The United States has one of the highest unintended pregnancy rates in the world, along with some of the most restrictive contraceptive access laws. Its rates of unintended pregnancy are 16 percent higher than those of Africa — large parts of which struggle with access to basic medicine, let alone contraceptives. While the circumstances are vastly different, the core principle remains the same: Limited access to contraceptives leads to unintended pregnancy.
Massachusetts is among those states with the most restrictive self-administered contraceptive access laws in the country. Thankfully, this legislative session, the state has the opportunity to correct its outdated laws by transitioning from the current physician prescription model to a pharmacist prescription model.
Currently in Massachusetts, women must visit a physician for a routine blood pressure test and consultation to receive a prescription for self-administered contraceptives. Once she has her prescription, she must then take it to her pharmacist, who fills the prescription. When factoring in the time taken off work, the copay costs for those with insurance, and the additional costs to those who are without insurance, accessing contraceptives becomes quite burdensome. As a result, many women opt for less effective contraceptive methods like condoms — which many younger, sexually active Americans consider to be quite expensive themselves.
In fact, younger women and lower-income women are the most at-risk for unintended pregnancy due to this lack of basic access to quality birth control. For lower-income women especially, unintended pregnancies contribute to a vicious cycle of poverty from which many never recover.
Limited access to quality contraception has resulted in millions of unintended pregnancies. In 2010 alone, almost half of pregnancies in Massachusetts were unintended. These pregnancies can have serious, negative effects on a woman’s physical, emotional and mental health. The circumstance can also result in severe financial consequences for these women — not to mention state and local governments, which pick up the tab for many of the associated health care expenses. In fact, the State of Massachusetts funded over 56 percent of the costs related to unplanned pregnancies in 2010, which amounted to roughly $360 million.
Given the high rate of unintended pregnancies and the concomitant costs — both to women and to taxpayers — expanding access to safe and effective contraception should be a primary focus for policymakers.
Fortunately, Bay Staters may soon get some relief. Sen. Michael O. Moore, D-Millbury, has introduced S.1309, which would allow pharmacists to prescribe oral contraceptives and contraceptive patches. The provision would apply to patients over 18 years old, as well as to those under 18 if they have had a previous birth control prescription from a doctor. There is increasing demand for this kind of contraceptive access: A recent national survey by the National Center for Biotechnology Information found that 68 percent of women were interested in “using pharmacies to directly access hormonal contraception without a prescription.”
The medical community widely regards the pharmacy access model as perfectly safe. The American College of Obstetricians and Gynecologists even issued a statement that advocates complete over-the-counter access to birth control. Indeed few, if any, risks are associated with Sen. Moore’s proposal. In fact, the pharmacy access model has proven quite successful in Oregon since its implementation in 2015 — to date, there have been no issues reported that would undermine the pharmacy access model’s safety or effectiveness.
As one of the first states to conform its laws to match the standards imposed by the Affordable Care Act, Massachusetts has long been at the forefront of progressive health care policies. In keeping with this record, Bay State legislators would do well to continue their legacy of innovating health care policy by increasing women’s reproductive choice and passing S.1309.