The largest physician-based women’s health organization – American College of Obstetricians and Gynecologists (ACOG) – has recommended that birth control pills should be sold without a prescription to curb the number of unintended pregnancies.
According to the data collected by the ACOG nearly 50% of all pregnancies in the US are unplanned. The federal government is forced to spend as much as $11.1 billion annually to cover the costs of these pregnancies.
While government funds are a big issue, yet it’s important to look at the consequences of unintended pregnancies on the lives of women and their families. If a woman’s health insurance policy doesn’t cover maternity then the costs of just prenatal care and delivery range between $6000 and $12000. These numbers are true for a pregnancy without any complications but increase dramatically during a high-risk pregnancy.
Raising a child gets even more expensive. According to the survey at Babycenter.com you can expect to spend about $10,000 just in the first year, and according to CNN Money the total cost of raising a child to a 17-year old age is $235,000 (that’s not including inflation or college education.)
Unplanned pregnancy can be a financial nightmare for a family and especially for a single mom who can’t afford it.
Many countries around the world do not require prescription to buy birth control pills. This practice allows women to have better control over their health.
The opponents of the ACOG proposition say that taking hormonal pills without doctor’s supervision can be potentially harmful to women’s health. But again today many women take the Pill irregularly or rely on cheaper birth control methods (or none at all) because they can’t afford the price of a doctor’s visit.
The ACOG took a close look at the risks associated with taking birth control pills without prior consultation with a doctor. The biggest concern regarding over-the-counter provision of oral contraceptives is the potential harm that could result when the women with contraindications use them.
One of the recent studies included 399 women, ages 15-45. The participants were asked to self-assess their eligibility to take birth control pills while taking into account any contraindications that they might have. The results of self-assessment were compared with medical screenings and physician’s decision of the patient’s eligibility. 392 participants (astonishing 98%) obtained an agreement on medical eligibility.
Another study conducted in the UK showed that women take a more conservative approach than clinicians when deciding whether they can take birth control pills.
Another study showed that women seeking to buy birth control pills through online programs were as knowledgeable about all possible contraindications as were the women seen in the clinic. However, women who bought over-the-counter birth control pills in Mexico were more likely to have relative and absolute contraindications. These women weren’t self-screened and didn’t have access to health maintenance service.
Online access to birth control resources can be an important factor in determining how educated a woman is about risks and contraindications associated with taking oral contraceptives.
However, a screening by a pharmacist or health care provider can still be beneficial for many patients. In the Direct Access Study in Washington State several pharmacists were instructed to provide birth control pills and patches to the patients who met the World Health Organization’s Medical Eligibility Criteria for Contraceptive Use. The pharmacists were provided with a checklist to help them identify any health risks for the patients, they also measured blood pressure and body mass index. The results of the study were successful, 70% of the women continued using birth control pills during 12 months even though most of them had to pay out-of-pocket for the pharmacist evaluation (most health insurance providers didn’t cover the service.)
One of the growing trends in the US medical world today is telehealth – online consultations with a physician or a pharmacist. This service offers patients an easy way to ask their medical questions and to get refills on their prescriptions without a conventional visit to the doctor’s office. While birth control pills in the US still require a prescription women can use telehealth to their advantage to order oral contraceptives. Our website offers free consultation with a physician to all patients looking to buy birth control pills.
Another concern that stands in the way of making birth control pills available without a prescription is the possible increased cost of these medications. Women who use insurance coverage for their preferred contraceptive method may end up paying more for their oral contraceptives as insurance doesn’t cover over-the-counter meds. In any case, birth control pills are already a significant expense for many people, that is why the cost must be carefully considered before making a decision whether to sell birth control pills with or without a prescription.
The next step in making birth control pills available without a prescription is to motivate pharmaceutical companies to submit an application to the FDA to begin the over-the-counter approval process. The American College of Obstetrics and Gynecology hopes that their recommendation would be enough of a “boost” to motivate pharmaceutical companies for this step as it can potentially open up the doors for new populations to start using oral contraceptives.
In order to get approval from the FDA the company needs to have research on the safety of birth control pills as an over-the-counter medication (meaning that women at high risk of blood clots or stroke wouldn’t be buying these medications.)
The process of making birth control pills available without a prescription could take years because of all the steps involved. However, Dr. Daniel Grossman, who volunteers as vice chairman for the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice Bulletins, is optimistic about the future of this recommendation.
“It is a pretty bold move on the part of ACOG,” he said. “I really respect that the organization decided to make this statement after reviewing all the evidence. It’s not very common where you hear a physician organization say, ‘We think there should be a change so that our patients don’t have to see us anymore.’ ”