Wednesday, April 21, 2010

UT Researchers:
Women Want OTC Birth Control

image from Texas Window on State Government

Researchers looking at the El Paso-Juarez border found that women who needed birth control were more likely to go across the border to Mexico to purchase their pills over the counter than go through the extra hassle and expense of going through both a doctor and a pharmacist to get the method in the US.

Dr. Daniel Grossman of Ibis Reproductive Health, one of the researchers, said to

“In some ways our profession has been holding birth control hostage, where women come in and pay that annual ransom of getting that Pap smear,” he said. “We don't make men get testicular exams before they get condoms, even though testicular screening and testing are important health measures. They're not linked.”

Dang! According to a press release from the study's authors: "The fact that many women in El Paso make use of the cross-border option suggests a substantial latent demand for an over-the-counter option at pharmacies in the United States," says lead author Joseph E. Potter, a professor in the Sociology Department and Population Research Center at The University of Texas at Austin.

Imagine the cost savings in our health care system if women could get birth control--and prevent pregnancy--without the added expense and time barriers of having to see a healthcare provider, which in 1993 leading scholars in reproductive health deemed an unnecessary burden on women patients*.

Of course many phsyicians, whose income depends on routine patient visits, don't like this:

Dr. Kristen Plastino, an associate professor of obstetrics and gynecology at the University of Texas Health Science Center, said it's important for a woman to talk to her doctor about what kind of contraception would be best. “It's also a reminder: Don't forget about yourself,” she said. “Sometimes I am the only doctor these women see all year. That's where I screen and see that their blood pressure's high.”
It is paternalistic on the part of healthcare providers to take decisions about preventing pregnancy effectively out of the hands of their patients and hold birth control prescriptions for ransom by forcing them to come in and get a variety of unrelated health services--all of which cost the patient (or the state, if they get publicly-funded healthcare) more money. Plenty of women who can't pay for regular health services get "primary care" at publicly funded family planning clinics, but if the cost and time (which is itself a cost) of those services is prohibitive and they forego all of it because they can't afford it, they are at higher risk for pregnancy and the whole enterprise has shot itself in the foot.

I applaud the researchers for documenting that when women have the option to buy birth control pills over the counter, they will, but what this research doesn't tell us is whether the drugs the women bought were actually hormonal contraceptives--I've heard stories of women who wind up pregnant because they've gotten counterfeit birth control from Mexico.

* Trussell J, Stewart F, Potts M, Guest F, Ellertson C.Should oral contraceptives be available without pre-scription? Am J Public Health. 1993;83(8):1094–1099.

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