What about access to birth control and emergency contraception now that abortion rights are overturned?

Abstract

Abortion providers and advocates have long known that overturning Roe v Wade would have far-reaching consequences. According to Megan N. Freeland, PharmD, director of health communications at Planned Parenthood Federation of America, those consequences are already coming to life in real time.“Losing the federal constitutional right to abortion has created a rapidly evolving abortion access landscape that is even more fragmented than it already was,” Freeland said.However, the consequences may also extend beyond just the constitutional right to abortion in the United States. The same rationale used to overturn Roe v Wade could also be applied to roll back the right to contraception and other freedoms Americans currently have, said Freeland.There are several things pharmacists can do—like being a patient advocate—to support patients’ sexual and reproductive health care during this time. “Get familiar with the laws around sexual and reproductive health care in your state,” said Freeland. “The better informed you are, the more you can help your patients get the care they need.”Panic and concerns regarding access to birth controlIn this moment, people are worried about their sexual and reproductive health care. Access to birth control is one major concern, said Freeland.On June 24, 2022—the day the Supreme Court overturned Roe v Wade—scheduled birth control appointments increased by more than 150%, according to Planned Parenthood.Specifically, scheduled IUD appointments increased by more than 375% on June 24, 2022. On Roo, a Planned Parenthood sexual health advice chatbot, the organization found that there were twice the number of questions about birth control as usual on June 24, 2022.There were increases in website traffic to notable web pages featuring information on sterilization as well. On June 24, 2022, traffic to Planned Parenthood's webpage about how to get a sterilization procedure increased by 2,205%, and traffic to Planned Parenthood's web page about how to get a vasectomy increased by more than 1,500%.“These data show that during this time of chaos and confusion surrounding abortion access, it's essential that people can easily find accurate information in order to get the health care they need,” said Freeland.Navigating reproductive optionsIf a patient needs birth control that's not covered by their health insurance or they don't have health insurance, pharmacists and other health care providers can consider recommending that they call a local Planned Parenthood health center to see if there are any programs to help them get birth control for free or at a reduced cost, said Freeland.There are also other ways pharmacists can support their patients’ reproductive health.Be patient educators. When it comes to sexual and reproductive health care, misinformation is at an all-time high. “As patient educators, pharmacists should be offering straightforward, accurate information on sexual and reproductive health care, including birth control, emergency contraception, and abortion,” said Freeland.She suggests the following free Planned Parenthood resources pharmacists can share with patients: ▪Spot On is a free period and birth control tracking app. Patients can use this to remain compliant with their birth control regimen and monitor their menstrual patterns.▪Chat/Text (also called Chatea/Textea) is a service where people can live chat with health educators about their sexual health questions.▪Through the free Planned Parenthood Direct app, patients can get a prescription for the emergency morning-after pill called ella. ella is 85% effective on any day you take it for up to 5 days after unprotected sex.“There are lots of important counseling points. I encourage pharmacists to refresh their knowledge and skills with contraception and emergency contraception,” said Sally Rafie, PharmD, BCPS, APh, NCMP, FCCP, a pharmacist specialist at UC San Diego Health and founder of the Birth Control Pharmacist project. “We have lots of great home study courses and resource materials on birthcontrolpharmacist.com.”Be a safe community resource. Among health care professionals, pharmacists continue to be one of the most trusted providers. “Pharmacists are the first line of information for many people, particularly young people. The more accessible you can be at a time when everybody has questions, the better,” said Kathryn Kolbert, JD, a reproductive rights attorney in Philadelphia who was the charging counsel in Planned Parenthood v Casey, the 1992 case that reaffirmed Roe v Wade. “Patients come to us because they believe we will help them,” said Freeland. “It is important that pharmacists are safe community resources who allow patients to make their own personal medical decisions without paternalism and who offer patients accurate, supportive resources for care and information.”“About 400,000 [people] who become pregnant and are affected [by this ruling] need abortions in a given year. Probably only about 100,000 of them will be able to travel to a safe haven state,” said Kolbert. “Since many of the others are going to be pretty desperate for information and assistance, having the availability of local [community support] or Planned Parenthood phone numbers and being able to refer patients to places where they can get help is really critical.”A patient who wants or needs an abortion can use AbortionFinder.org to determine what options they have and where they can find care, said Freeland.Don't spread misinformation. Patients have lots of questions, like “what is the difference between the morning-after pill and the abortion pill?” or “how does the morning-after pill work?” Pharmacists’ duty is to give patients medically accurate information.“Many people do not understand the difference between emergency contraception and medication abortion, so there's been a big run on emergency contraception lately in pharmacies across the country,” said Kolbert. “Some people think they're buying the abortion pill. So, it's really important for pharmacists to be able to explain the differences to people so that they understand what they are buying and how they are using it.”“If you don't know the answers, that's okay,” said Freeland. “Don't be afraid to say you don't know and you'll have to research it or direct them to a resource like Planned Parenthood, where they can find honest, judgment-free answers to their sexual and reproductive health questions.”View Large Image Figure ViewerDownload Hi-res image Download (PPT)Be vocal about the need to support sexual and reproductive health care in the community. “Silence perpetuates stigma and gives confidence to bad actors. Now is the time to be vocal about the importance and necessity of sexual and reproductive health care and of education in our profession and communities,” said Freeland.To be clear: Pharmacists must understand that access to birth control and emergency contraception is no substitute for abortion access. “Whether you're dispensing levonorgestrel or mifepristone, your patients deserve the best care possible,” said Freeland.Political unrest“Roe v Wade and my case, Planned Parenthood v Casey, prevented states from imposing some restrictions on abortion and other reproductive health care [rights], but the Supreme Court changed the law,” said Kolbert. “Although the law supported constitutional protection, they imposed their own political views, changed the law, and now the only thing standing between the availability of abortion in about half the states are state legislatures.” She said that about 26 states are going to ban medical abortion, and in some cases surgical abortion. “Hundreds of thousands of women in those states are going to be affected,” said Kolbert.Because the court has 6 conservative justices who have imposed their own political views by forsaking the rule of law, they upended what millions of women across this nation have relied upon for 50 years, said Kolbert.“There's no explanation other than sheer politics, and that has been the goal of the antiabortion movement for 50 years, [which now] has come to fruition. That's the reality,” said Kolbert.“Elections matter, and the only way we're going to change this is to ensure that those who are champions of choice are [elected or] re-elected to the state legislatures and Congress.”What the future holdsThe Supreme Court decision has shed light on the importance of access to reproductive health services, including contraception. “For this reason, I believe states will continue passing legislation granting pharmacists the authority to prescribe birth control and make it more accessible in their communities,” said Rafie.In late July 2022, HRA Pharma submitted an application to FDA for the first OTC birth control pill. “I am optimistic that the FDA will agree that the progestin-only pill can safely be used without health care provider oversight,” said Rafie. “Hopefully, other products will follow.”Planned Parenthood believes that all people deserve access to the sexual and reproductive health care and information they need to make personal medical decisions for their own lives and futures, said Freeland.To ensure that this essential human right is upheld, the Right to Contraception Act, which would protect the right to birth control, was passed in the House; however, at the time of publishing a vote on this bill has been blocked in the Senate.Many questions remain that affect pharmacists and the availability of medication abortion, birth control, and emergency contraception. “Those questions are going to have to work their way through the courts,” said Kolbert. “So, relying upon individual assessments based on your state and your own circumstances are critical. Chain pharmacies will have to make decisions based on the risks. [Therefore,] risk analysis from lawyers could be useful for many pharmacists.” Abortion providers and advocates have long known that overturning Roe v Wade would have far-reaching consequences. According to Megan N. Freeland, PharmD, director of health communications at Planned Parenthood Federation of America, those consequences are already coming to life in real time. “Losing the federal constitutional right to abortion has created a rapidly evolving abortion access landscape that is even more fragmented than it already was,” Freeland said. However, the consequences may also extend beyond just the constitutional right to abortion in the United States. The same rationale used to overturn Roe v Wade could also be applied to roll back the right to contraception and other freedoms Americans currently have, said Freeland. There are several things pharmacists can do—like being a patient advocate—to support patients’ sexual and reproductive health care during this time. “Get familiar with the laws around sexual and reproductive health care in your state,” said Freeland. “The better informed you are, the more you can help your patients get the care they need.” Panic and concerns regarding access to birth controlIn this moment, people are worried about their sexual and reproductive health care. Access to birth control is one major concern, said Freeland.On June 24, 2022—the day the Supreme Court overturned Roe v Wade—scheduled birth control appointments increased by more than 150%, according to Planned Parenthood.Specifically, scheduled IUD appointments increased by more than 375% on June 24, 2022. On Roo, a Planned Parenthood sexual health advice chatbot, the organization found that there were twice the number of questions about birth control as usual on June 24, 2022.There were increases in website traffic to notable web pages featuring information on sterilization as well. On June 24, 2022, traffic to Planned Parenthood's webpage about how to get a sterilization procedure increased by 2,205%, and traffic to Planned Parenthood's web page about how to get a vasectomy increased by more than 1,500%.“These data show that during this time of chaos and confusion surrounding abortion access, it's essential that people can easily find accurate information in order to get the health care they need,” said Freeland. In this moment, people are worried about their sexual and reproductive health care. Access to birth control is one major concern, said Freeland. On June 24, 2022—the day the Supreme Court overturned Roe v Wade—scheduled birth control appointments increased by more than 150%, according to Planned Parenthood. Specifically, scheduled IUD appointments increased by more than 375% on June 24, 2022. On Roo, a Planned Parenthood sexual health advice chatbot, the organization found that there were twice the number of questions about birth control as usual on June 24, 2022. There were increases in website traffic to notable web pages featuring information on sterilization as well. On June 24, 2022, traffic to Planned Parenthood's webpage about how to get a sterilization procedure increased by 2,205%, and traffic to Planned Parenthood's web page about how to get a vasectomy increased by more than 1,500%. “These data show that during this time of chaos and confusion surrounding abortion access, it's essential that people can easily find accurate information in order to get the health care they need,” said Freeland. Navigating reproductive optionsIf a patient needs birth control that's not covered by their health insurance or they don't have health insurance, pharmacists and other health care providers can consider recommending that they call a local Planned Parenthood health center to see if there are any programs to help them get birth control for free or at a reduced cost, said Freeland.There are also other ways pharmacists can support their patients’ reproductive health.Be patient educators. When it comes to sexual and reproductive health care, misinformation is at an all-time high. “As patient educators, pharmacists should be offering straightforward, accurate information on sexual and reproductive health care, including birth control, emergency contraception, and abortion,” said Freeland.She suggests the following free Planned Parenthood resources pharmacists can share with patients: ▪Spot On is a free period and birth control tracking app. Patients can use this to remain compliant with their birth control regimen and monitor their menstrual patterns.▪Chat/Text (also called Chatea/Textea) is a service where people can live chat with health educators about their sexual health questions.▪Through the free Planned Parenthood Direct app, patients can get a prescription for the emergency morning-after pill called ella. ella is 85% effective on any day you take it for up to 5 days after unprotected sex.“There are lots of important counseling points. I encourage pharmacists to refresh their knowledge and skills with contraception and emergency contraception,” said Sally Rafie, PharmD, BCPS, APh, NCMP, FCCP, a pharmacist specialist at UC San Diego Health and founder of the Birth Control Pharmacist project. “We have lots of great home study courses and resource materials on birthcontrolpharmacist.com.”Be a safe community resource. Among health care professionals, pharmacists continue to be one of the most trusted providers. “Pharmacists are the first line of information for many people, particularly young people. The more accessible you can be at a time when everybody has questions, the better,” said Kathryn Kolbert, JD, a reproductive rights attorney in Philadelphia who was the charging counsel in Planned Parenthood v Casey, the 1992 case that reaffirmed Roe v Wade. “Patients come to us because they believe we will help them,” said Freeland. “It is important that pharmacists are safe community resources who allow patients to make their own personal medical decisions without paternalism and who offer patients accurate, supportive resources for care and information.”“About 400,000 [people] who become pregnant and are affected [by this ruling] need abortions in a given year. Probably only about 100,000 of them will be able to travel to a safe haven state,” said Kolbert. “Since many of the others are going to be pretty desperate for information and assistance, having the availability of local [community support] or Planned Parenthood phone numbers and being able to refer patients to places where they can get help is really critical.”A patient who wants or needs an abortion can use AbortionFinder.org to determine what options they have and where they can find care, said Freeland.Don't spread misinformation. Patients have lots of questions, like “what is the difference between the morning-after pill and the abortion pill?” or “how does the morning-after pill work?” Pharmacists’ duty is to give patients medically accurate information.“Many people do not understand the difference between emergency contraception and medication abortion, so there's been a big run on emergency contraception lately in pharmacies across the country,” said Kolbert. “Some people think they're buying the abortion pill. So, it's really important for pharmacists to be able to explain the differences to people so that they understand what they are buying and how they are using it.”“If you don't know the answers, that's okay,” said Freeland. “Don't be afraid to say you don't know and you'll have to research it or direct them to a resource like Planned Parenthood, where they can find honest, judgment-free answers to their sexual and reproductive health questions.”Be vocal about the need to support sexual and reproductive health care in the community. “Silence perpetuates stigma and gives confidence to bad actors. Now is the time to be vocal about the importance and necessity of sexual and reproductive health care and of education in our profession and communities,” said Freeland.To be clear: Pharmacists must understand that access to birth control and emergency contraception is no substitute for abortion access. “Whether you're dispensing levonorgestrel or mifepristone, your patients deserve the best care possible,” said Freeland. If a patient needs birth control that's not covered by their health insurance or they don't have health insurance, pharmacists and other health care providers can consider recommending that they call a local Planned Parenthood health center to see if there are any programs to help them get birth control for free or at a reduced cost, said Freeland. There are also other ways pharmacists can support their patients’ reproductive health. Be patient educators. When it comes to sexual and reproductive health care, misinformation is at an all-time high. “As patient educators, pharmacists should be offering straightforward, accurate information on sexual and reproductive health care, including birth control, emergency contraception, and abortion,” said Freeland. She suggests the following free Planned Parenthood resources pharmacists can share with patients: ▪Spot On is a free period and birth control tracking app. Patients can use this to remain compliant with their birth control regimen and monitor their menstrual patterns.▪Chat/Text (also called Chatea/Textea) is a service where people can live chat with health educators about their sexual health questions.▪Through the free Planned Parenthood Direct app, patients can get a prescription for the emergency morning-after pill called ella. ella is 85% effective on any day you take it for up to 5 days after unprotected sex. “There are lots of important counseling points. I encourage pharmacists to refresh their knowledge and skills with contraception and emergency contraception,” said Sally Rafie, PharmD, BCPS, APh, NCMP, FCCP, a pharmacist specialist at UC San Diego Health and founder of the Birth Control Pharmacist project. “We have lots of great home study courses and resource materials on birthcontrolpharmacist.com.” Be a safe community resource. Among health care professionals, pharmacists continue to be one of the most trusted providers. “Pharmacists are the first line of information for many people, particularly young people. The more accessible you can be at a time when everybody has questions, the better,” said Kathryn Kolbert, JD, a reproductive rights attorney in Philadelphia who was the charging counsel in Planned Parenthood v Casey, the 1992 case that reaffirmed Roe v Wade. “Patients come to us because they believe we will help them,” said Freeland. “It is important that pharmacists are safe community resources who allow patients to make their own personal medical decisions without paternalism and who offer patients accurate, supportive resources for care and information.” “About 400,000 [people] who become pregnant and are affected [by this ruling] need abortions in a given year. Probably only about 100,000 of them will be able to travel to a safe haven state,” said Kolbert. “Since many of the others are going to be pretty desperate for information and assistance, having the availability of local [community support] or Planned Parenthood phone numbers and being able to refer patients to places where they can get help is really critical.” A patient who wants or needs an abortion can use AbortionFinder.org to determine what options they have and where they can find care, said Freeland. Don't spread misinformation. Patients have lots of questions, like “what is the difference between the morning-after pill and the abortion pill?” or “how does the morning-after pill work?” Pharmacists’ duty is to give patients medically accurate information. “Many people do not understand the difference between emergency contraception and medication abortion, so there's been a big run on emergency contraception lately in pharmacies across the country,” said Kolbert. “Some people think they're buying the abortion pill. So, it's really important for pharmacists to be able to explain the differences to people so that they understand what they are buying and how they are using it.” “If you don't know the answers, that's okay,” said Freeland. “Don't be afraid to say you don't know and you'll have to research it or direct them to a resource like Planned Parenthood, where they can find honest, judgment-free answers to their sexual and reproductive health questions.” Be vocal about the need to support sexual and reproductive health care in the community. “Silence perpetuates stigma and gives confidence to bad actors. Now is the time to be vocal about the importance and necessity of sexual and reproductive health care and of education in our profession and communities,” said Freeland. To be clear: Pharmacists must understand that access to birth control and emergency contraception is no substitute for abortion access. “Whether you're dispensing levonorgestrel or mifepristone, your patients deserve the best care possible,” said Freeland. Political unrest“Roe v Wade and my case, Planned Parenthood v Casey, prevented states from imposing some restrictions on abortion and other reproductive health care [rights], but the Supreme Court changed the law,” said Kolbert. “Although the law supported constitutional protection, they imposed their own political views, changed the law, and now the only thing standing between the availability of abortion in about half the states are state legislatures.” She said that about 26 states are going to ban medical abortion, and in some cases surgical abortion. “Hundreds of thousands of women in those states are going to be affected,” said Kolbert.Because the court has 6 conservative justices who have imposed their own political views by forsaking the rule of law, they upended what millions of women across this nation have relied upon for 50 years, said Kolbert.“There's no explanation other than sheer politics, and that has been the goal of the antiabortion movement for 50 years, [which now] has come to fruition. That's the reality,” said Kolbert.“Elections matter, and the only way we're going to change this is to ensure that those who are champions of choice are [elected or] re-elected to the state legislatures and Congress.” “Roe v Wade and my case, Planned Parenthood v Casey, prevented states from imposing some restrictions on abortion and other reproductive health care [rights], but the Supreme Court changed the law,” said Kolbert. “Although the law supported constitutional protection, they imposed their own political views, changed the law, and now the only thing standing between the availability of abortion in about half the states are state legislatures.” She said that about 26 states are going to ban medical abortion, and in some cases surgical abortion. “Hundreds of thousands of women in those states are going to be affected,” said Kolbert. Because the court has 6 conservative justices who have imposed their own political views by forsaking the rule of law, they upended what millions of women across this nation have relied upon for 50 years, said Kolbert. “There's no explanation other than sheer politics, and that has been the goal of the antiabortion movement for 50 years, [which now] has come to fruition. That's the reality,” said Kolbert. “Elections matter, and the only way we're going to change this is to ensure that those who are champions of choice are [elected or] re-elected to the state legislatures and Congress.” What the future holdsThe Supreme Court decision has shed light on the importance of access to reproductive health services, including contraception. “For this reason, I believe states will continue passing legislation granting pharmacists the authority to prescribe birth control and make it more accessible in their communities,” said Rafie.In late July 2022, HRA Pharma submitted an application to FDA for the first OTC birth control pill. “I am optimistic that the FDA will agree that the progestin-only pill can safely be used without health care provider oversight,” said Rafie. “Hopefully, other products will follow.”Planned Parenthood believes that all people deserve access to the sexual and reproductive health care and information they need to make personal medical decisions for their own lives and futures, said Freeland.To ensure that this essential human right is upheld, the Right to Contraception Act, which would protect the right to birth control, was passed in the House; however, at the time of publishing a vote on this bill has been blocked in the Senate.Many questions remain that affect pharmacists and the availability of medication abortion, birth control, and emergency contraception. “Those questions are going to have to work their way through the courts,” said Kolbert. “So, relying upon individual assessments based on your state and your own circumstances are critical. Chain pharmacies will have to make decisions based on the risks. [Therefore,] risk analysis from lawyers could be useful for many pharmacists.” The Supreme Court decision has shed light on the importance of access to reproductive health services, including contraception. “For this reason, I believe states will continue passing legislation granting pharmacists the authority to prescribe birth control and make it more accessible in their communities,” said Rafie. In late July 2022, HRA Pharma submitted an application to FDA for the first OTC birth control pill. “I am optimistic that the FDA will agree that the progestin-only pill can safely be used without health care provider oversight,” said Rafie. “Hopefully, other products will follow.” Planned Parenthood believes that all people deserve access to the sexual and reproductive health care and information they need to make personal medical decisions for their own lives and futures, said Freeland. To ensure that this essential human right is upheld, the Right to Contraception Act, which would protect the right to birth control, was passed in the House; however, at the time of publishing a vote on this bill has been blocked in the Senate. Many questions remain that affect pharmacists and the availability of medication abortion, birth control, and emergency contraception. “Those questions are going to have to work their way through the courts,” said Kolbert. “So, relying upon individual assessments based on your state and your own circumstances are critical. Chain pharmacies will have to make decisions based on the risks. [Therefore,] risk analysis from lawyers could be useful for many pharmacists.”