Over the Counter Birth Control Presents Problems for Women Who Speak Little or No English

The recent first-ever approval of an over-the-counter (OTC) birth control pill here in America presents unique risks for all young girls, especially our sisters with limited English. Health side effects, nonmarital pregnancies, and abortions all loom on the horizon.

The Biden Administration’s U.S. Food and Drug Administration (FDA) approval in July of an OTC birth control pill means that for the first time in American history, a young woman will be able to buy a daily oral contraceptive pill right off the store shelf, without consulting a medical provider, pharmacist, or in the case of minor girls, her parents. Access to a powerful drug without medical supervision has the potential to lead to deleterious consequences; add language barriers to the mix and immigrant women and girls could be even less informed about the drug’s effects than others.

Even among our growing Latino population, many of whom belong to the Catholic Church which teaches that premarital sex is wrong, it is foreseeable that young girls, especially if pressured by older males, may begin use of birth control if the package of pills can just be grabbed off the shelf at their local store.

Research has shown that when Latinos do have access to a health care provider, more than half of Latino adults have difficulty communicating with the provider because of a language or cultural barrier. But now, the onus will be on the young Latino girl to read and fully comprehend the drug package labeling, with all its warnings and instructions for proper use. For Latino and other immigrants with limited English proficiency, this could pose a real challenge, especially if there is no health care provider that speaks her language available to consult.

At the time of the FDA’s deliberations, the New York Times reported Dr. Karen Murry, deputy director of the FDA’s Office of Nonprescription Drugs, as saying, “if this product is approved, people might get it in a pharmacy, but they also might get it in a gas station or a big box store with no health care professionals around.”

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Typically, the FDA asks that the studies used to support a drug application include 30% of participants with limited literacy, thereby mirroring the estimated general population of users. But in this case, the actual use study only had 14% of participants in the use phase that had limited literacy, leading the FDA reviewers to warn that “because persons with limited literacy may make a greater number of use errors, underrepresentation of this population in this study may overestimate the results on appropriate use/selection.” User error could lead to pregnancy which could lead to abortion.

Young girls and women who start using any type of contraception may be under the misconception that they cannot become pregnant. Yet this perception is belied by the statistics — close to half of women experiencing an unintended pregnancy are using a method of birth control during the month they become pregnant.

In the case of Opill (the birth control pill approved by the FDA), it has very strict requirements for its use. The FDA website explains: “The drug must be taken every single day and at the same time, or the effectiveness is reduced and pregnancy may occur.” (emphasis added). Moreover, when first beginning use of Opill, the user must also use a backup barrier method of birth control during sex for the first 48 hours because it takes two days for the drug to begin to work. Will young girls with limited literacy be able to read and comprehend this as they run into the corner drug store to quickly pick up a tube of lip gloss and a package of birth control?

The effectiveness of Opill can also be compromised if the woman or young girl uses the dietary supplement St. John’s Wort, sold without a prescription in many health food stores and drug stores. Prescription seizure medicines also have the potential to interact with Opill — the FDA warned in its own briefing materials that could lead to “seizures in an individual with a seizure disorder.” Although the proposed package labeling will advise the user to “ask a doctor or pharmacist before use” in these instances, how many young Latino girls and women with limited English proficiency will be able to read it?

Supporters of over-the-counter access may argue that the benefits outweigh the risks, but the FDA’s approval of over-the-counter sale of a birth control pill to any minor girl, including new immigrants, without their parents’ knowledge is especially alarming. In its Bellotti decision, a plurality of the U.S. Supreme Court said that children’s constitutional rights are not equal to that of an adult’s because of “the peculiar vulnerability of children; their inability to make critical decisions in an informed, mature manner; and the importance of the parental role in child rearing.”

Young immigrant girls will be especially vulnerable to misuse of the product if they have limited or no English proficiency. How will these minor girls make an “informed, mature” decision if they cannot read or understand the package labeling and there is not a health care provider around to counsel her? Lastly, the parents’ role in the upbringing of their child is especially important in the realm of sexuality, which is linked to possible pregnancy, sexually transmitted disease, and the facilitation of sexual promiscuity (in direct opposition to the religious beliefs of many parents).

It appears that political expediency has carried the day at the FDA at the expense of immigrant women and girls.

LifeNews Note: Muskett is President of Pro-Family Women.

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