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First ever OTC birth control still available in Alabama after abortion medication ruling

The U.S. Supreme Court is ruling to uphold access to one of two pills used in medication abortion. The declaration is the high court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.

Mifepristone has long been used safely and effectively in medication abortions around the world and was used in nearly two-thirds of all abortions in the country last year. In Alabama, mifepristone is not available through pharmacies but instead, only through an authorized provider.

The nine justices ruled abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s (FDA) approval of the medication and the FDA's subsequent actions to ease access to it. The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.

Meantime, the first over the counter birth control pill remains on the shelves across Alabama. Still, supporters of abortions rights are cautioning a federal ban on contraceptives could be coming.

Opill is the first prescription-free, FDA-approved over the counter (OTC) birth control in the U.S., creating a new way for people to access oral contraception. Manufactured by Perrigo, the medication is an estrogen free, daily birth control pill that was approved for OTC by the FDA in July, 2023. It is the first of its kind to hit the shelves without a prescription needed.

“For the first time, people do not need a prescription to access birth control pills. They can just go into local store, pharmacy or online wherever they are and access the daily contraception,” said Evelyn Furia, senior director at Opill.

Since the medication is available OTC and is relativity low cost (starting at $19.99 for a one-month supply at most retailers in Alabama), Opill is making birth control more accessible for those who have struggled to get a prescription.

“For people who are uninsured, or have trouble getting to a doctor, don't have a doctor near them, or would previously have to take time off of school or work to try to get to a doctor, this is a great option to get birth control,” said Furia.

According to its website, Opill contains progestin, and is 98% effective at preventing pregnancy when it is used as directed. It starts working 48 hours after taking the first pill.

Because Opill does not contain estrogen, it can be taken by most people who can become pregnant. Furia and the makers of Opill advise that users should be sure to read the labels and consult with a health care professional before use. The medication should not be taken by people who have or who have had breast cancer.

“It’s been really exciting to see the support that we've been getting from customers and retailers. We've seen great feedback on our social media,” said Furia. “It's nice to see excitement from the community.”

Opill can be found in stores in the family planning aisle and can also be found online though the Opill website and through select retailers.

Hannah Holcombe is a student intern at the Alabama Public Radio newsroom. She is a Sophomore at the University of Alabama and is studying news media. She has a love for plants, dogs and writing. She hopes to pursue a career as a reporter.
Baillee Majors is the Morning Edition host and a reporter at Alabama Public Radio.
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