On Thursday, the Food and Drug Administration approved a hormonal birth control pill, called Opill, to be sold over the counter — a landmark decision that was largely met with excitement by many women and teenage girls in New York. The pill will be sold in stores and online, without age restrictions, starting early next year.

If Shandra Rogers, 21, had had over-the-counter access to Opill as a teenager, she may have avoided an unwanted pregnancy, she said.

Ms. Rogers, a student at Howard University on summer break, said she became pregnant when she was 15. She used her mother’s health insurance to get an abortion — but even with coverage, the process was arduous.

“There were a lot of steps, like who will accept my health insurance?” she said. “Will they give me proper care, as a black woman?” And most clinics were “far away — they’re removed from our community,” she added. Those same issues, she said, apply to contraceptives, and can end up dissuading girls from seeking them.

An inflatable pill would remove many barriers, she said.

Almost half of all pregnancies in the United States are unintended. Rates are highest among women in his twenties. The move to greenlight Opill, which is commonly known as the minipill because it contains only progestin, is a “total game changer” for that demographic, said Dr. Elise Berlan, a physician at Nationwide Children’s Hospital in Columbus, Ohio, who served. as an independent scientific advisor to the FDA when it discussed the approval of Opill.

For young people, accessing birth control can be “really difficult,” she said. “Sex education is very vague, so there are a lot of people who just don’t have very good information,” she added. And it’s more complicated “for people with low incomes who have transportation issues or who live in rural parts of the United States”

A an inquiry conducted last year by KFF, a research firm, found that 77 percent of women 18 to 49 favored the decision to make the pill available without a prescription. Thirty-nine percent said they were likely to use it, citing convenience as the main reason. Of those who said they were unlikely to use it, the main reason was that they had no plans to use oral contraception; the second most cited reason was that they would want to discuss it with a supplier first.

The New York Times interviewed 18 women and girls about the FDA decision on Thursday and Friday. Some teens noted that having access to the pill in a store would be helpful for those who didn’t feel comfortable talking to their parents about birth control. “My mom doesn’t approve of birth control” because of her more conservative Sri Lankan heritage, said Tharushi Samarasinghe, a 19-year-old student at Hunter College. “I took birth control once because of hormonal issues while I was going through puberty. I was on it for a year and then my mom said, ‘No more.'”

Elizabeth, 18, said she was wary of the mini-pill’s potential side effects, but described it as a great option for someone like her, whose parents were “quite conservative”. She added: “They brought me up in a Catholic church. I’m not comfortable talking to them about this.” (She asked that her last name be withheld to avoid potential conflict with her family.)

For others, safety concerns have long kept them away from hormonal birth control options, and, they said, over-the-counter availability wouldn’t change their minds. “I’ve never used it in my life — I’m 51 years old,” said Lisa Verlin, a babysitter in Manhattan. “I’m not comfortable using that because of all the side effects.” (According to the Centers for Disease Control and Prevention, the most common side effect of the Opill is unplanned bleeding. Although the pill is not associated with many serious long-term risks, it is not recommended for those who have had breast cancer or severe liver disease.)

The idea that there were no age restrictions gave some women pause. For June Jean, 55, the thought was so disturbing that she shook her head violently. “Not good, no,” she said. “I’m an old-fashioned girl but I don’t think girls — 13, 14 years old — should be able to go and just take pills.”

“So you could go get it if you’re 12?” said Melina Luna Smith, 43, who runs a nonprofit organization. “So much happens to your body when you’re young, so I think it’s important to have someone talking about it — some kind of medical guidance.”

She said she would be “too chicken” to use it without having more information. What women need, she added, is better access to doctors, not just easy access to contraceptives.

For people with access to health care, an over-the-counter pill that is just as effective as prescription pills has been seen as a convenient backup option. Dana Pangori, who is 24 and works in advertising sales, said her primary care doctor was often so busy that it could be difficult to refill a pill prescription. “I’ve actually been away from it because I find it difficult to reach her,” Ms Pangori said. Before moving to New York, she lived briefly in Michigan and Illinois, and she said that every time she moved, it was a burden to find a local doctor to refill her prescription.

An unresolved concern for many of the women interviewed was how much Opill would cost. Perrigo Company, the maker of the pill, did not say what it would charge for each pack of 28 pills, although the company’s chief executive said in a statement that Perrigo was committed to keeping it “affordable.” While most women who spoke to The Times suggested they would pay between $20 and $30 for a pack, the KFF survey found that only one in six of those most likely to use the pill would be willing or able to pay more than $20 a month. . That price would put it in line with other over-the-counter options: A pack of 12 condoms, for example, is often about $10, while the emergency contraceptive pill Plan B costs about $50.

The pill’s availability in stores represents a broad shift in attitudes toward hormonal birth control pills, said Claudia Goldin, an economics professor at Harvard University who has studied how the first oral contraceptive pill was introduced in the 1960s. changed women’s career and marriage decisions.

“Many of us remember a time when you had to go to the desk and ask the pharmacist for a condom,” she said. Now the pill “will just sit there on the shelf and you can just take it like you buy your Advil — no shame. That’s huge.”

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