Will Pharmacists Give You Birth Control Without a Prescription? The Survey Says…

For those who may have been following this blog since its inception, you may recall that I was conducting a research project with Dr. Rafie last year. We conducted a survey study to gauge pharmacists’ attitudes towards a recent California law that will allow pharmacists to provide hormonal birth control directly to women without a prescription.

Kevin Vu ACCP MeetingI recently had the opportunity to present my findings at the American College of Clinical Pharmacy (ACCP) Global Conference on Clinical Pharmacy. Held in San Francisco, this conference was a gathering of pharmacists from around the world and provided a platform for those in the field to network, share and exchange ideas, as well as learn the latest developments in the pharmacy world.

So what were some of the findings I presented from our survey of community pharmacists in California?

  1. Only half of the pharmacists were familiar with the new law that allows direct pharmacy access to birth control.
  2. Most pharmacists (about 70%) said they were very likely or somewhat likely to participate in this new service. It’s promising to see all the excitement and interest within the pharmacy community around this new authority! We are hopeful that this will manifest as lots of pharmacists actually providing the service when it becomes available. We don’t want women to have to call or visit multiple pharmacies before they find a pharmacist who can help them.
  3. The main reasons for why pharmacists said they wanted to participate in this service was that patients would benefit from improved access and that this service would foster increased use of birth control. This increased use and consistent use could eventually translate to fewer unplanned pregnancies, which currently stands at half (51%) of all pregnancies that occur in the U.S. every year.
  4. Nearly all (98%) of pharmacists feel comfortable intervening if they notice a patient had a drug interaction with their birth control. This is encouraging given that pharmacists are often seen as the final safety check when it comes to medications, ensuring that patients are getting medications that are safe and effective.

As the service is on the brink of being rolled out, I’m glad to say that some California pharmacists have already begun participating in training programs specifically aimed to help prepare them for participation in this service. With time, the hope is that patients and pharmacists across the country will recognize the value of direct access to birth control, and that other states will follow and adopt a similar authority.


About the Author: Kevin Vu is a fourth-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences.

My Personal Journey from “Choose Life” to “Choose Control”

I am a pharmacy student at UCSD and if you would have told me one year ago that I would be spending my summer advocating for adolescent reproductive health I probably would have laughed.

My Conservative Background

You see, I was born and raised in the central valley in California, in a conservative community, in a conservative Christian home. I was raised to value human life, including the unborn. You could (and should) call me pro-life. However, during the winter quarter of my first year in pharmacy school, Dr. Sally Rafie, PharmD gave us a lecture about emergency contraception that really impacted me. She shared some staggering statistics. You see, in the United States over 50% of pregnancies are unplanned. Of those unplanned pregnancies, 40% are going to end in abortion. That’s about 20% of all pregnancies in the U.S. But it was her next comment that really struck me and got me interested in this topic, “if we are ever going to decrease the number of abortions, we have to decrease the number of unplanned pregnancies.” That was a lightbulb moment for me.

Courtney Light Bulb Birth Control Sally Rafie

Why I Care About Teens and Family Planning

This summer I have the privilege of doing a project with Dr. Rafie on pharmacists’ growing role in reproductive health services for adolescents. Teen pregnancy in the U.S. is at an all-time low of roughly 26 births per 1000 teens. Now this sounds like a pretty good statistic right?  Less than 3% of teens are actually having babies every year (of course even more are getting pregnant)!  Until you consider the fact that is one of the highest teen birth rates among developed countries and places like the Netherlands have only 5 births per 1000 teens. That means 5 times as many teens are having babies here in the United States. In the central valley where I grew up, our rates are well above the national average and some counties (like Tulare) nearly double it. Obviously what and how we are teaching our teens about and the access that they have to birth control services is not working.

Studies have repeatedly shown that increasing knowledge of and access to birth control methods and services does not increase the number of teens having sex or even how often or with how many people they have sex with. The only statistic that it affects is the number of teens having safe sex and the number of teen pregnancies and teen births. Studies have also revealed that abstinence-only education is ineffective in decreasing the number of teen pregnancies. When we as conservative Christians fight to implement abstinence-only educational programs in schools and limit teens’ access to information and birth control methods, we are contributing to the number of teen pregnancies, the number of abortions, and the number of teen parents and children in the foster system. That is not a statistic that I want to be a part of. Additionally, unless parents know for 100% sure that their child will be living a life of celibacy, family planning education will be valuable to them at some age even if they remain abstinent until marriage. It can also be helpful for teens to share information with their friends who could benefit from accurate knowledge about birth control.

What I’m Doing About It

A new law was passed in California that will allow pharmacists to provide hormonal birth control directly to patients in pharmacies regardless of age. My project this summer is focused on teen girls to see if this is a service that they are interested in and how pharmacies can serve them best. This project will be very important in helping pharmacists prepare to meet the needs of adolescents in their communities as this new program is rolled out.

If you have questions about any of the statistics I discussed or you just want to know more about my research please feel free to contact me. As you might have guessed, this is something that I feel very passionate about and I would love to discuss it with you more.

About the Author:  Courtney Miller just finished her first year of pharmacy school at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. She is from the central valley which has the highest rates of teen pregnancy in California so this topic is very close to her heart!

What Your Organ Transplant Means for Your Fertility

For women undergoing an organ transplant, you’ve got a lot on your mind and birth control probably isn’t high on your list.

I recently did a study with Drs. Sally Rafie, PharmD, BCPS and Sheila Mody, MD, MPH to find out more about the education women get about birth control and which methods they are using after their transplants. This study was just published in December in the Progress in Transplantation journal. Here’s what you need to know.

Transplant Contraception Birth Control Choose Control Sophia Lai Sally Rafie

Why use birth control after a transplant?

There are three major reasons to be on birth control after an organ transplant.

  1. The transplant restores a woman’s fertility. While fertility may have been impaired before the transplant because of severe disease, it returns quickly. So women are at risk of an unplanned pregnancy if they don’t use an effective form of birth control.
  2. Getting pregnant may cause serious damage to a transplanted organ. Pregnancy is a big deal for a woman’s body and even more so for women with certain conditions, such as an organ transplant. Women with a transplanted kidney who become pregnant may cause serious damage to their kidney. Generally, it is recommended that women wait 1-2 years after their transplant surgery to become pregnant. In some cases, this can be done safely after 6 months. This is a decision that is made best upon consultation with a transplant provider.
  3. Transplant medications can cause birth defects. After an organ transplant, many medications have to be taken to keep the immune system at bay so the body doesn’t reject the organ. Some of these medications, called immunosuppressants, can increase the risk of birth defects.

Since one out of every three women who gets a transplant is of reproductive age, we wanted to find out what information they get about birth control and which methods they use.

What were the key findings?

Just to get an idea of the “average” patient we were looking at, the average age was 34 years old and the average time after transplant was 9 months.

  1. Most patients received counseling on condoms, birth control pills, and intrauterine devices (IUDs). Patients were counseled by their transplant team, which includes a transplant doctor, transplant nurse, and transplant pharmacist. However, nearly half of the patients wanted to be counseled by an Ob/Gyn doctor, who specializes in female reproductive organs.
  2. Women are not using highly effective birth control methods after their transplants.  Most women are just using condoms for birth control, which are not as effective as other methods and not reliable enough for women following an organ transplant.

What should you do about birth control and pregnancy planning if you have had a transplant?

You have the right to be informed about all your birth control options. Talk to your primary care doctor or transplant provider (doctor, nurse, or pharmacist) about your plans.

If you would like to become pregnant, your transplant provider will need to be involved in planning for changes to your health and may want to consult an Ob/Gyn doctor. If you do not want to become pregnant, ask your transplant provider to refer you to an Ob/Gyn doctor or other family planning specialist so you can find out your birth control options. You can even start these conversations before your transplant.

About the Author:  Sophia LSophia Lai Choose Control Transplant Birth Control Contraception Studyai is a fourth-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. Upon graduating in 2015, Sophia plans to pursue additional training in a pharmacy practice residency program.

(Photo above of doctors with patient from Seattle Municipal Archives via Flickr)