England plans to launch two pilot programs in the London area that will provide women with nonprescription access to birth control pills, the PA/Google.com reports. The pilot programs will begin next year in the Lambeth and Southwark primary care regions of England’s National Health Service, and the results will be used to determine whether the program should be expanded across England. Under the program, women seeking nonprescription oral contraception will undergo an interview with a qualified pharmacist. Strategic health authorities — which manage local health services under NHS — will be required to provide pharmacists with sets of instructions known as patient group directions, including special directions for girls younger than age 16, the PA/Google.com reports. According to the PA/Google.com, patient group directions are required by law to dispense medications without a doctor’s prescription and currently are used for administration of emergency contraception. The directions for dispensing EC to girls younger than 16 include a mental health assessment.
I think that any measure designed to help women have easier access to birth control is great, and I think it would be fantastic if birth control could be offered without a prescription. On the other hand, though, I worry about the interview with the pharmacist (or nurse, as the case may be). From personal experience, I have medical issues (family history of high blood pressure and certain cancers) that restrict the kinds of birth control pills I was/am able to take (I’m no longer on the Pill but have an IUD instead). I felt more comfortable going through a more involved process, one that required me to go in for some minor, noninvasive tests after the first three months on the Pill to make sure it wasn’t doing major damage.
Now, I assume that during the interview process, medical history will be taken into account and if a patient has health issues that prevent her from being on the Pill, the pharmacist or nurse will recognize that. In the Daily Mail article, the author mentions that pro-life groups have criticized the plan because they don’t think the pharmacist’s interview will have the same safeguards. However, I don’t think that’s really an issue. When I was going on the pill for the first time, I had my vitals taken and was asked questions about my sexual health and family history. I am sure a pharmacist could administer those checks just as well as a gynecologists. However, I have concerns about what happens if a women who, for medical reasons, should not be on the Pill, decides to go ahead with it anyway? My question is: what kind of safeguards will be in place to prevent women whose health issues prevent them from going on the Pill?
I’m not saying I want to deny women the right to be on the Pill. But speaking from my own experience, I had to switch pill brands when I went to graduate school, because my health center didn’t offer my original pills at a reduced rate. The doctor I was seeing did not pay attention to my health history, and gave me pills that made my blood pressure go through the roof. Now, I’m not inferring that those mistakes will happen during this pilot program (I mean, they might, but that’s not really my concern). What were to happen if a woman had blood pressure issues was told to avoid the Pill, but wanted to take it anyway? Would she be allowed to? What if she got sick? Who would be liable? The pharmacist, or her? I guess I’m kind of Libertarian in the sense that if a woman wants to do something that might make her blood pressure spike and possibly make herself sick, that’s her decision. On the other hand, as I said, who would be responsible if she went against medical advice?
I guess I need to have more confidence in people. I mean, would a woman really want to risk endangering her own life just to be on the Pill? I know I wouldn’t. On the other hand, I’m lucky that I’ve had plenty of opportunity for contraception education and could afford the up-front expenses of an IUD – maybe there are women willing to take a risk just because they don’t know what else to do. Although one hopes that a pharmacist would be able to give them Pill alternatives.
I genuinely hope that this pilot program will be successful, and I’m optimistic that it will work. I am confident that the professionals running this program have taken all concerns into account. I look forward to seeing how this program turns out, and hope that more comprehensive information about the pilot is released soon.
Crossposted at This is What a Feminist Blogs Like.