Copyright © 2017 Albuquerque Journal
Starting today, pharmacists who undergo training will legally be able to prescribe and provide birth control pills to women in much the same way they already provide various vaccinations and flu shots.
The initiative is an attempt to deal with a shortage of primary care doctors, gynecologists and obstetricians in New Mexico, particularly in rural areas, as well as the large number of unintended pregnancies in the state, said Dale Tinker, executive director of the New Mexico Pharmacists Association.
The training program is expected to begin shortly, he said, adding it is still too early to determine how many pharmacists will participate.
“The key issue here is access to care in your community,” said Denicia Cadena, policy director for Young Women United, one of the community-based organizations that participated in the effort to have pharmacists prescribe birth control pills.
“In our rural state, this change will significantly impact the lives of real people currently navigating barriers to the care they need, including transportation and cost,” she said.
Doctors and nurses, working in conjunction with the American Civil Liberties Union and other community organizations, developed training and protocols for pharmacists that will allow them to safely prescribe the medications, Tinker said. They were subsequently reviewed and approved by the New Mexico Board of Pharmacy, the New Mexico Board of Nursing and the New Mexico Medical Board.
Nine hours of training is required for a pharmacist to “opt in” and agree to fill these prescriptions. But pharmacists are not required to take the training, Tinker said.
Pharmacists can still contact a doctor to renew an expired prescription, though the intent of the new regulation is to expedite access to contraceptives for women without the need for a doctor’s approval.
Women who seek contraceptive pills but who have complex health issues will be referred to health care providers, Tinker said.
Pharmacist-written birth control prescriptions may be covered by a customer’s health insurance, depending on the terms of the policy, Tinker said.
New Mexico’s population includes about 425,270 females of child-bearing age – 13 to 44 – according to a 2014 report from the Guttmacher Institute. More than 30,200 of them are under age 20.
A 2012 report from the state Department of Health based on live births in 2009 and 2010 said that 53 percent of women giving birth during that time indicated their pregnancies were intended, leaving 47 percent of those pregnancies as unintended.
Dr. Lauren Thaxton of the University of New Mexico’s Department Obstetrics and Gynecology said the “multidisciplinary effort” will improve the health of New Mexicans.
Thaxton, one of the physicians who worked on developing the pharmacist training and protocol, said a “robust body of research” published in peer review and medical journals shows that “pharmacist provision of contraception is patient-centered, safe and effective.”
Access to contraceptives through pharmacies “allows women the opportunity to take health care into their own hands,” Thaxton said.
Lack of access to contraception is a nationwide medical issue and a contributing factor in maternal mortality and morbidity.
Thaxton pointed to a study conducted by the World Health Organization showing that the maternal mortality ratio for the United States between 1990 and 2013 more than doubled from 12 to 28 per 100,000 births – a higher rate than is found in Iran, Libya and Turkey. Each year, about 1,200 women in the United States die as a result of complications from childbirth and 60,000 suffer near-fatal complications.
New Mexico now joins California, Colorado and Oregon as states that allow pharmacists to prescribe oral contraceptives. According to Erin Armstrong, staff attorney for the ACLU of New Mexico, “This evidence-based policy has the potential to eliminate barriers to contraception, which is a critically important part of health care for so many individuals in our communities.”