Inconvenient Contraception

[Joanne98]

For millions of women, getting birth control is a laborious process. Would making the pill an over-the-counter drug be the best policy fix?

Beth Schwartzapfel | March 17, 2009 |

Last week, birth control for college students got cheaper. An "affordable birth control" provision in the 2009 appropriations bill, which President Barack Obama signed last Wednesday, restored an incentive for drug makers to offer college health clinics discounts on the pill (the longstanding incentive had been inadvertently eliminated in a 2005 deficit-reduction bill). Still, even when it's cheaper, birth control will continue to be two things: inconvenient and thoroughly tied up with the medical system.
A trip to the doctor. Time off from work. A waiting room. A pap smear. A co-pay (assuming you're insured, of course). A trip to the pharmacy. Another co-pay. Then, finally, your birth control: 28 little pills, packaged in foil and plastic, standing between you and a pregnancy you don't want.

If you are one of the 11.6 million women in this country who relies on the pill to prevent pregnancy, this scenario, or some variation on it, has played out in your life again and again. It may not have to be this way.

"A pap smear is important. The pill is important. There's not really a connection between the two," says San Francisco gynecologist Dan Grossman. "It's a very paternalistic attitude to say, as a physician, we have to hold women's pills hostage -- you can't get your contraception until you get your pap smear."

England's National Health Service recently announced that later this year it will launch a pilot program to allow young women in two London neighborhoods to buy birth control over the counter after a brief consultation with a pharmacist. The London program is modeled after a pilot program that was conducted in Washington state between 2003 and 2005, in which 26 pharmacists throughout Seattle safely provided hormonal contraception -- the pill, patch, or ring -- to almost 200 women without a prescription. A similar study is being planned for California.

Now, a group of doctors, pharmacists, researchers, and advocates have received a grant from the Hewlitt Foundation to fund a working group that studies the feasibility of making oral contraceptives available over the counter: as easy to purchase as aspirin. According to the reproductive-health think tank the Guttmacher Institute, nearly half of women will experience at least one unintended pregnancy by the time they're 45, and almost a third will have had an abortion. Part of the reason for this, those in the working group say, is that the barriers to birth control are simply too high.

"It's harder and harder to access contraception care if you want it, here in the U.S.," says Grossman, who is a senior associate at the nonprofit research organization Ibis Reproductive Health, which coordinates the Working Group. "Non-use of contraception is going up among people who don't want to be pregnant, especially among vulnerable populations, like poor women and women of color." The group's hypothesis is simple: If birth control were easier to access -- fewer medical gatekeepers, less inconvenience, and lower cost -- more women would use it. If more women used it, there would be fewer unintended pregnancies.

Fair enough. But is it safe? What effect would a switch to over-the-counter status have on poor women's access to the medication? And if women were no longer required to get birth control from their doctor, would they still go for their annual exams?

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http://www.prospect.org/cs/articles?article=inconvenient_contraception

[Warpy]

1. Selling it over the counter would bypass the prissy pharmacists

whose morbid religious scruples enable them to pass judgment on the female half of the human race.

That would be the main advantage.

Some women would skip that OB-Gyn visit once a year, though. If you don't have the money, you don't go. However, the decrease in complications from unwanted pregnancy would likely offset the risk of having something go undiagnosed by a frequent gynecologic exam.

[burning rain]

3. Ought to have a law revoking the licenses of phramacists...

who refuse to prescribe contraceptives. It's part of their job; if they refuse to do their job they should be in a different line of work.

[Stargazer09]

5. Oh, but they are God's gift to the world of medicine!

They have the moral authority to decide whether or not a medication is "right" for someone. :grr:

(And yes, the title of this post is meant to be sarcastic. Just in case anyone missed that.)

[burning rain]

7. I understand that there are also bumptious Christian physicians...

who make a point of refusing to prescribe contraception for unmarried women. They have some crappy organization... forget the name... perhaps someone else recalls.

[Stargazer09]

8. Whether they like it or not

Unmarried women have just as much right to have birth control as married women do.

A marriage license shouldn't be a requirement for a woman to have sex. It certainly isn't required for men. But these are the same doctors/pharmacists/etc. who think that women exist only for their pleasure and for baby-making (not necessarily the same woman for both--adultery is okay in their view as long as they cry when they are caught).

I don't recall the name of the organization, either, but I know what you are talking about.

[Warpy]

6. They are violating state pharmacist practice acts

and can have their licenses revoked.

We just have to complain about them first. Give name, place, date and time.

Stupid's "conscience" executive order has been revoked. Their violation of the state practice act is no longer covered by anything.

[pleah]

2. I am all for selling birth control over the counter. I wish

it had been over the counter years ago when I needed it.:P

I quit taking the pill in the eighties when the price for mine went up to $15 a month. It was $4.95 a month when I started taking them.

If they do get this to happen, I certainly hope it is affordable.

[Stargazer09]

4. What a paternalist attitude!

"And if women were no longer required to get birth control from their doctor, would they still go for their annual exams?"

How many MEN go in for annual exams? Does anyone chew them out for missing an exam? Do they get treated like miscreant children every year? Are they ever expected to beg for medications?

I realize that birth control pills can seriously mess up a woman's body. There's no disputing that. However, without easy access to birth control, there will be more unintended pregnancies, which in turn leads to more abortions. We need to make it easier for women to get the birth control medication that works best for them.

Once a woman finds a birth control pill that works well with her body, she should be able to buy it over the counter. Barring that, the doctor should allow her to get refills without coming in and begging for them. That's a hassle, an unnecessary expense (both time and money), and demeaning. We trust women to raise our children but not to take their birth control pills properly?

And we definitely need to get rid of the requirement that women submit to gynecological exams just to get their medications. Yes, Pap smears are important, but low risk women don't need them every single year. My doctor recommends having one every three years.

:rant: