Under a law expected to go into effect by April, women in California will be able to stop by their neighborhood pharmacy and buy birth control pills without a prescription.
Proponents argue that easing women’s access to birth control will reduce unintended pregnancies, which make up as many as half of all pregnancies nationwide.
The new initiative is part of a larger effort to simplify America’s healthcare system, proponents say, as more people becoming insured under Obamacare look for quick and convenient ways to get medical care.
A similar effort in Washington state, where broad laws have enabled women to obtain birth control from pharmacists for more than 30 years, has done just that, said Don Downing, a professor at the University of Washington School of Pharmacy.
“That’s the beauty of it — in that it’s a new portal into healthcare delivery, without having to know the entire healthcare system,” he said. “Just walk into a pharmacy.”
Hawaii lawmakers introduced a similar measure last month, and advocates in New Mexico and Alaska say they want to follow suit.
As it is now in California, a woman must get a prescription from her physician for birth control, whether it’s for an intrauterine device or a daily pill. Though most insurance plans provide birth control to patients for free, many healthcare experts say the often time-consuming process of making an appointment and seeing a doctor to get contraception effectively limits access.
“The easier it is for someone to access medication, the more likely they are to use it,” said Sarah McBane, president of the California Pharmacists Assn. and a professor at UC San Diego.
Under California’s new law, pharmacists can dispense what is called self-administered hormonal contraception, which includes patches, pills and vaginal rings.
Failop Chu, 37, of Saratoga, said she was looking forward to being able to pop into her local pharmacy to pick up birth control. Typically, the only reason she visits a gynecologist each year is to get her birth control prescription, she said.
“That would be so convenient,” Chu said.
Many argue that women should not be required to get prescriptions for contraception when men are able to easily purchase it at drug or grocery stores.
But some worry that not requiring patients to visit doctors for birth control will mean women won’t get the preventive tests that they often receive during visits to the gynecologist. These include testing for sexually transmitted diseases, breast cancer screenings and pap smears, which check for cervical cancer.
A study found that women who lived in Texas but could buy over-the-counter birth control across the border in Mexico were less likely to get these tests than those who got their birth control at family planning clinics stateside.
Other advocates of expanded access to birth control say that women are smart enough to know when they need to visit their doctor.
Plus, before dispensing birth control, pharmacists must administer a screening questionnaire covering medical issues that could raise red flags, and they are required to recommend that patients see a physician if they think they need further guidance or medical care.
“There’s not a medical link between those preventive health screenings and getting birth control,” said USC clinical pharmacy professor Kathleen Besinque. “It’s a little paternalistic to hold their birth control hostage.”
Virginia Herold, executive officer of the California Pharmacy Board, said she expected the law to be enacted by April 1.
California pharmacies won’t be required to offer the services. A spokesman for CVS said the drugstore chain is waiting to review the final rules before deciding whether to participate.
Ralphs spokeswoman Kendra Doyle said the grocery chain is also monitoring the regulations and is already training pharmacists. Current pharmacy students receive the training needed to dispense such medicines, and others will require a few hours of extra training.
“We’ll certainly be ready to serve the patients once the details get ironed out,” said Doyle, who added that almost half of the 203 Ralphs stores in Southern California have pharmacies.
Oregon’s law included an age provision, mandating that a patient younger than 18 first get a prescription from her doctor, which a pharmacist can then refill.
Camille Giglio, head of the antiabortion advocacy group California Right to Life, said she thinks California’s law should have included more such safeguards, calling it an “irresponsible way to deal with a very, very important subject.”
Giglio sees a benefit in a patient having a conversation with her doctor about her sexual partners. “That doctor could have a little bit of concern, a little bit of connection, should have a little bit of understanding for what’s going on,” she said. “It’s not the purpose of a pharmacist.”
The American Congress of Obstetricians and Gynecologists has also spoken out against the law. The group supports federal legislation that would make birth control truly over-the-counter, instead of requiring that patients seek permission from a pharmacist or a doctor. Initiatives such as California’s, the group believes, could detract from their efforts.
Dr. Mark S. DeFrancesco, president of the obstetricians group, said that women could be deterred from seeking contraception under California’s soon-to-be-enacted measure because pharmacists could charge a fee to dispense birth control. Others, however, say that many pharmacists will probably not charge patients.
“We do not think this law goes far enough,” he said.