America's reproductive healthcare system is weakening in multiple ways, which is hitting the most vulnerable communities hardest. While politicians debate policy, real people are losing access to basic reproductive health services. The good news? Some innovative solutions are emerging that don't require waiting for Congress to act.
Since 2022, over 100 hospitals have closed their ob/gyn units, leaving entire communities without essential reproductive health services, and rural areas are getting hit especially hard. Community health centers, often the last healthcare option in struggling areas, are also shutting down. When federal funding got frozen, Virginia lost half of its community health centers practically overnight, leaving women and families without basic healthcare.
Here's something that might surprise you: nearly 1 in 3 pharmacies have closed since 2010. We're talking about thousands of closures, and they're not happening randomly. The closures hit Black and Latino neighborhoods at much higher rates—37.5% and 35.6% respectively—compared to predominantly white areas at 27.7%.
Between 2018 and 2021 alone, 41 states saw their pharmacy numbers drop. This creates "pharmacy deserts" where people have to travel more than a mile just to fill a prescription. In major cities, researchers found that 670 neighborhoods—about 14% of all studied areas—qualified as pharmacy deserts. For reproductive health specifically, pharmacy closures eliminate convenient access to contraceptives, diagnostics, and other essential reproductive health products.
Healthcare workers are burned out and leaving in droves. The COVID-19 pandemic pushed pharmacist burnout rates from about 45% to nearly 90%. More than three-quarters of community pharmacists say they can't fill open positions. Some CVS and Walgreens locations have had to cut hours because they simply don't have enough staff.
It's gotten so bad that pharmacy workers have staged walkouts. In Kansas City, pharmacists at 22 CVS locations didn't show up for work because corporate policies were putting both patients and staff at risk.
The current political climate has intensified these access challenges through systematic cuts to reproductive health funding. The Trump administration froze $65 million in family planning funds, threatening contraceptive access from Mississippi to California. Various executive orders have targeted programs like Title V Maternal and Child Health Services and Title X Family Planning Services.
Meanwhile, anti-abortion groups are going after birth control too, falsely claiming that pills, IUDs, and even emergency contraception are "abortifacients." A legal victory in Texas has already restricted minors' access to birth control.
While the healthcare infrastructure falters, some companies are finding workarounds that don't require fixing the entire system.
In 2023, the FDA approved Opill—the first over-the-counter birth control pill in the US. It's a progestin-only minipill that's now available on store shelves without a prescription, no questions asked. For the roughly 30 million Americans without health insurance, this is huge. The regular Pill (the estrogen/progestin pill) is slowly working through the process to (hopefully) become OTC.
And it's not just about convenience. Research suggests people might actually use birth control more consistently when they don't have to jump through prescription hoops. No more scheduling appointments, taking time off work, or driving long distances to see a provider who might not even be available.
Here's where things get really interesting. Emergency contraceptives have been rolling out into convenience stores, gas stations, and 24-hour locations—15,000 spots across 49 states. The Morning After Pill® costs about $25 compared to Plan B's $50+ price tag.
Why does this matter? Well, people often search for emergency contraception late at night when regular pharmacies are closed, but 7-Eleven is open. And convenience stores are everywhere—there are over 100,000 of these small stores in every neighborhood throughout the country—for many women the only store within walking distance.
The placement matters too. Instead of being locked up behind pharmacy counters, these products sit on shelves next to condoms. No awkward conversations with pharmacy staff, no stigma, no barriers for teenagers who might feel embarrassed asking for help.
The pipeline is expanding beyond birth control. We're seeing FDA-authorized over-the-counter test kits for chlamydia, gonorrhea, and trichomoniasis. There are new UTI prevention products and hormone testing kits coming soon.
Over-the-counter products solve multiple problems at once. They eliminate geographic barriers because they can be sold anywhere—grocery stores, gas stations, dollar stores. They remove the need for healthcare appointments, which is crucial when provider shortages mean you might wait weeks to see someone. And they're available 24/7, which traditional healthcare often isn't.
For young people, those with irregular work schedules, or anyone dealing with transportation issues, OTC access can be a game-changer. It's particularly valuable in rural areas that have lost their healthcare infrastructure entirely.
Let's be clear: over-the-counter products aren't going to fix America's healthcare crisis. They can't replace comprehensive reproductive health services, regular gynecological care, or prenatal support.
The communities hit hardest by clinic closures and pharmacy deserts—predominantly Black, Latino, and low-income areas—still need systemic solutions. Better Medicaid funding, policies that support independent pharmacies, and healthcare infrastructure investments are all still necessary.
The reproductive health access crisis won't be solved overnight, and it won't be solved by any single intervention. But while we wait for policymakers to act, over-the-counter solutions are providing real help to real people right now.
Company innovations can happen faster than legislation. The key is making sure these solutions actually reach the people who need them most. That means getting wide distribution in underserved areas, keeping prices affordable, and even finding ways for insurance coverage for OTC products. Over-the-counter reproductive health products represent a crucial tool for bridging some of the access gaps as we work towards rebuilding and improving our reproductive health infrastructure.
