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Time has come for over-the-counter hormonal birth control


Women need easy and reliable access to birth control. As physicians, we want our patients to safely access these important medications without unnecessary restrictions.

Current law requires patients to have an appointment with a health care provider to start or continue birth control pills, patches, and vaginal rings. This prevents many women from using these methods, especially poor women and those who live in rural areas. Maybe they can’t get a timely appointment with a doctor or a nearby clinic, or the appointment is too expensive. Maybe they don’t have health insurance. Many reasons exist why patients can’t make it back to our offices every time they need birth control.

Julie Kwatra

Julie Kwatra

The American College of Obstetricians and Gynecologists since 2012 has endorsed over-the-counter contraception to minimize barriers to access.  Studies have shown these medications can be safely dispensed this way. A self-screening questionnaire would help women decide which medication is right for them and what is safe based on their individual health history.

Sounds simple, right?  Problem fixed! Well, it’s a little more complicated.

Any over-the-counter medication needs approval from the U.S. Food and Drug Administration, and that takes time.  Full over-the-counter access is probably years away. 

However, a bipartisan group of Arizona legislators hopes to fix this problem – to remove the barrier – with an intermediate step while we wait for the FDA to catch up to the science. 

Sen. Michelle Ugenti-Rita, R-Scottsdale, has introduced SB1493, which allows women over 18 years old to consult with a pharmacist, fill out the self-screening assessment, and obtain birth control.  The “prescription” is a standing order from the Arizona Department of Health Services – so no need for a doctor’s appointment.

Arizona already uses a standing order prescription system to make the opioid-blocking drug naloxone available. We have heard wide support from politicians on both sides of the aisle and the Arizona Medical Association. Several states have passed similar laws, including Utah – where it passed unanimously. 

Of course, we still recommend women see their doctor regularly, but delaying or missing an appointment should not be a reason to be denied contraception.

The Centers for Disease Control and Prevention named contraception as one of the 10 great public health achievements of the 20th century.  Self-administered hormonal contraception, which includes birth control pills, patches, vaginal rings, among other methods improve health and well-being, reduce global maternal mortality, create health benefits of pregnancy spacing for maternal and child health and allow for women’s engagement in the workforce and economic self-sufficiency.

Improving access to these types of contraceptives will reduce unintended pregnancy, which can reduce health care costs and lower the abortion rate. Additionally, doctors use these medications to treat myriad conditions including hormonal imbalances, painful periods, endometriosis and acne and they can decrease the risk of endometrial and ovarian cancer. 

Family planning is good for everyone, and we know that access to contraception is critically important.  Safely removing barriers to access is an excellent policy, and by undertaking this important step, lawmakers will improve the health and economic opportunity of Arizona women. 

We encourage all our lawmakers to support and pass SB1493 because this is an important piece of legislation.

Dr. Julie Kwatra is an obstetrician-gynecologist in Scottsdale and legislative chairwoman of the Arizona section of Arizona College of Obstetricians and Gynecologists.

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