Here’s an item from the annals of “no shit, Sherlock!” science: A UCSF study shows a stunning decrease in unintended pregnancy and abortion when women are dispensed a year’s supply of birth control pills at once. What’s stunning is not the basic trend line, but the magnitude of the study’s findings. Science Daily recaps it:
Researchers observed a 30 percent reduction in the odds of pregnancy and a 46 percent decrease in the odds of an abortion in women given a one-year supply of birth control pills at a clinic versus women who received the standard prescriptions for one — or three-month supplies.
Can I rephrase those numbers? Pregnancy declined by nearly a third, and abortion by nearly half!
This is such an an simple yet elegant idea, you’d think it would have occurred to someone decades ago. It’s also a politically charged idea in an era where Planned Parenthood is having to fight for its very existence.
Insurance usually issues a maximum of a three-month supply of any medication, including birth control pills. This is true even for medication that people clearly have to take for the rest of their lives, such as thyroid pills. (I haven’t been on the Pill in years, but I still sometimes come close to running out of my thyroid meds.) The situation is often tougher if you have to buy the Pill through a community clinic:
The findings of this study have implications for women using oral contraceptives across the country. Most oral contraceptive users in the United States get fewer than four packs at a time; nearly half need to return every month for resupply, according to a 2010 study published in Contraception.
Obviously, the requirement to physically show up at a clinic is most likely to hit poor women – and it will be most onerous precisely for these women, whose low-wage employers are unlikely to grant them time off for medical matters. As is so often the case in reproductive health, this is a social justice issue. I really hope this study will get the attention it deserves.
I adore this quotation from the project’s principal investigator:
“Women need to have contraceptives on hand so that their use is as automatic as using safety devices in cars, ” said Diana Greene Foster, PhD, lead author and associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences. “Providing one cycle of oral contraceptives at a time is similar to asking people to visit a clinic or pharmacy to renew their seatbelts each month.”
Of course, some Americans object to seatbelt laws – and even seatbelt use – as an infringement on their liberty. But I’m not talking about laws to require use of the Pill; I’m only saying that women should have access to it.
While we’re on the automotive analogy, isn’t the Pill more like a reliable set of brakes?
And wouldn’t the conservative attack on access be akin to sabotaging someone’s brakes?
Patron cat of Kittywampus (1985-2001)
Wow.
Wouldn’t it be nice if common sense could translate into common practice?
I’ll never forgive myself for losing the article with all the juicy quotes and references, but going back at least as far as the 1980s anti-choice group leaders agreed that most people in what we’d now call the squishy middle would lose interest in abortion as an issue if the rate fell below a certain threshold. And I think that’s true. Anyway, they gave that as a reason for opposing any initiative to merely lower rates instead of outlaw abortion completely.
I’m… pretty sure this accounts at least in part for their organized opposition to contraception. (The other major element, I think, is just general “mission creep” metastisis common to movements of all sorts.)
Anyway, since I too would love, love, love to eliminate demand for abortion by eliminating the need for abortion I think this is pretty great news.
Thanks for the head’s up, Sungold!
figleaf
Mm, yes. I take several meds I am supposed to be on for the rest of my life, and find it a hassle to keep in supply. I have finally got my doc to give me prescriptions for three month supplies with a refill so I don’t have to keep telephoning, and have at last got them close enough to synched up that I can pick up the supply for all of them in one trip. I am still somewhat annoyed about it, because he insists I come in every six months to sit in a waiting room for forty five minutes and in an exam room for another thirty, and pay a hundred and twenty bucks or so to answer a series of simple questions, get weighted, and have my blood pressure and heart rate measured.
Every six months is standard, I understand, if you’re on any medication at all.
When I had prescriptions for one months supplies, I had to start calling the doctor asking him to approve a refill the week after I picked up my prescription, or there’d be a good chance I’d end up in an emergency sort of deal. The way the clinic I go to works, I end up leaving messages with a call center and I have no idea if they actually get through to my doctor until I get a call from the pharmacy that my script is ready. So I could, and have, had the joy of calling the pharmacy and the clinic every couple of days for two or three weeks at a go trying to get them to deal with each other enough to keep me medicated. It is completely batty, especially since I am drug-dependent and will become very ill if denied my meds, and those meds are to control anxiety. I spent the better part of every month freaked out anxious over my access to my anti-anxiety meds. Doctors, of course, complain that the biggest problem with psych meds is patient non-compliance, but making it so stressful to get hold of the stuff made quitting the meds pretty tempting.
If I’d needed an office visit every month to get the script, it could never have worked — very often one can’t get an appointment the same month you try to schedule it. I find that to be pretty typical. It’s insane to have such an arrangement for any kind of long-term medication, but I’m sadly not surprised — I’ve had docs suddenly decide that they want me to come in, and coerce me to do so by withholding prescription refills until they see me, never mind that I called for the refill three weeks before I was bound to run out and the doc is booked for the next six weeks.
Yes – I’ve had really long wait times to see just my regular doctor, too. I don’t understand why anyone should get less than a year’s prescription if it’s a maintenance med that is well regulated for a stable condition. Why not tell the patient to set up an appointment if they start to feel worse (as in your case)? In other words, why not see appointments as a chance to promote health rather than just exerting control over prescriptions?
The situation is worse for long-term meds if the drug is psychiatric or falls under the controlled substances laws. I understand why such laws exist but think we err on the side of keeping drugs away from people whose lives would be a lot better if they had access.
It does make a certain amount of sense if I was taking something that’s a potential drug of abuse, but my psych meds are very boring ones.
People I know who have chronic pain problems and do legitimately take meds that are reasonably considered abusable go through holy hell to get them. It’s hilarious, in a bitter sort of way — it’s no big deal that I am addicted to a drug that’s not fun, but being dependent on a drug that could be fun, even if it’s not fun for you, why that’s just unthinkable. This is even more amusing when you look at the side effect profiles for boring psych meds (all manner of weird and nasty things could happen, and you’ll be drug dependent) vs. opiates (you’ll get constipated, and be drug dependent.)