pharmacies in the United States," says lead author Joseph E. Potter, a professor in the Sociology Department and Population Research Center at The University of Texas at Austin.
"Since crossing the border can be time-consuming for many, a domestic over-the-counter option would provide even more convenience than the cross-border option that's available in El Paso."
The study's other authors are Kari White and Kristine Hopkins of The University of Texas at Austin, Jon Amastae of the University of Texas at El Paso, and Daniel Grossman of Ibis Reproductive Health, a non-profit research organization based in Cambridge, Mass., and Oakland, Calif.
Women are now required to get a prescription to obtain oral contraceptives in the U.S. But the high prevalence of unwanted pregnancy and mounting evidence about the safety of such pills have led some to call for an over-the-counter option.
Grossman, who also coordinates a group of researchers, clinicians and advocates exploring the feasibility of an over-the-counter option for pills in the U.S., says, "This study gives us a better idea of who might take advantage of the over-the-counter option if it were available in the U.S., and it suggests that it would appeal to a broad range of women."
As part of the study, researchers interviewed more than 1,000 El Paso women, about half of whom obtained their birth control pills across the border at Mexican pharmacies and half of whom went to U.S. clinics to get their pills.
Older women and those who were born and educated in Mexico were more likely to buy their pills in Mexican pharmacies. Women who received public assistance from such federal programs as Women, Infant and Children were more likely to go to the U.S. clinics.
Among both groups, most of the women said they believed the facility where they obtained the pills was cheaper and more convenient than the options on the other side of the border.
About 90 percent of the women who obtained oral contraceptives on the U.S. side say they trusted their clinic to give them good information (versus 46 percent of Mexican pharmacy consumers) and that they liked the other health services provided there.
Conversely, about 90 percent of the women who bought pills from the Mexican pharmacies said they wanted to bypass a doctor's prescription and be able to send family or friends to pick up the pills.
"Making oral contraceptives available over the counter in the U.S. would add another option for women who find the clinic inconvenient or inaccessible. Our research shows that some women highly value the services they receive at clinics, and it's important that they continue to have access to those services even if the pill goes over the counter," says Grossman.
- J. E. Potter, K. White, K. Hopkins, J. Amastae, D. Grossman. Clinic Versus Over-the-Counter Access to Oral Contraception: Choices Women Make Along the US-Mexico Border. American Journal of Public Health, 2010; DOI: 10.2105/AJPH.2009.179887
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