- Nearly 20 million women live in contraceptive “deserts” in the U.S.
- But experts point out that women should have more access to hormonal birth control.
- A new study has found that web- and app-based services that give prescriptions for birth control appear largely safe.
Getting birth control isn’t the easiest.
Many women lack the time, finances, and insurance coverage to obtain a prescription for hormonal birth control. And then there’s the 19.5 million women who live in contraceptive deserts — areas where there’s little to no access to health clinics that offer contraception.
But support for improving access to birth control seems to be growing.
New research from Harvard Medical School and UC Davis shows that web-based and digital-app services offering prescription oral birth control are generally very safe and reliable.
The study, which was published today in The New England Journal of Medicine, suggests that digital-based healthcare is a very safe, viable way of getting birth control.
And this comes as medical experts report that hormonal birth control should be more easily available.
This week, the American College of Obstetricians and Gynecologists (ACOG) announced its recommendation that all types of hormonal birth control — including birth control pills, contraceptive patches, vaginal rings, and the Depo-Provera injection — be available over the counter (OTC) with no age restrictions.
Selling birth control over the counter and raising awareness about online vendors could help more women safely and efficiently gain much-needed access to contraception.
“Patients can struggle to access the care that they need, and anything innovative that can help them safely access contraception is going to be good for patients,” Dr. Nancy Stanwood, an OB-GYN and the section chief of Yale Medicine Family Planning, told Healthline.
To evaluate the safety and reliability of online birth control services, researchers recruited 7 patients to purchase birth control pills online.
Some of the patients were taking medications or had health conditions that would make them ineligible for certain contraceptive methods.
The participants each requested birth control from 9 different vendors. Altogether, they made 63 online requests for oral birth control.
The study found that the online vendors adhered to safety guidelines laid out by the U.S. Centers for Disease Control and Prevention (CDC) — which ensures birth control isn’t given to women with certain medical conditions — 93 percent of the time.
Although the analysis highlights the overall safety and efficiency of the online providers, the researchers did find a few issues that could be improved upon.
In 3 out of 45 instances, women with a health contraindication received birth control when they shouldn’t have.
According to the researchers, this is likely because the woman had a rare condition not specified in the guidelines. These contraindications could easily be missed by a healthcare provider in an in-office visit as well — and they’re missed about 14 percent of the time, Stanwood said.
In addition, some of the online providers didn’t counsel women about alternative options, such as those that would require an in-office visit.
For example, it’s difficult for some women to remember to take a pill every day, so it’s worth counseling people about other effective methods such as an intrauterine device (IUD) or the birth control arm implant, Stanwood explained.
There’s a lot of evidence highlighting the many barriers preventing people from obtaining birth control, according to Dr. Jennifer Kerns, an associate professor of obstetrics and gynecology at the University of California San Francisco.
Some people have difficulty taking off from work or don’t have a mode of transportation to get to a clinic.
Others don’t ask due to the stigma attached to birth control, Kerns said.
Web- and app-based prescription services have the potential to break down these barriers and help women get the medications they need.
Rather than drive a lengthy distance to visit a clinic, telecontraception involves completing an online questionnaire and receiving a birth control prescription either by mail or at a local pharmacy.
“Online options and telemedicine make the process of obtaining birth control pills easier. Fewer hurdles to obtaining contraception means more people using the contraception that they want to be using,” she said.
In addition to the online services, selling hormonal birth control over the counter could exponentially increase access to birth control — especially among underserved and adolescent women who may face more
According to the ACOG, needing a prescription is a major challenge holding women back from getting their preferred type of birth control.
“The need to consistently obtain a prescription, get a refill approval, or schedule an appointment can lead to inconsistent use of a preferred birth control method,” Dr. Michelle Isley, an OB-GYN who coauthored the ACOG’s recommendation, said in a statement.
“Making more methods available over the counter would lead to reliable, equitable access for more women,” she said.
Hormonal contraception is generally very safe, the ACOG noted. The main concern is that hormonal birth control could increase the risk of venous thromboembolism (VTE), which is a rare type of blood clot.
Still, OTC contraception would require females to self-screen for contraindications.
Hormonal birth control that contains estrogen is considered unsafe for women with migraine headaches with aura, a history of blood clot or stroke, and high blood pressure, Kerns said.
Implants, IUDs, and progestin-only pills would be a safer option in certain situations.
Therefore, it’s crucial to be aware of your risks before exploring your birth control options.
Lastly, the ACOG encouraged all women to stick with their annual gynecology appointments, even though obtaining birth control shouldn’t require an exam or doctor’s visit.
A new study from Harvard Medical School and UC-Davis shows that web-based and digital-app services offering prescription oral birth control are generally very safe and reliable.
Additionally, the ACOG announced their recommendation that hormonal birth control should be available over the counter.
Permitting OTC contraception and supporting digitally-prescribed birth control services could significantly expand access and break down the many barriers preventing millions of women from getting the medication they need.