The Intersection of Geography and Healthcare: Exploring Geographical Factors that Affect Access to Over-the-Counter Birth Control Pills Among Uninsured Women in Texas

As of 2018, Texas had the highest rate of uninsured women of reproductive age in the country, with approximately one-third lacking health coverage. This study investigates the accessibility of the newly approved over-the-counter (OTC) birth control pill, Opill®, in Texas. Using a mystery caller methodology, female researchers conducted calls to 500 retail pharmacies across Texas between April and May 2024, posing as customers seeking information about Opill®. The probability-proportion-to- size selection was used to generate a sample of 500 retail pharmacies to cover community’s representative of Texas. The research also includes qualitative analysis of pharmacy worker responses. Findings suggest that OTC birth control may help address contraceptive needs for uninsured populations, potentially mitigating some of the impacts of recent policy changes and healthcare access limitations. This research contributes to our understanding of reproductive healthcare access in the changing landscape of U.S. contraceptive policy and emphasizes the urgent need to address barriers preventing Texans, especially women of childbearing age, from obtaining comprehensive medical coverage.