Written by Emma Glassman-Hughes
According to your 700+ likes on the ol’ Facebook, it would appear that many of you fabulous feminists out there are pretty stoked about the introduction of Oregon’s physician-less birth control (BC) distribution measures that went into effect on January 1st of this year. I mean, on the surface, allowing pharmacists to prescribe pills (a year’s worth of which will be covered by insurance and the Affordable Care Act) instead of requiring costly and inefficient doctor’s visits will remove a barrier to necessary BC access, and thus put us on the path toward better healthcare for women. However, many of your comments indicated key details that should be taken into account before entirely celebrating this kind of healthcare measure. To make it all a lil easier, I’ll compile those thoughts here, weigh the pros and cons, and deliver a neat consensus straight from our team to your hearts. Here we go:
First, let’s peep the pros. You readers out there who use some form of hormonal BC probably have horror stories under your belts (below your belts?) about any step of the process, like the confusion or inconvenience or incompetence of anyone trying to provide you with your regimen. In my experience--as someone who began taking BC pills as a young, nonsexually-active teen to help with skin problems--the pill has been quite a heap of mixed blessings. Sure, it cleared my skin (only for a little while though #theworst) but it was never particularly easy to get, especially if I wanted to remain on a consistent brand. Up until recently, the communication between doctors and pharmacists always seemed to be rather poor, and I wound up unwittingly switching between three or four generic pill brands over the course of just a few months for reasons I didn’t know (maybe because doctors’ specific orders were getting lost in the shuffle? Maybe because pharmacists were just slipping me whatever they had lying around because no one was there to hold them accountable? Idk). Either way, the constant switching was definitely not good for my health, and my doctor (only just recently) had to start demanding I receive the same brand each month--and she explained that pharmacies switch BC brands all the time. Somethin’ tells me that this brand-switcheroo wouldn’t happen nearly as much if it were the pharmacists prescribing and providing all in one swift motion--they simply wouldn’t be able to prescribe what they don’t have on hand. SO, long story short: a big pro is that this measure will cut out the middlewoman to ensure increased efficiency and accuracy. Bingo.
What else? Well, speaking of efficiency, the measure also calls for a year’s supply of pills to be covered up front in full by insurance and the Affordable Care Act. A) Hooray for a year’s worth getting insurance coverage! B) Studies have actually shown that birth control is far more effective when women have larger supplies available to them for longer periods of time, so that they can continuously take pills from month to month without worrying about refills. OK, rad. What else, else? Oregon’s measure will, of course, benefit low-income women who don’t have a whole lot of extra money or time to spare at costly doctors’ appointments just to receive the contraceptives they need on a daily basis. Sure, they’ll still need to be able to visit a doctor for an annual check-up, but their sex lives will no longer be dependent on those visits.
How ‘bout some cons? Many women and activists alike are worried that removing the doctor from the equation is unsafe and irresponsible legislature. There’s concern that women will start skipping their yearly doc appointments if they no longer have the contraceptive-incentive waiting for them on the other side; and there’s talk about the dangers of taking hormonal BC without consultation with a doctor and a thorough assessment of potential risks. It’s true that many women are unaware of the (relatively weak but certainly real) connection between the pill and the health complications like stroke or deep vein thrombosis, and critics of this measure worry that it will be harder for women to be truly informed of all the potential side effects.
OK, that was a lot. Now it’s time for our point of view.
Our Point of View
Heavily regulating a woman’s BC access out of concern for her ability to take care of herself is not super different from restricting access to reproductive healthcare. Both are rooted in a desire to control women’s bodies, which is a big no-no for us at Team THINX. Ideally, people should just trust women to make the right decisions for themselves without holding their pills or their reproductive healthcare and abortions hostage. Crazy, no? Contrary to popular belief, women are actually not toddlers who need to be lured into the doctor’s office with the promise of shiny little pills! We have been known to get ourselves to the doctor when we need it, and we have been known to be smart about our own medical decisions, too. In fact, a 2006 study showed that women who were asked to assess their own risks in taking the pill had matching assessments with their doctors 90% of the time--and the other 10% was typically women exercising more caution than the doctors in the study. Yowza.
And finally, instead of punishing women with exorbitant hoop-jumping, this new measure should require pharmacists to be exceptionally clear with their customers about side effects and possible need for doctor consultation. The health concerns expressed by critics are 100% legitimate, especially because as contraception has grown as an industry, we’ve seen the fine-print lists of side effects growing adversely. However, many health professionals rationalize this by highlighting potential risk that all drugs carry, and also how oral contraception is no more dangerous than a pregnancy.
AND, even while we sit here and quabble over the details of this specific measure in Oregon (and soon to be California), there are some groups who are pushing to abolish the prescription (whether from a doctor or a pharmacist) altogether. The American College of Obstetricians and Gynecologists has endorsed the over-the-counter (OTC) policy for contraception since the year 2012, and most women, when asked, say they believe they should be getting their pills without a prescription. These folks claim that prescriptions of any kind separate certain women with the most troubles from the BC they desperately need. Where do you stand? Join the conversation here.