Pandemic, research demonstrate the need for expanded birth control access
Social media has been littered with self-styled experts who have speculated that roughly nine months following the institution of the COVID-19 stay-at-home orders, there will be a baby boom.
What else are couples going to do while they’re isolated for months at a time, they pondered.
It’s a fair supposition, but it remains to be seen whether there is any merit to the coronavirus baby boom hypothesis.
Rather, one study suggests that this will not be the case because the majority of individuals don’t plan on conceiving. But that paints an incomplete picture because around 60 percent of Georgia’s pregnancies are unplanned – often because women don’t have adequate access to hormonal contraceptives. Yet this – along with recent events – have demonstrated just how critical it is to reform the contraceptive access system.
Under current law, in order for Georgians to obtain hormonal birth control, they must visit a doctor’s office, submit to a blood pressure check, and self-report their medical history. Only then can they receive a contraceptive prescription, which a pharmacist later fills. However, this unnecessarily creates undue risks and burdens for many women.
Doctors’ offices exemplify the locations that public health officials have warned Americans to avoid since the pandemic’s genesis. Physicians’ offices are crowded with sick people, and to force women into these places puts them in harm’s way. Of course, Governor Kemp wisely signed an emergency order allowing pharmacists to “dispense a ninety-day supply of a prescription drug if a patient has no remaining refills,” which helps keep many out of clinics. Nevertheless, this privilege isn’t permanent and doesn’t extend to women seeking their first birth control prescription.
Even in the absence of a debilitating pandemic, the results of Georgia’s birth control access paradigm have been devastating. Doctor’s appointments can be time-consuming, costly — especially for the uninsured — and geographically prohibitive. Indeed, Georgia has one of the nation’s worst physician-to-patient ratios. Seventy-nine of Georgia’s 159 counties don’t have an OBGYN, and nine don’t even have a single medical doctor. Combined, these hurdles discourage women from obtaining birth control, even though it is desperately needed for family planning and to reduce the taxpayer burden. After all, in 2010 alone, taxpayers paid for around 80 percent of Georgia’s unintended births, to a tune of almost a billion dollars.
Rather than funneling women into risky doctors’ offices and perpetuating a harmful system, Georgia lawmakers should consider what 12 other states and the District of Columbia have done. They simply removed the intermediary in the birth control prescription process — doctors — allowing women to get their birth control directly from pharmacists who have opted into the new system, received special training, and examined the patient to ensure that they are healthy enough for birth control. And why not? Pharmacists are already more than qualified to check for contraindications and measure patients’ blood pressure, which is all that doctors must do now.
Perhaps the most prominent criticism of the pharmacy access model is that it will lead to more cases of VTE (venous thromboembolism) – a rare but serious complication sometimes associated with birth control. However, specially trained pharmacists are able to screen for this. What’s more, the risk for VTE is many times higher for women who have recently given birth than to women on birth control – meaning more accessible hormonal contraception could limit unplanned pregnancies and as a result, reduce the prevalence of VTE.
Hormonal birth control is considered so safe that virtually every major national medical association supports making hormonal contraceptives available over the counter (OTC). In fact, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American Medical Association all support this, and more than half of all countries permit OTC birth control access too.
While OTC access would require federal action, the pharmacy access model has enormous upside. Oregon was the first state to adopt the pharmacy access model. Two years later, unintended pregnancies, abortions and Medicare costs associated with unplanned births in the state had all declined.
Adopting the pharmacy-access model would increase the number of birth control providers and lower the cost of obtaining hormonal contraceptives. What’s more, estimates suggest that expanded birth control access would reduce unplanned pregnancies among the underprivileged by seven to 25 percent. More than a quarter of women who are not currently on birth control would be if it became more readily available, which would result in far fewer unintended pregnancies and limit the associated costs that hinder Georgia’s hardworking taxpayers. Further, it could keep more women from making unnecessary trips to germ-infested doctors’ offices during future pandemics.
We may never know how the pharmacy access model might have impacted a supposed coronavirus baby boom in Georgia, but the paradigm’s benefits are manifold and could prove critical in the future.
Marc Hyden is the Director of State Government Affairs for the R Street Institute, and he is a longtime Georgia resident. You can follow him on Twitter at @marc_hyden.