Leah Morris has been using birth control since she was a teenager. She recalls that her initial consultation was straightforward, with the doctor recommending it due to her age. She began taking Yasmine, a popular estrogen-based oral contraceptive. Initially, refills were easily obtained from her local pharmacy. However, as Morris’s career in international development and venture capital led her worldwide, obtaining a prescription became challenging at times.
In Canada, oral contraceptives are the most prevalent form of birth control among women but are only accessible with a prescription, unlike many other countries. In countries outside Western Europe, Canada, New Zealand, Australia, and South Africa, birth control is often available without a prescription, even in conservative nations such as Saudi Arabia, Turkey, or Indonesia. The United States made birth control available without a prescription in 2023, raising questions about why Canada continues to require prescriptions.
The majority of oral birth control methods since 1960 are combined pills containing estrogen and progestin to prevent ovulation. While these pills like Yasmine have side effects such as bloating and headaches, they also carry risks like cervical cancer and blood clots, with risks increasing with age. Dr. Wendy Norman, a sexual health researcher at the University of British Columbia, highlights that countries with a higher tolerance for medical risk usually allow prescription-free access to combined pills.
Recent prescription-free birth control options no longer rely on estrogen but on progestin-only pills like Opill, which thicken cervical mucus to prevent sperm from fertilizing an egg. These pills require strict adherence but are safer without medical supervision. Dr. Amanda Black, from the Society of Obstetricians and Gynecologists of Canada, suggests that some progestin-only pills in Canada could be available without a prescription but notes the complexities involved.
Health Canada’s strict requirements for approving drugs for over-the-counter sale, including costly medical trials, have deterred pharmaceutical companies from pursuing prescription-free status for their products. Dr. Norman points out that keeping birth control prescription-only has benefits, such as healthcare coverage, but advocates like Kelly Blanchard argue that prescription requirements create barriers for many women seeking birth control.
Blanchard’s campaign, Free the Pill, aims to increase contraceptive access, emphasizing that prescription requirements disproportionately affect women of color and Indigenous women. She suggests that outdated medical practices and patriarchal beliefs may be hindering progress in making birth control more accessible without prescriptions. Morris shares her experience of not being adequately informed about risks and alternatives during prescription refills, indicating a need for change in the current system.