It has not been the best of times for American women and their ability to make personal choices about health care and specifically about reproductive rights. Last June 6th, the United States Supreme Court overruled the landmark Row v Wade decision allowing women to exercise their own choices on the right to abortion. In doing so, the Court negated a half century of settled law.

The majority ruling, which came as no surprise, was accompanied by Justice Sam Alito’s affirmation that the 1973 high court decision allowing abortion was “egregiously wrong” and “must be overturned.” Months before the early summer decision, a leaked draft signaling the Court majority’s intention to rule on Roe and thought to be the work of Alito, made the announcement a foregone conclusion. Alito has denied he leaked anything and a subsequent investigation into how the document made the light of day has turned up no proof that it was him who leaked nor has it zeroed in on anyone, including high court clerks, who might have made the draft public. Still, doubts linger on the veracity of his denial.

But just weeks after the Dobbs decision, the name attached to the law overturning Roe, the Food and Drug Administration ruled that an approved hormonal birth control pill—Opill—could be sold over the counter. The July 13th FDA announcement allowed the pill to be sold in stores and online in early 2024. Buying the pill will not be accompanied by any age restrictions.

For many teenage girls and women, the FDA decision means that access to birth control will require neither a doctor’s prescription nor health insurance, impediments for many with neither a doctor nor medical insurance.

The FDA decision has been uniformly endorsed by Planned Parenthood and its president/CEO Alexis McGill Johnson who called the decision one based on “essential health care.” The FDA announcement, she said, follows the science and removes an unnecessary barrier to accessing basic health care. Birth control, she said, “is a critical part of protecting our reproductive freedom, especially as states across the country continue to double down on their unpopular abortion bans and restrictions.”

Pro-life groups who hailed the Supreme Court decision overturning Roe decried the FDA’s decision to sanction over-the-counter birth control. The decision—one that doesn’t require doctors—makes it “easier for criminals to cover up their sexual abuse and statutory rape crimes,” said SLA President Kristan Hawkins.

Despite opposition to the FDA decision, a Kaiser Family Foundation survey conducted in 2022 found that 77 percent of women 18 to 49 stood firmly with the decision making the pill available. Additionally, 39 percent of those surveyed said they would use the pill because it was convenient and would not require a doctors’ office visit. Objections to using the contraceptive device were made by those who thought consultation with a doctor was essential if they were to even consider using it.

Perhaps one of the pills’ biggest selling points for teenage girls is that they could have access to the pill without either discussing it with their parents or having to visit a physician. Still, there were other young girls surveyed about the pill who were leery about taking something without knowing of any side effects. According to the research on the Opill, one side effect is unscheduled bleeding. The pill, according to the FDA, has no serious long-term risks but it is not recommended for women who have had breast cancer or a history of breast cancer in their family. Physicians also recommend that those who have had severe liver cancer avoid use.

While costs for the pill have not been made public, its manufacturer, Perrigo Company, said that it intends on keeping the price point for a 28-pill package “affordable.” It is estimated that the ultimate cost would be in the $20-$30 price range. While those figures do not seem unreasonable, a New York Times survey found that “only one in six” would be willing to pay more than $20 a month. By contrast, a package of twelve condoms costs around $10, an emergency ‘day after’ pill around $50.

Buying over-the-counter birth control pills is a giant leap from the early days of the birth control pill which came available in 1960. Within two years of its introduction, more than 1.2 million women were using birth control pills or ‘the pill,’ as it became known. The ‘pill’ ushed out the days when adult women had to discreetly ask pharmacists just to buy condoms. For many others, it also eliminated the shame in making a purchase.

The ‘pill’ also altered the course of American society. Soon after it became available and the preferred choice for family planning for millions of women, the complexion of the workforce as well as gender diversity on college campuses slowly began to change. No longer were young women relegated to staying home and taking care of growing families. For the first time, the ‘pill’ gave them and their families a freedom that previous generations could only imagine.