If you lived in Russia or China or Korea, you could walk into your local pharmacy and grab some birth control pills off the shelf.  In fact, birth control pills are over-the-counter (OTC) in over 100 countries around the world. In the United States, where 50 percent of pregnancies are unintended, you need a prescription.  What’s wrong with this picture?
To be an OTC drug in the America, a drug must be safe and easy to use. It needs to have few interactions with other drugs. You should be able to read the label and figure out if the drug is safe for you. It must have low toxicity, low danger from an overdose, and low potential for abuse. The progestin only birth control meets the requirements.  Lots of other American drugs have gone from prescription to OTC. Examples include proton pump inhibitors for heartburn and steroid nasal sprays for allergies.
Almost OTC: Birth Control Pills Prescribed by Pharmacists
Birth control pills have been around for over 50 years. They are the most common form of birth control for American women. Surveys show that over 60 percent of women want the pill to be OTC.  Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Physicians (AAFP) support OTC birth control pills. They state that making access easier and more convenient will reduce unintentional pregnancies and that far outweighs any risks. [2,4]
The recent United States Congress has been more concerned with overturning the Affordable Care Act and its requirement that birth control be covered by insurance. Making the pill OTC is not on their horizon for now.  But some states have taken matters into their own hands. California, Oregon, Washington, and a growing number of other states now allow pharmacists to dispense birth control pills without a doctor’s prescription. 
If you live in one of these states, you can go to your pharmacy and fill out a questionnaire. You will go through a checklist to make sure the pill is safe for you. You may need to be over 21. You may need to show that you have had a doctor visit recently. The doctor visit requirement overcomes one of the few concerns about OTC birth control pills. Some women may avoid their routine checkups and screenings if they can bypass the doctor. 
When birth control pills eventually become OTC – which is likely – the pill that will be available will probably be the progestin only pill. Progestin is a hormone that stops ovulation. It is safer than the combination birth control pill the include estrogen. It has less risk of heart, blood clot, and high blood pressure effects. 
Why Wait for the Emergency?
What you can do in America – no matter what your age – is walk into any pharmacy and get an emergency contraception pill off the shelf. This pill, called Plan B emergency contraception is also a progestin only pill. In fact, it has more progestin that the progestin only birth control pill. You take one pill within 3 days of unprotected sex to prevent pregnancy. Plan B has been OTC since 2013. So if the Plan B emergency pill can be OTC, why not the birth control pill? That would be common sense, right? [1,5]
- GoodRx, Could OTC Birth Control Be Coming to Pharmacies Soon?
- American Academy of Family Practitioners, Over-the-Counter Oral Contraceptives
- Henry J Kaiser Family Foundation, Oral Contraceptive Pills
- ACOG Statement on OTC Access to Contraception
- ACOG, Emergency Contraception