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birth control pills

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Editorial: A timely proposal on birth control

  • Article by: EDITORIAL BOARD
  • Star Tribune
  • December 2, 2012 - 7:19 PM

"Surprising" was the word often used by commentators to describe a new birth control pill recommendation from an influential medical organization. "Timely'' or "sensible" would have been more appropriate choices.

Late last month, the American College of Obstetricians and Gynecologists put its institutional heft behind the long but under-the-radar push to make oral contraceptives available without a prescription. While such a change is still years away -- a manufacturer would have to petition the U.S. Food and Drug Administration and get approval for the change -- the proposal from one of the medical group's advisory committees should generate a overdue debate about easing access to birth control pills.

Like any medication, using the pills carries some risk -- mainly, blood clots -- though the pills have about a half-century-long safety record that compares favorably to many common over-the-counter (OTC) drugs such as ibuprofen or acetaminophen. There are also questions about how such a change would affect affordability, given that the Affordable Care Act requires insurance coverage of the pills without a copay because they are considered preventive health care.

That's why making birth controls available without a doctor's visit is not necessarily a slam-dunk decision. But it's long past time to seriously consider how greater availability of this effective contraceptive might reduce the nation's high rate of unintended pregnancies -- a rate that hasn't budged in two decades, according to the college. The annual cost of unplanned pregnancies to taxpayers? About $11.1 billion annually.

The medical organization's science-based recommendation should also help nudge the national dialogue about women's health back into the modern era. The past election's illogical comments about rape and objections to birth control coverage set the debate back by decades.

There was no particular time peg for the recommendation from the medical organization-- committee members began looking at it during their routine considerations of practice issues and guidelines. Dr. Kavita Nanda, a North Carolina physician who sat on the committee, said medical studies indicate that women in other countries where the pills are available through pharmacies have used them safely and appropriately. (Oral contraceptives are available without a prescription in Mexico and many South American countries).

Nor are women using OTC birth control pills more likely to miss key health screenings, such as the test that checks for cervical cancer. As far the science is concerned, there's no reason the pills should not be available without a prescription, Nanda said.

Dr. Jan Strathy, a respected Park Nicollet obstetrician and gynecologist, welcomed the recommendation by Nanda's committee and the faith it reflects in women's ability to make intelligent health choices for themselves. Strathy said the strong, accumulating evidence on the pills' safety would provide a solid foundation for a serious debate about OTC birth control pills.

"It's a reasonable conversation to have,'' she said, "and I think a lot of women would benefit.''

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