'I think it will absolutely prevent unplanned pregnancies'

A new South Carolina law will let women get birth control pills and other forms of hormonal contraception from pharmacists without a prescription. That’s great news, say an OB-GYN who specializes in family planning and an assistant professor in the College of Pharmacy at the Medical University of South Carolina. 

Jessica Tarleton, M.D., the OB-GYN, said it will make what can be an essential aspect of women’s health care much easier to get. “I think it will absolutely prevent unplanned pregnancies. I'm a complex family planning specialist, so my agenda is to increase access to contraception any way that we can. I think it's a really positive move.”

David Shirley, Pharm.D., who worked for years as a community and compounding pharmacist, agreed. “I think it's a win for patients. Patient safety and access to birth control are going to greatly improve. And I think adherence will improve as well,” he said, referring to women’s consistent use of birth control pills and other contraception.

South Carolina joins 17 other states and the District of Columbia in empowering pharmacists to become frontline hormonal birth control providers. Shirley summarized what pharmacists in this state will be able to offer, through a Joint State Protocol, prescription-free, by December 

“Self-administered hormonal contraceptives, including birth control pills, the vaginal ring and any patch that's available - anything that you would dispense to a patient, that the patient then goes home and consumes or utilizes. Additionally, the pharmacist can administer injectable products.” he said.

The best-known birth control injection, Depo-Provera, involves getting a shot every three months. A pharmacist could give those shots just like they can already give immunizations for everything from COVID-19 to shingles.

Tarleton, who in addition to seeing patients serves as an assistant professor in the College of Medicine, said pharmacists’ new power may mean a slight decrease in women coming to her clinic – but it’s worth it. “The easier we can make it for people to take care of themselves, it's better for everyone.”

But Shirley said ease doesn’t mean skipping the risk assessment process required before a patient gets hormonal birth control. “It's not just, ‘Oh, hey, now I can hand this to you.’ There will be requirements that are going to be written jointly through the Board of Medical Examiners and the Board of Pharmacy. It's not unlike our current immunization practices where we can dispense certain immunizations without a prescription.”

Women with certain health conditions will be referred to doctors. “What comes to mind is certain breast cancers. For instance, if somebody has a history of that, we need to make sure that they see either a oncologist, a family doctor, or a provider with a more thorough knowledge of the patient’s history and risk factors,” Shirley said.

But Tarleton said that for most women, hormonal birth control, including pills, is safe. “Pharmacy prescribing of contraception has been shown in the literature to be effective, even outside the doctor's care. There are many women who delay care, who cannot access care in a doctor's office for different reasons – cost, time, they’re afraid to go to the doctor. And so I kind of see it like we're encouraging women to be able to access the care that they need when they need it more often if we allow them to buy birth control pills at the pharmacy.”

However, she said a pharmacy visit for birth control does not replace checkups. “It's important to keep in mind that just because your contraception is taken care of, your general wellness screening isn’t. And so it'll still be important to see your gynecologist as directed.”

As for the pharmacists, Shirley said the hormonal birth control care will be optional. Pharmacists who want to do it will have to undergo training as specified in the protocol. 

Shirley said it will be a way to continue to practice at the top of their profession. “I think you're going to see increased communication between providers and pharmacists because of this, which benefits patients. I think you're also going to see more clinically oriented counseling from pharmacists to patients."