Birth control pills should be nearly as easy to procure as condoms – nearly, since the pill is, after all, a drug that goes into the body. A bill before the House that would allow pharmacists to prescribe contraceptives would help do just that.
The ability to reliably plan families through the use of contraceptives didn’t exist a few generations ago. “The pill,” as it’s still called, was first approved for contraceptive use in 1960. Thanks to the hormone-based drug, the state’s network of family-planning centers and other factors, New Hampshire has the best track record in the nation when it comes to planned versus unplanned births, according to the Guttmacher Institute, a research and policy organization that supports reproductive rights.
In 2013, New Hampshire’s adolescent pregnancy rate was 22 per 1,000, the lowest rate in the country. The unintended pregnancy rate for all women is also the lowest in the land, yet according to the state’s Division of Public Health Services slightly more than 4 in 10 births are unintended. Making contraceptives more accessible and affordable would mean even fewer unplanned pregnancies and, dare we say it, fewer abortions.
New Hampshire is already one of the states that allow the over-the-counter sale of some so-called morning-after pills, but contraceptive pills for routine use still require a prescription from a physician. For women without insurance, with little money to spare, or with a work schedule or rural residence that makes doctor visits difficult, the requirement is a barrier to care. An appointment with a primary care provider, if one can be found, can take weeks or months to arrange and can be costly for a person living close to the bone. Allowing pharmacists to prescribe, presumably after receiving suitable training, some forms of routine-use contraceptives would reduce that barrier.
The bill has the backing of the 16-member study commission – just four of whom were lawmakers – along with the state’s Medical Society, Board of Nursing, Pharmacy Association, Planned Parenthood and Board of Pharmacy. The experts on the matter have given it a thumbs-up. The Legislature and governor should do the same.
Lawmakers should also enact companion legislation, Senate Bill 421, which would require that insurers cover a 12-month supply of self-administered contraceptives. The bill would also prevent the imposition of patient cost-sharing that make preventing unwanted pregnancies more expensive.
If the bill passes, New Hampshire will join Oregon, California and Washington, states that already allow pharmacists to prescribe hormonal contraceptives. The process typically involves a short meeting to discuss treatment and fill out a short health questionnaire. Pharmacists, who now prescribe morning-after contraceptives under a collaborative agreement with a physician or physicians, should also provide patients with information on doctors’ offices and nearby low-cost clinics in case follow-up becomes necessary.
In 2011, the Guttmacher Institute reported that the unintended pregnancy rate for women with a family income below the federal poverty level was five times the rate of women with a family income more than double the poverty level. That gap represents a medical, moral and societal problem that must be solved. Passing the two bills would be a start.