The states of Oregon and California have new laws that will make access to birth control a whole lot easier for women when it become legal to obtain contraceptives from their pharmacist without a doctor’s prescription.
Even as the Supreme Court prepares to consider another divisive case involving access to contraception, public health advocates hope these arrangements could spread across the country, as states grappling with persistently high rates of unintended pregnancy seek to increase access to birth control with measures that so far have been unavailable under federal law.
Most Western countries require a doctor’s prescription for hormonal contraceptives like pills, patches and rings, but starting sometime in the next few months, women in California and Oregon will be able to obtain these types of birth control by getting a prescription directly from the pharmacist who dispenses them, a more convenient and potentially less expensive option than going to the doctor. Pharmacists will be authorized to prescribe contraceptives after a quick screening process in which women fill out a questionnaire about their health and medical histories. The contraceptives will be covered by insurance, as they are now.
The laws are the latest effort to make birth control more accessible, a longstanding goal of medical professionals and policy makers. But unlike other recent debates over contraception — including the firestorm over the Obama administration’s requirement under the Affordable Care Act that all health plans pay for contraceptives — these legislative efforts have been largely free of political rancor.
“I feel strongly that this is what’s best for women’s health in the 21st century, and I also feel it will have repercussions for decreasing poverty because one of the key things for women in poverty is unintended pregnancy,” said State Representative Knute Buehler, a Republican who sponsored Oregon’s [l]aw.
Advocates of this approach, including pharmacists’ organizations, plan to lobby for it across the country. “We are actively going to come up with a statute to spread to other states, and I think it can spread pretty quickly,” said Mr. Buehler, the Oregon legislator, who is also an orthopedist. Pharmacy board representatives from states including Arizona and Idaho observed a recent meeting in Oregon about the new rules. A New Mexico proposal that failed in 2012 is expected to be revised to reflect the Oregon and California measures, said Dale Tinker, the executive director of the New Mexico Pharmacists Association.
…Many reproductive health experts have come to support pharmacist-prescribed contraceptives, persuaded that pharmacists can safely dispense contraception without a doctor’s prescription and that women can assess their health risks on questionnaires. “There’s a growing body of evidence that there isn’t a safety concern,” said Dr. Daniel Grossman, vice president for research at Ibis Reproductive Health and a professor of obstetrics and gynecology at the University of California, San Francisco. “There are studies showing that women can really accurately identify the conditions that make it appropriate to use certain contraceptives, using a simple checklist.”
The new laws are extensions of arrangements now found in almost every state: collaborative practice laws that allow pharmacists to administer vaccines or prescribe certain medications if they have agreements with physicians or other health providers. The laws vary widely, and some include only specific diseases or drugs. But in some places, like Washington State and Washington, D.C., collaborative practice laws are broad enough for pharmacists to prescribe birth control if their physician agreements permit it.
The laws in Oregon and California differ in some ways. California’s has no age restriction; the Oregon law requires that teenagers under 18 obtain their first contraceptive prescription from a doctor. In California, pharmacists will also most likely have to take women’s blood pressure for contraceptives containing estrogen.