University of Texas at Austin Population Research Center
Population Research Center, UT-Austin • UT-El Paso • Ibis Reproductive Health

About the Study

Oral contraceptives (OCs) are one of the most effective, safe and widely-used contraceptive methods available to women worldwide. The US is different from many other countries because women need a health care provider's prescription to obtain their pills. One of the questions our study addressed is whether women can safely and effectively use oral contraceptives without mandatory contact with a healthcare provider, that is, can women effectively screen themselves for contraindications to the pill. We were also interested in learning about women's experiences with the pill.

We compared the experiences of women who got their pills in clinics in El Paso to those who got their pills in over the counter (OTC) in Ciudad Juárez. The El Paso-Ciudad Juárez region made for a unique “natural experiment” in which we could examine many aspects of pill use, using the key variable of whether women obtained pills in the US through clinical screening or in Mexican pharmacies, where practice has been to sell many medications over the counter without prescription.

Our research has answered important questions about the appropriate role of medical supervision in the provision of the pill. In addition, this study has helped us better understand the contraceptive experiences of Hispanic women in a border community, and found that many women who use the pill in this setting would actually prefer to rely on a permanent method of contraception, particularly female sterilization.

The Border Contraceptive Access Study was funded by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to the Population Research Center at the University of Texas at Austin (R01-HD047816-01; Joseph E. Potter, Principal Investigator), the Society of Family Planning and the Center for Border Health Research.


On November 20, 2012, The American College of Obstetricians and Gynecologists (ACOG) issued a committee opinion recommending that Oral contraceptives (OCs) should be sold over the counter (OTC) in drugstores without a doctor’s prescription.  According to the College, easier access to OCs should help lower the nation’s high unintended pregnancy rate, a rate that has not changed over the past 20 years and costs taxpayers an estimated $11.1 billion annually.  This opinion drew heavily on the findings from the Border Contraceptive Access Study, and cited nearly all of the published results related to screening for contraindications, use of preventive services and continuation.  

Read the ACOG press release.

Press coverage


OCs OTC Working Group web site - The Oral Contraceptives (OCs) Over-the-Counter (OTC) Working Group is a coalition of reproductive health rights and justice organizations, nonprofit research and advocacy groups, university-based researchers, and prominent clinicians who share a commitment to providing all women of reproductive age easier access to safe, effective, acceptable, and affordable contraceptives.  The working group was established in 2004 to explore the potential of over-the-counter access to oral contraceptives to reduce disparities in reproductive health care access and outcomes, and to increase opportunities for women to access a safe, effective method of contraception, free of unnecessary control, as part of a healthy sexual and reproductive life.