From the time menses begins, to the time it ceases, a woman must make decisions that affect her fertility. Whether it's viewed as a gift, a curse or just a responsibility, a woman’s right to choose when, how and if a pregnancy occurs is a relatively new experience.
Over the last 50 years a woman's access to birth control methods, whether oral, patch, or IUD, has greatly increased. However, such a prescription usually requires a visit to a doctor along with a pelvic exam.
Oregon House Bill 2879 has changed this as of January 2016. Under the new law, women can bypass their physicians and go straight to their local pharmacist for an oral or patch contraceptive prescription.
Increased Accessibility the Answer to Unintended Pregnancies?
Driving this ground-breaking legislation is the rising rate of unintended pregnancies. Medical experts and reproductive health advocates have pushed for a change in the accessibility of birth control methods to help curb the growth. There are significant social and economic consequences of unplanned pregnancies and experts claim that increased accessibility is the answer.
Considered safe by most medical experts, any health concerns in using hormonal contraceptive methods take a back seat. The American College of Obstetrics and Gynecology has even suggested that oral contraceptives be available over-the-counter. Can you imagine going into a drug store and choosing a packet of birth control pills off the shelf? With the number of different medications on the market and the potential side effects unique to individuals, how will a woman make that decision?
New Requirements for Pharmacists
For years women have been fighting for more control over their reproductive lives. Does this legislative step move them closer to that goal?
Of course the new Oregon law is not without controversy. This new task for pharmacists invokes the question: are they qualified to make and oversee these prescriptions?
The Oregon Pharmacy Board says that although the bill has passed, implementation is likely to be slow. Educational requirements and specific practice guidelines need to be defined to ensure pharmacists are qualified. Then they will need to complete the specialized training and update their license for the new prescriptive rights. Also the logistics of how best to incorporate the increased service into a pharmacy’s current workflow needs to be addressed.
Educational requirements for Oregon pharmacists are already impressive and include classroom and direct patient care experience. To prepare for the added task of issuing prescriptions, pharmacists will be expected to complete specialized training on contraception methods. In addition, they can access the Standard Procedures Algorithm to aid in prescribing the pills or patches.
All women seeking a prescription for contraception from a pharmacy will be expected to complete a self-screening questionnaire assessing their health risks and eligibility for different birth control methods. But will this prepare pharmacists for the complications inherent to many contraceptive medications? Will they be expected to manage these complications or end up referring women back to their health care practitioners?
Will Refusal of Service Become an Issue?
Another concern for women regarding the recent law may stem from a non-health care related issue, refusal of service. While some states limit what services or prescriptions can be refused, other states, such as Oregon, have a "conscience and refusal clause" written into the law. The clause allows pharmacists to refuse to write or fill prescriptions for birth control based on moral or religious beliefs. However, pharmacies will still be legally responsible for referring the customer to another pharmacist or pharmacy that will provide service. The referral may not be a problem in more populated areas but could decrease access in rural areas with fewer pharmacies.
For years women have been fighting for more control over their reproductive lives. Does this legislative step move them closer to that goal? Will Oregon pharmacists be able to fulfill the task set before them with the new law? Will personal beliefs be a stumbling block for fulfilling the law? Will unintended pregnancy rates decline?
Only time will answer these questions. But for now, the plan has been set in motion for women to have a little more control over their fertility.
What thoughts do you have about this groundbreaking legislation?