Let Pharmacies Prescribe Birth Control

Back in 1933, Rep. Walter Pierce of Oregon introduced a bill in Congress to let doctors discuss birth control with their patients. The need for such a bill showed how controversial the subject was. But this was the heart of the Great Depression, when impoverished Americans could barely feed the children they had.

Oregon, along with California, is again ahead of the curve in promoting women’s access to contraceptives. Both states will soon let pharmacists dispense the pill, patches and other hormonal contraceptives without a doctor’s prescription. This is a major advance for the following reasons:

–Logistics. Needing a prescription from a physician requires having a physician. Many women don’t, and those who do must often wait for appointments. Or they may have had a recent checkup and want birth control without going through the other unpleasant procedures in a gynecologist’s office.
–Cost. It’s a cheaper way to obtain birth control.
–Convenience. The United States has a very high percentage of unintended pregnancies. Many are the result of women being unwilling to jump through the hoops to secure birth control before having sex. The hurdles of convenience, cost and logistics are higher for poor women.

Please spare us the lectures on personal responsibility. The objective here is to prevent unwanted pregnancies.

Some argue that these state laws don’t go far enough in “freeing” the pill. They want it sold over the counter just like aspirin and toothpaste.

Hormonal contraceptives are already sold over the counter in much of the world — in nearly all of Asia and Latin America and in most of Africa. A prescription is still required in Canada and in western Europe, with the interesting exception of Portugal.

One can argue for requiring some sort of prescription, at least for the time being. Health insurance generally doesn’t cover over-the-counter medications but will pay for prescribed contraceptives. The federal Food and Drug Administration, meanwhile, takes forever to approve over-the-counter medications (another problem that needs fixing).

Although these contraceptives are generally very safe, they can cause complications for a few women. Both Oregon and California will ask pharmacists to have women fill out short questionnaires to help determine whether hormonal birth control poses any risks to the patient.

Arizona, Idaho and New Mexico have shown an interest in following the Oregon and California example. Washington state already lets pharmacists prescribe contraceptives, but only under special agreements with physicians; they can get complicated.

As we look forward to more easily obtainable birth control, we can also observe the past at work in a case now winding through the U.S. Supreme Court. It is the umpteenth challenge to the Affordable Care Act requirement that employers provide coverage for birth control. (Houses of worship are already exempt.)

The plaintiffs this time are the Little Sisters of the Poor in Baltimore. They argue that the Obama administration’s accommodation for religious nonprofits opposed to contraception, such as theirs, is too burdensome.

In truth, all they have to do is fill out a short form saying that birth control violates their religious beliefs and they won’t have to pay for it. The group says doing even that makes them “complicit” in the alleged immorality tied to birth control.

Americans have to agree on certain principles, and access to birth control is widely accepted, including among Catholics. In this world of increasing religious diversity, many principles will conflict with theological teachings. In short, Obama has stretched religious accommodation far enough.

Back to the future, thank the American West for leading the way toward curbing unwanted pregnancies — the results of which no one of faith or otherwise wants. Letting pharmacies prescribe contraceptives should become law across the land.