In most states, women need to go to their doctor or health clinic to get a prescription for hormonal birth control. But thanks to recent legislation, women in California and Oregon will now be able to buy hormonal birth control at the pharmacy without a doctor's prescription.
Though an innovative policy, this is hardly controversial from a scientific perspective. Instead, it aligns with a significant body of research showing that hormonal birth control is a strong candidate for pharmacy access. Not only is this access common in most of the world, the American College of Obstetricians and Gynecologists has endorsed over-the-counter access for birth control pills since 2012.
From a safety perspective, ACOG notes that many over-the-counter medications, like aspirin or acetaminophen (Tylenol) are linked to serious medical complications yet remain available without a doctor's prescription. What's more, the risk of blood clots, the main complication associated with birth control, might seem frightening at first glance, but research suggests that pregnancy and the post-partum stage are even riskier when it comes to developing these same clots.
“In many ways, by preventing pregnancy you actually are lowering an individual woman’s risk for blood clots, in general,” said Dr. Taraneh Shirazian, an assistant professor at NYU Langone Medical Center. She also pointed out that because hormonal birth control can help manage other health conditions, expanding access can empower women to take even greater control over their health beyond contraception. Hormonal birth control can minimize excessive bleeding during periods and pain during periods. It can also help clear up acne and moderate mood swings, she said.
Women are in favor of the move, too. A nationally representative survey published in 2013 found that almost two-thirds of women wanted to make birth control pills available over-the-counter. The poll also found that 30 percent of women using less-effective birth control would switch to the pill if they could buy it directly, reported Reuters.
Several studies show that women are perfectly capable of determining, on their own, whether hormonal birth control is right for them. A study of 399 women published in 2006 found that 90 percent of women of reproductive age were able to answer a medical questionnaire that matched their doctor’s in assessing whether or not hormonal birth control was right for them. A similar UK study found that women and doctors were able to agree 93 percent of the time when it came to identifying a woman’s risk factors.
While California’s law went into effect at the beginning of 2014, full implementation of the law still faces regulatory hurdles from the state’s Board of Pharmacy, which regulates pharmacists in California. Oregon, on the other hand, just signed their bill into law last week, reports USA Today, and unlike California’s law, it only gives women 18 years and older access to birth control.
These state laws are significant because while the Affordable Care Act ensures that hormonal birth control like the pill, patch and ring will be covered by health plans, there are still women who either can’t access that coverage (like undocumented immigrants), women who don’t want it to show up on statements (like daughters who are still covered on their parents’ insurance) and women who either can’t afford or simply don’t have time for a doctor’s visit just to get a birth control prescription, explained Shirazian.
Per California’s law, women still have to briefly consult with a pharmacist to see if the medication is right for them, explained Jon Roth, CEO of the California Pharmacists Association, which co-sponsored the bill. The pharmacist would screen for things like blood clot risk, current pregnancy and other factors that would prevent women from taking hormonal birth control. The crucial, convenient difference between that and the old protocol is that women will be able to leave immediately with their meds after their visit to the pharmacist.
"That the patient can have a clinical interaction with a pharmacist and leave immediately with their contraception is a great expansion of women’s health," said Roth.
California and Oregon’s new laws are good news, but there are still barriers to access, said Shirazian. While hormonal birth control will technically be available with fewer hurdles to jump through, the laws do nothing to lower the cost of hormonal birth control. The pill, for example, can cost as much as $50 a month.
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