Access to Birth Control

In this episode, your host Dr. Celestine, discusses the recent push to allow birth control to be prescribed and/or administered directly from the pharmacy without a visit to your doctor. We touch on the rules and regulations for this in many states across the country and compare it to the most recent changes in the state of West Virginia. Also, has this not been in many countries way before America got on board?? Listen to the episode to find out how and where you can get your birth control!

Transcript

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Hey for vaginas only family. How have you guys been? I personally missed you. It's Dr Cellasene here and welcome to a brand new episode of Four Vaginas only. In this episode we're going to be talking about access to birth control just recently in the state that I currently live in West Virginia. It was a bill was passed that's allowing women. Thio gets birth control directly from the pharmacy kind of without seeing a gynecologist. But we'll get a little bit more into that into the episode. And plus, I'm also gonna talk about some other states that have implemented this and how it's been working. So let's get right into it. Cue the music theme. Hello and welcome to four vaginas only the podcast about everything. Female. I'm your host, Dr Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. Okay, so welcome to Episode number 23 of four Vaginas only in this episode I'm very excited that West Virginia has recently passed a bill allowing people to access contraceptive care straight from the pharmacy without having to wait for a guy's gynecologist appointment. Can I even say my profession's name? A gynecologist appointment, which, in my opinion, is great. I know a lot of people have different opinions on it, and everybody is allowed to have their own feelings. I'm never against that. But let's talk a little bit about what that law means for West Virginia, where else this law has been implemented and how it's helped or maybe not helped in other parts of the United States. Okay, so let's start off with why this is a big deal in the first place. So there's kind of two sides to it, but will talk about as much as I can in this limited episode. So, first of all, the ease of access, I know a lot of you patients out there. I'm a patient to, you know, in some respect it's hard to get an appointment with your doctor. It's hard sometimes. If you just want to get a refill of prescription, they might not be able to see you for a few weeks when you would already be running out of your birth control. So the ease of access of having a pharmacist be able to prescribe or dispense birth control, depending on what state you're in, is beneficial in that respect. Also in general, less than a little bit. Less than 50% of pregnancies in the United States are unintended pregnancies, meaning accidental or not on purpose. And a lot of those unintended pregnancies end up leading to abortions or just feelings of regret and even sometimes postpartum depression, which is its own separate entity that will talk about on a later podcast episode. So the thought behind having birth control be more readily available is to potentially decrease those side effects of unintended pregnancy. Okay, so in general, those are some of the positives. I think you guys a lot of people that air patients out there on birth control. They know some of the barriers that exist on dhe, some of things that have happened to them because of not being able to access birth control. It's just very real thing. Some people don't know about that because they don't see that side of the world that side of patient care. But trust me, it definitely is, you know, in a pharmacist, sometimes just more easily accessible than a physician, which is how it is in a lot of cultures. I mean, even with my not even cultures in a lot of practice is even with my open Gioia, Sometimes I have to wait weeks, if not months, to see them. So, um, I know a lot of women under there out there can understand that now the negatives. So for me, the first thing that sprung to mind was the fact that hormonal contraceptives are dangerous, you know, Um, yeah, Millions of people take them and they're completely fine, But there are some serious risks. Although those serious risk don't happen that often. When they do happen, there are completely catastrophic, such as pulmonary embolisms or a D V tees, early strokes, early heart attacks. These things can kill you, so just making sure that there's the proper education out there. For the people, prescribing this medication is definitely of the utmost importance. Also making sure that the way that this is done does not allow you to just skip appointment with your doctor. In general, you know, I've always voted being an advocate for your health, and I've always promoted preventative medicine and for a gynecologist, especially, which is really the only thing I truly have. Ah, full well versed background in. You need to see your gynecologist annually. Even if you feel fine, things can happen. We can see things that you don't always see. If so, even though Pap smears yes, have now gone to every three years or every five years and still important to you gynecologist annually. And sometimes if you're not doing that because you're on Lee really seeing them for birth control, there are things that can be missed because we do a lot of other screening and we could notice a lot of other things that you might not notice. So that's one negative. Also, it increases the pharmacists duties. I mean, I have friends who are pharmacists. And to be honest, I've talked to them about how they feel about this, and what they've come back and told me is that they are like almost chickens with their heads cut off back there in the pharmacy. They are busy, busy, busy, and sometimes they have under staffing that lead Thio not being able to sit down and have a conversation with you about your health and go through a consultation before being able to prescribe a birth control pill or dispense a birth control pill directly through the pharmacy basis on Lee, so it increases their workload as well. And I'm afraid that maybe something's might slip through the cracks or not be as good, I guess, is the right word as good as they could be, um, with, you know, pharmacist already overworked as it is. So those are just a couple of pluses and minuses. They're a lot more out there, and I'll probably mentioned some more as we go along in this podcast episode. But, yes, I'm a proponent for access to birth control. Um, but you know, we have to do it in a smart way. Is basically what's on my mind So continuing on that conversation. Yea, I am very excited that birth control is gonna be accessible to more people with less missing pills, less missing your birth control because you can't see the doctor and getting pregnant with, you know, unintentionally and the side effects that go with that that is fantastic. And it's not the first time this has happened in West Virginia is just happened recently. I think it was just implemented, probably within the last week. But the bill had passed a couple months ago, and a lot of other states have done it as well, such as California, New Mexico. Oregon was actually the first state I believe to do something similar to this a few years ago. Colorado, Hawaii. Turn a C. Washington State These are all places where this type of thing has gone into effect for many years before West Virginia's new or more recent law. So I think it's you know it's spreading, is becoming more worldwide, and overall, that's a good thing. If it's done smartly, okay, now what can be given out and what cannot and what are the real rules behind it? So there are about 10 or 11 states that do this. I mentioned a few just a moment ago, but each state has its own individual laws of what it's actually able to dispense, or even for the pharmacist to prescribe on their own. Um, what age you have to be and so on and so forth. So I recommend that you look into what your state actually does, because really none of the states are truly the same in their rules and regulations. If you live in California, Colorado, Hawaii, Oregon or Washington, there's actually a website called Birth Control pharmacies dot com that shows you a map. And if you put in your zip code, it will tell you exactly what pharmacies are able to prescribe birth control for you. So not every pharmacy can do that. Segway. Yes, it might be allowed in your state, but a pharmacist skin or a pharmacy in general can choose whether or not they want to do it. And if they do decide to do it, then they have to go through some training in order to be able to do that for you. And also, not all pharmacies can prescribe it. In some states, the pharmacist cannot actually prescribe it for yourself to get the prescription from your doctor. But then they can dispense it for within whatever time from the state decides they can dispense it from the time that you've gotten that initial prescription, regardless of how many of refills that initial prescription allows youto have. If that makes sense and the reason for this is not only because of the dangers of certain birth control's ah, lot of these states have kind of fallen under the category of self administered birth control. So they are only allowed to give you birth control that you can administer yourself. But some are also allowed Thio injectable Priv era as well, which is the birth control injection that's used every three months. If you have any questions or any, you know, wanted to know any more about birth control that all the different types of birth control, how they're administered their benefits there, negative sides there adverse reactions. I do have an entire podcast on birth control that you can go back to whether you want to look in iTunes, Spotify or Google play. So anyway, continuing. Not many pharmacies do it. For example, about one in every 10 pharmacies in California actually do this, and in California, specifically, they can. Actually the pharmacist can prescribe you birth control. The same goes for Oregon. The same actually goes for Hawaii. So depending on your state, you might be able to get the birth control from your pharmacist or from your doctor. The reason why not many farmers he's there doing it is because, ah, few things when it costs to train the pharmacist and sometimes they don't have the money for that and also cost the do the counseling occasionally. So, for example, there is a pharmacy in California that charges $45 for the consul, where they go through the question year that you need to have done on a few other things before they're even allowed to prescribe you birth control. So it's not always completely free or cheaper to do it that way to putting on if you have insurance or not. But I'm glad that it is an option. It's still out there as long as it's done safely now in terms of the different states, and they're different laws. So I live in West Virginia, so we'll go through that and a little more detail for anybody that's listening from out here. But to just kind of brought in my scope to around the country, for example, in California, there they can actually prescribe the birth control for you without having a doctor do the prescription. There's no age limit for this, and they're allowed to give you the pill, the patch or the ring, which is most commonly known as the Neutering. In addition to the deputy, Rivera injection every three months in New Mexico, if you're under 18 you two parents consent, but over 18 you can get the pill, the patch or the ring. Um, same goes for Oregon over 18 Pill of patch, or you can get double Priv era. And in Colorado, over 18 you can get the pill or the patch. So you really need to look into your own individual state. Because no matter what I say on this podcast today, you know, depending on what pharmacy you're going to, and depending on where you live, things are gonna be a little bit different for each of you. Now, what's been set up in mostly other states have been doing this for years. Is you still need to have a consultation and screening done. So, for instance, there is a screening form that I was able to pull up from one of the states that they have to go through a whole bunch of questions, including a health history, a pregnancy screen. They'll ask you, Have you recently been pregnant? Have you recently had a miscarriage or abortion? They want to know the first day of your last period, how long it's been since you've had a period or your last time that you had sex, especially unprotected sex. They want to know what medications you're on because certain medications interfere with birth control out of the birth control kind of in activates the medication you're on or vice versa. And the half through blood pressure checked. Because if you have high blood pressure in certain ages and with certain other problems that you may have in conjunction with the high blood pressure, it may not be safe to put you on a certain type of birth control. So they'll be doing that as well. So it's not just kind of like you go in and come out and get your birth control. There are still some precautions in place in other states. For West Virginia in particular, it's relatively new. So they're still, I believe, working on their health questionnaire, and it hasn't gone statewide to all the pharmacies, just as yet, all right, so I can't get into all of the 10 or 11 states that this has gone into effect with, But let's talk about with West Virginia in particular, so you can get a kind of idea of what most states are doing an order for you to get this birth control by a pharmacist. So for West Virginia rules, you need to be 18 or older in order to do this. But for West Virginia, the pharmacist is actually not able to prescribe you the birth control, which is common in other states as well. You actually need a standing prescription order from your doctor initially without any other prescriptions on file for a birth control so they can't be any other conflicting prescriptions. He has to be it a self administered contraceptive. That's what they call it, because something that you can do yourself, such as taking the pill every day, putting on the patch weekly or using the NuvaRing monthly. So there's the three that are allowed to be dispensed from the pharmacy in West Virginia. Like I mentioned before, different states have different rules. Different birth control is that they are able to give you the self assessment still needs to happen, And in West Virginia they're still waiting for state approval. On this self assessment. It has to be kind of approved by I don't know, whatever medical society plus the government plus the pharmacy society in order to deem it necessary or good enough in order to make sure that we're not missing a medical problem that could be very dangerous for you taking the birth control pill or a patch or a ring et cetera. Now, even as a doctor, you know it's not easy to catch everything 100%. And even if you have no risk factors, things constituent happen on birth control. So nothing is ever gonna be 100% but they're going to try to make it as good as they possibly can. You're gonna have to receive either written and or aural education because even though you're allowed to get the self administered pill, patch or ring, there are sometimes better birth control's out there for you or for your particular situation, such as the I E. D. S or the next split on that goes in your arm for three years, things like that that they're not able to give you and you actually need from your doctor. Also, they talk about the importance of doctor visits because in general, you know, like I mentioned earlier, I think doctor visits are also very important maybe not every three months or six months for birth control, but at least every single year. Um, and in West Virginia, they're only able to dispense 12 months of the particular birth control from the initial prescription that you got from your doctor. Now, I think that this is good, but also strange, at least the way that I practice because usually what I d'oh personally, if I'm starting you on a brand new birth control, I will give you a prescription. Enough for three months. I will have you come back to the office, follow up, see how you've been doing on that birth control. See if you want to stay on it or if you want to change something else and if you want to stay on it, then I will give you a prescription for a full year. So it's not like you really need the pharmacy to kind of extend my prescription per se unless you go for that visit. And you never come back after the for the three month follow up, which I guess would make sense in this case. So I'm not sure from a true fan of that, and I don't really know what would make it better or worse. I mean, some states are allowed to dispense it for three years from the initial prescription, or they can create the prescription on their own. I kind of I don't need to look into that little bit further. If you live in any other state that's doing this and you want Thio, let me know a little bit more about how it's been working or not working in your state. Please feel free to message mean at Dr C at f B only dot com. You could send me a direct message on Instagram at four vaginas only as well, because I'm just curious as to how this works in other states and what you think are the pluses and minuses of the exact time frame. You know, I think it's a perfect place to mention that this is mainly newer for the United States. But there are many countries all over the world that have had over the counter birth control availability for a long time. South America. It's readily available. Many areas of Africa of Asia, a couple areas in Europe, you know, this has been available in a long time overseas, according to us, US spoke overseas, so I know I have a lot of listeners from overseas as well. So if you have any inclination of wanting to tell me about how it's going on in your country and what you think the pluses and minuses are, please feel free to message me as well. I would love to hear about it. So, like I said, West Virginia's 12 months other states I've seen three years. I can personally see a lot of pluses and minuses on both sides, but it's always been my flaw. I can kind of see the pluses and minuses of everything, which kind of leaves me in the middle sometimes, but yeah, so that is what is going on in West Virginia and what's been kind of going on around the country. West Virginia is 1/10 state to actually implement this law, but like I said, every state implements it just a little bit differently. So look at your laws in your state wherever you live, and especially if you live in California, Colorado, Hawaii or Oregon or Washington State birth control pharmacies dot com We'll let you know what pharmacies actually participate in this in your state. I haven't found anything yet for the other states that are involved in this. But I will keep looking and I will let you guys know on Instagram if I do find anything else for the other states as well. So that is it for this episode. Thank you so much for listening. I love doing little episodes on new things have kind of come up across the country that not everyone might know about. And please message meet. Let me know what's going on in your state. Let me know what's going on with your health care, especially with birth control on this particular pockets episode, because I'm very curious as to what's going on in places where I don't live or where I don't know people. So thank you so much for listening to this episode of four vaginas on Lee. A little bit of an update on birth control where you now have access to it in terms of whether you can get it directly from the pharmacy or not. I'm looking forward to seeing how this plays out with the rest of the country over time. I really think This is a push in the right direction. I'm all about access to care and being in charge of your own health care. As long as everybody's open, honest, well trained and we try to minimize the risk as much as possible. So thank you so much for listening. Catch me at four vaginas on Lee on Instagram and also on Facebook. Also, you could message me a doctor See at f ve Onley dot com And I love you guys for listening and I will talk to you soon in the next episode. Bye bye.