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Iowa professionals debate moving birth control to over-the-counter

BY BRIANNA JETT | NOVEMBER 30, 2012 6:30 AM

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Soon, birth-control pills could sit alongside vitamins and pain medicine in the local pharmacy.

The American College of Obstetricians and Gynecology released a December 2012 committee opinion last week pushing for oral contraceptives to be available for women over-the-counter.

However, some local people are in disagreement over the consequences of such a suggestion.

“A potential way to improve contraceptive access and use, and possibly decrease unintended pregnancy rates, is to allow over-the-counter access to oral contraceptives,” the report said. “[Oral contraceptives] should be available over-the-counter.”

According to the Centers for Disease Control and Prevention, 10.7 million women were using the Pill as of 2008.

Linda Stewart Kroon, the director of the UI Women’s Resource and Action Center, is in favor of over-the-counter access — as long as safety for users is maintained.

“In general, I am in favor of making options for birth control more available,” she said. “If this would help that, I’d be in favor.”

One opinion that proponents of increased access to birth control focus on is the idea that contraceptives provide more freedom for women.

“To be on fairly equal footing with men, socially and economically, women need to be able to choose if and when and under what conditions they become pregnant and give birth,” Diana Cates, a University of Iowa professor who teaches a Sexual Ethics course, wrote in an email.

Jennifer Price, the director of the Emma Goldman Clinic, 227 N. Dubuque St., agreed.

“Birth control absolutely does empower women,” she said.

However, not everyone believes contraceptives provide the power.

“We should be empowering [young people] to take control of their bodies and see them as what they are — a gift from God,” said Maggie DeWitte, the director of Iowans For Life. “We don’t see birth control as anything that we should be giving our young women.”

Kroon suggests the contraceptives be restricted in the same way that some cold medicine is — the user must speak first to the pharmacist.

“There might be a way to dispense [the pills] without a physician where you can still talk to a pharmacist,” she said.

Price favors no restrictions on birth-control pills if they were to be released over-the-counter.

“We are strong advocates of any move that allows women to take more control of their reproductive lives,” she said.

Some disagree about whether they should be available for purchase over-the-counter.

“I think it’s just a completely terrible idea,” DeWitte said. “They get the perception that if something is available over-the-counter, it’s safe.”

Noelle Bowdler, a clinical professor of obstetrics and gynecology at the UI Hospitals and Clinics, worries as well about the health impacts. 

Although rare, some serious side effects of oral contraceptives include high blood pressure, blood clots, heart attacks, or strokes, according to the U.S. Food and Drug Administration.

Bowdler said she believes birth control pills are safe, but a physician should assess a patient before using them.

“My personal opinion is for some sort of health- care provider to assess patients for increased risk and provide counseling about alternatives,” she said.

Another benefit of speaking with a physician before prescribing birth control pills is the chance to discuss other aspects of a sexually active lifestyle, Bowdler said.

“One aspect of sexual activity is risks for sexually transmitted infections, so the time of discussion about contraceptives is also a time to discuss screening for STI’s and condom use,” Bowdler said.

Bowdler said she respects the opinions of the American College of Obstetricians and Gynecologists. 

However, she says the best-case scenario would be one in which combination pills — those containing both estrogen and progestin — would not be available over the counter.

The CDC reports that 94 percent of women age 15 to 44 have had premarital sex and half of all pregnancies are unintended. According to the FDA, only about nine out of every 100 women using combination birth control pills gets pregnant.

“The risks associated with pregnancy are greater than the risks associated with hormonal birth control,” Bowdler said.


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