Don’t look for easy solutions

In recent years, California and Oregon have enacted legislation granting pharmacists the ability to prescribe oral contraceptives to women over the age of 18. These laws have been created to address the concern for accessible birth control amongst American women. Just this month, a new protocol has been implemented in Colorado in which the state will allow pharmacists the ability to prescribe hormonal-contraceptives to women.

States such as Missouri, Hawaii and Tennessee have also proposed similar legislation that would allow women to obtain birth control while eliminating an initial need to visit an obstetrician or gynecologist (OBGYN). These new laws may significantly improve access to self-administered contraceptives and decrease unintended pregnancy, but it raises many concerns, as I believe it would significantly put many of our reproductive organs at great risk for long-term issues.

As reported by The Los Angeles Times and The Denver Post, it is very simple for a female — confirmed by identification or driver’s license — to obtain birth control at a local pharmacy in California, Oregon or Colorado. During a 15-minute consultation, the pharmacist will review a self-assessment as completed by the patient and also check the individual’s blood pressure. The pharmacist, who has spent three or four years extensively studying medication, will decide which oral contraceptive is appropriate for the patient’s needs. After a quick consultation, the patient will leave the pharmacy, with birth control in hand.

No examination is required prior to drug administration. It is not until after three years that the patient is required to visit a doctor for further medical examination. Further consultation with doctors may include pelvic and breast exams, and also tests for sexually transmitted infections.

The proposed laws obviously address convenience, or lack-thereof, as being an important factor in preventing unplanned pregnancies. Of course it is ideal for oral contraceptives to be widely available at our local Walgreens or CVS pharmacies. We could finally eliminate the uncomfortable and awkward time spent at our yearly OBGYN appointment. But ladies and gentlemen, as much as we hate those yearly visits, routine visits to the gynecologist are critical components in keeping our bodies healthy and maintaining the health of our reproductive organs.

Although many view an annual trip to a primary physician as a “hurdle” in obtaining birth control, it is keeping many American women, and men, safe. Studies from the American Sexual Health Association show one of every two people will contract a sexually transmitted infection (STI) before the age of 25, proving that although we may think we are invincible from STIs, we really are not.

It is a statistic that I can imagine will only rise if we eliminate physicians from the process of administering oral contraceptives. Three years is an excruciatingly long time for a sexually active individual to wait before seeing a doctor and those waiting will be exposed to many health risks within a 36-month time period. Let us not forget that no examination is required prior to prescription of the drug, leaving pharmacists unaware of the women’s previous reproductive history.

And while we endure most annual examinations to receive a yearlong prescription of our birth-control medication, we must remember a very important part of these visits. Examinations usually include many critical preventative healthcare measures such as breast and pelvic examinations, and most importantly STI testing. Health complications often go unnoticed or even ignored, creating obvious concerns for men and women alike.

Pelvic inflammatory disease (PID) is an unfortunate result of STIs that are left untreated, often because an individual may not have shown any signs of infection. PID is the cause of 15 percent of all infertile women in America, according to the American Journal of Public Health, while another 12 percent of women will develop invasive breast cancer. Fortunately, these frustrations can be prevented, detected and treated with routine visits to a primary care physician.

In addition to infection prevention, women need safe and comfortable environments to discuss their concerns regarding sexual intercourse. It will not come as a surprise that after increasing contraceptives, women will only have more questions and concerns about their sexual history, past, present and future. Sex, while seemingly easy, is rather complicated and always raises questions at some point in our lifetime. I’m not sure about you, but the pharmacist at our local Walgreens is not where the sensitive nature of these questions and concerns should be asked or discussed.

A number of us have experienced longer trips than expected to our local drug store and had an even longer wait behind the pharmacy window. It seems as if it is a place where there are constant complications requiring pharmacists’ approval or solutions. Can you imagine how long our waits would be if birth control was made so widely available?

Pharmacists would have an influx of patients and a substantial increase in responsibilities regarding patient care. There will be new liability concerns in a place that was once without such worries. There are many concerns that I raise in response to the concept that this legislation will improve access and care for the patients’ needs.

Pharmacist Kelsey Schwander, of Good Day Pharmacy in Colorado, said to The Denver Post, “People could be coming in to buy shampoo or vitamins, and they can have that conversation with a pharmacist.” Her idea that birth control being as carefree and comparable to shampoo, is the exact reason I am turned off from the implementation of making oral-contraceptives so widely available. Birth control should not be perceived as a convenience product, or a product that is frequently bought with little comparison or buying effort.

Many women do not use oral contraceptives for sexually related reasons. Birth control is widely used as an easy solution for heavy or irregular menstrual periods. Oral contraceptive administers estrogen and progestin hormones, thus altering the natural processes of a woman’s body. The hormones regulate and reduce many frustrations usually brought on by Mother Nature.

A pharmacist, however, is not a qualified person to be making such decisions that would alter a woman’s reproductive process. Heavy or irregular menstrual cycles may lead to more serious and long-term issues in a lady’s future. And while pharmacists have spent years studying medication and its effect,
they have not spent years studying the delicacy of a female body’s reproductive organs.

And while pharmacist-prescribed birth control sounds ideal to many, we have to remember that we must advocate for women’s preventive health care. Physicians are crucial components in keeping women healthy and free of any health risks in their future. Legislation may fix a short-term access problem, but it creates significantly more long-term complications for women
and men both.

Originally published for the Western Courier by freelance writer, Victoria Hall.


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