January 8, 2016

PLANNED PARENTHOOD HARDEST HIT: Getting the Pill Without a Doctor: The Revolution Begins.

As Virginia Postrel has written, requiting women to get a prescription for hormonal birth control means that some of them will end up resorting to other forms of birth control they don’t prefer, because they forgot to get to the doctor before the prescription ran out.

That may not mean a whole lot of extra unintended pregnancies or births. (Used correctly, over-the-counter methods like condoms are pretty effective, especially when a backup like the morning-after pill is available.) But “does it prevent a lot of extra unintended births” is far too narrow a question for policy makers to ask. The Soviet system, in which birth control was unavailable but abortions were extremely common, prevented a lot of unintended births. It was still a lousy system.

Absent a compelling reason that women need to see a doctor, it should be as easy as possible for them to get any form of birth control they might like to have. Obviously, this is not practically feasible in every case. We are not going to see at-home IUD insertions any time soon. But it should include oral contraceptives, some of the most extensively studied medications of all time.

Oregon now requires patients to fill out a short questionnaire and have their blood pressure checked in order to get a prescription from a pharmacist, which seems like a reasonable enough procedure to weed out the small number of women who really shouldn’t take it. Though even that may go too far.

I’m conflicted. On the one hand, I think that the dangers of hormonal birth control are substantially underestimated. On the other, I think that the vast majority of prescriptions for same are nothing more than a toll charged by doctors, with no significant actual medical oversight involved.

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