R Sheets State Policy

R Sheet on Birth Control Access in North Carolina


Courtney Joslin
Resident Fellow and Senior Manager, Competition Policy
Marc Hyden
Director, State Government Affairs

Key Points

North Carolina suffers a primary care shortage virtually across the state.

Intended pregnancies in North Carolina only make up 56 percent of all pregnancies, which is likely in part due to this primary care shortage and the ability to obtain prescriptions for effective contraception.

Taxpayers spent $858 million on the medical costs associated with unintended pregnancies in North Carolina in 2010.

The pharmacy access model to contraception means alleviated primary care shortages, as well as fewer unintended pregnancies.

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Over the last several years, state lawmakers have increasingly looked for innovative ways to improve access to primary care medical services and reduce unintended pregnancies. A popular measure across many states—17 plus Washington, D.C. to date—is allowing pharmacists to prescribe hormonal birth control directly to patients. North Carolina should consider adopting this pharmacy access model for the numerous benefits it brings to citizens.

According to the North Carolina State Office of Rural Health, the state suffers from a “severe” shortage of primary care professionals, and the vast majority of North Carolina counties are designated as health professional shortage areas (HPSA). In 2020, North Carolina ranked 11th for most primary care HPSAs.

Further, survey data from 2016-2017 shows that only 56 percent of pregnancies in North Carolina were intended. This is coupled with the fact that only 27 percent of the postpartum women surveyed in North Carolina were using effective contraceptive methods like birth control pills. The pharmacy access model offers women better access to effective contraception, leading to fewer unintended pregnancies and, in turn, fewer abortions.

Unplanned pregnancies are costly to states and their public health insurance programs. In 2010, unintended pregnancies in North Carolina cost an overall $858 million to taxpayers—almost $215 million of which was shouldered by the state government.

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