There happen to be a few risks in not taking the pill, like pregnancy and childbirth. Besides being desperately unwanted in many cases, they harbor serious perils of their own: diabetes, high blood pressure, obesity, stroke, kidney failure and depression, and soaring college costs. Each year, some 700 American women die while giving birth.
Many contraceptives can help avert these outcomes. But few are as safe and reliable as oral contraceptives. Women who take them properly have only a 1 in 100 chance of getting pregnant in a given year -- much better odds than for those who rely on condoms or diaphragms.
Most women would love to be able to get birth control pills without the trouble and expense of seeing a physician. A poll this year found that nearly two of every three American women favor the idea. Some 30 percent of those who are now using less effective contraception, or none, said they would probably start taking the pill if they didn't have to get permission.
Doctors are warming to the idea as well. Last year, the American College of Obstetricians and Gynecologists endorsed the change as a way to improve access and stem the tide of unintended pregnancies -- which, they noted mournfully, have remained stuck at about half of all pregnancies for two decades. Fewer unwanted pregnancies would also mean fewer abortions.
Whether and when the change will occur is anyone's guess. The FDA typically waits for a pharmaceutical manufacturer to ask for reclassification before it considers action. So far, none has.
But Ibis Reproductive Health, an international nonprofit, has discussed that possibility with some drug makers. "After ACOG issued its opinion last year, the interest among pharmaceutical companies escalated a bit," Britt Wahlin, director of development and communications, told me.
Scraping the existing restriction would be a triumph of logic. Though it may pain Michael Bloomberg, a woman currently needs no prescription to have sex. She can do it strictly on her own choice. Now, there's a concept.