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Literature Review 7 students through abstinence-only programs, in which schools do not teach adolescents about oral contraceptives. However, this barrier was largely eliminated in North Carolina in 2009, with the passage of the Healthy Youth Act. Under this law, NC school districts must teach an evidence- based sexuality education curriculum. This curriculum must include all FDA-approved contraceptive methods and FDA-approved methods for prevention of sexually transmitted infections. Parents must be permitted to withdraw their child from the course; school districts may choose to use either an opt-in or opt-out method of enrollment (Healthy Youth Act FAQS, 2016). EXISTING KNOWLEDGE ON OTC BIRTH CONTROL A study by Amanda Dennis and Daniel Grossman (2012) observed barriers to contraceptive access, and examined whether making oral contraceptives over the counter would contribute to lower levels of unintended pregnancies in the United States. Their study used focus groups of 45 low-income women in the Boston area to explore how these women obtained contraception and their thoughts on having oral contraceptives available over the counter. 33% of the women reported using the pill as their primary contraceptive method, although most had reported trying it. These women, who were on the pill, stated they prefer this method and supported increasing access. Further, other research has shown that women at risk for unintended pregnancies support over the counter birth control options (Grossman and Grindlay et al., 2013). The ease of use, effectiveness, and secondary health benefits of birth control pills all supported why women appreciate this method. However, women did express their concern about how the pill does not protect against sexually transmitted diseases (ibid). A study in Kuwait used multivariate analysis to observe the differences in demographics in women who use over the counter oral contraception, versus those who visit a clinician. (Shah et al., 2001). There were no socioeconomic or demographic differences between these two groups, implying women had equal opportunity and access to visit a clinician (ibid). However, this study may not be applicable to a United States context. The Population Research Center at the University of Texas Austin (2011) observed purchasing patterns when women were given the option to obtain pills from a clinic in the United States near the Mexican border, or cross into Mexico to obtain over-the-counter pills. Based on this research, they determined that the potential market of over-the-counter pills would be seventeen to twenty- two million women (Landou et al., 2006). SAFETY Current data indicates that oral contraceptives meet the safety requirements needed for over the counter medication (McIntosh et al., 2011). The Food and Drug Administration requires that over the counter medication be non-habit forming, and safe to use without the foresight of a healthcare practitioner (Grindlay et al., 2013). Both of these requirements are fulfilled by oral contraceptive methods. Further, while only the FDA can make medications fully over the counter, states can permit medications to be dispensed with only a pharmacist prescription without meeting these requirements. Regular visits with a healthcare provider for birth control refills also serve to enable routine pelvic exams and Pap smears. However, notably, recommendations for routine Pap smears have