Over-the-Counter Birth Control Study for American Indian Women and Adolescents in King County

Abstract

Abstract Background: American Indians and Alaska Natives experience reproductive health disparities. Despite this, little is written regarding their perception and barriers to birth control (BC), including over-the-counter birth control pills. Over-the-counter birth control pills (BCP) are pending approval from the United States Food and Drug Administration. To our knowledge, this timely research is the first of its kind to focus on over-the-counter birth control and American Indians and Alaska Natives in King County, Washington. The study aimed to identify birth control preferences and acceptability of over-the-counter birth control; identify perceived barriers to birth control access; and identify favorable locations of over-the-counter birth control. Methods: A qualitative online study of 18 items about current birth control use, perceived barriers, potential benefits, and potential solutions of over-the-counter birth control was distributed to American Indian and Alaskan Native women of reproductive age by survey link and QR code. Recruitment was done by a research team via email snowball method and print media from May-July 2022. Most potential participants (308) were fraudulent bots that did not meet the criteria.

Results: The 6 eligible participants were <32 years old; 83% had insurance coverage, 33% had history of pregnancy, 33% were parents, 50% had issues with transportation, 83% reported current use of birth control. The majority (83%) of participants would consider switching to progestin-only over-the-counter birth control pills. Approximately, 67% percent would consider switching to over-the-counter birth control. Barriers were noted, including transportation, risks of side effects, religious concern, cost, and lack of knowledge on health care information. Eighty-three percent report online retailer or pharmacy as the preferred delivery mechanism of over-the-counter birth control pills following 33% on vending machines, and community colleges. Conclusion: Evidence suggests American Indian/ Alaskan Native women and teens are interested in OTC BCP. Adolescents reported barriers at higher frequencies than adults on average. Although the small sample size alone cannot inform the rollout plan of OTC BC in Washington, trends within this study will be noted and further investigated as the project scales up. These preliminary findings suggest further research may provide more context to perceptions of over-the-counter birth control for American Indian/ Alaskan Native women across the United States.