By Sally Rafie
So often, women and couples find themselves in a bind when it comes to getting birth control. You might look in the medicine cabinet on the last day of your pill pack and realize you have no refills left. Or you might be in a new relationship and, though you’re not interested in getting pregnant, you’re not using birth control yet. Maybe your current birth control method isn’t working the way you’d like and you want to try something new but you are having a hard time finding time for a visit to the doctor’s office. Do any of these situations sound like something you’ve experienced before?
Fortunately, a recent state law is making it easier to get birth control by giving women in California the option to go directly to the pharmacy. While having a yearly exam with your primary care provider or obstetrician/gynecologist is important for other health reasons, it is not necessary to link it to hormonal birth control. Now, women can get birth control pills, the patch, the ring, or the shot directly from a local pharmacist and without needing a doctor’s visit or prescription first.
Although taking any medication has some risks, these birth control methods are considered safe for most women. All that’s needed for a pharmacist to determine if a method is safe for a particular person is a review of personal health history and a blood pressure measurement. The biggest risk is a very rare one — blood clots. To put the risks of blood clots in perspective, the added risk from hormonal birth control is far less than the added risk from pregnancy or postpartum.
There are a number of important things to know before you go to a birth control pharmacy:
- You can find a birth control pharmacy near you by visiting birthcontrolpharmacies.com or calling your local pharmacy to see if they offer this service. As more pharmacies implement this service, availability will expand.
- Once at the pharmacy, you will fill out a short form about your health history
- The pharmacist may need to take your blood pressure
- The pharmacist can discuss all your options and help you pick one if you’re not sure what you want
- Plan to set aside 15-30 minutes if you are starting birth control or switching methods. Plan to set aside 10-15 minutes if you are continuing your current birth control method.
- Your birth control will be covered by your health insurance just as if a doctor wrote the prescription
- Everything at the pharmacy is confidential. Even for minors.
- Most pharmacies charge a small consultation fee for this service that is not covered by health insurance. You can use your health savings account to cover this fee.
Right now, California law doesn’t mandate that insurance companies cover the consultation service, although Medi-Cal will make that change by 2021. We already know that cost is one of the common obstacles that leads people to skip doctor’s appointments and that could be true for pharmacy visits, too. This financial barrier must be removed before birth control is truly accessible to everyone who needs it.
In a national survey of women, almost one in three who have ever tried to get a prescription for birth control said they’ve had problems. Unplanned pregnancy is still very common in the United States and some birth control also reduces pain and heavy bleeding with periods and helps prevent acne and anemia. Making it easier to start using contraception and keep using it longer is fundamental to women’s health and well-being.
In the future, we may see some birth control pills available directly over-the counter, on pharmacy shelves, available without a prescription or consultation. While this option isn’t available yet, there are efforts underway to move in that direction by the Free the Pill campaign. Over-the-counter access to the pill might sound revolutionary, but it is already available without a prescription in more than 100 countries. Women don’t need the oversight of healthcare providers to determine if and when they want to have children and they should have convenient access to the tools to help them make decisions about pregnancy effectively.
Sally Rafie is an assistant clinical professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego and provides this birth control service at The Pharmacists Clinic inside Point Loma Shelter Island Drug.