Oregon and California attracted national notice this year as battlegrounds in the struggle for accessible contraceptive care. New laws in both states allow pharmacists to prescribe hormonal birth control to women directly. Yet the fight for increased access to contraception isn’t being fought on the West Coast alone; it’s also taking place on computer and smartphone screens all over the country.
A handful of companies and nonprofits have developed websites and phone apps allowing women in most states to obtain a prescription for oral contraception from a physician without visiting a doctor’s office, either by answering a series of online questions or talking to a clinician via video or online call. Many of these apps, such as San Francisco-based Nurx and Planned Parenthood’s Planned Parenthood Care service, deliver birth control pills right to users’ doorsteps.
The apps aim to fix a problem facing teenage and adult women across the United States: Nearly half of pregnancies here are unplanned — almost three million per year. Many women become pregnant not because their birth control fails, but because they never had birth control in the first place. Some women — especially young ones — are nervous asking their doctors for contraception. For others, doctor’s appointments come at too high a cost: Low-income women may not be able to cover the co-payments doctors charge for extra services in-house, or they can’t afford to take time off work.
Birth control prescription apps are an innovative answer, especially in places where politics get in the way of progress. Letting pharmacists prescribe contraception, as Oregon and California do, requires legislation, and few states are willing to make such a controversial change. The same goes for over-the-counter contraception: It might be the most effective tool in preventing unplanned pregnancy, but it’s also unlikely to gain political traction. In many cases, it is up to a prescription drug’s manufacturer rather than any federal actor to reclassify a product. Apps are a smart workaround.
Of course, regulatory workarounds can come with risks. Some doubt that birth control prescription apps can adequately screen users for health issues. Others worry that women who can get contraception remotely will be discouraged from seeing physicians in person. But doctors say oral contraception is just as low-risk as other drugstore medications that don’t require a clinician’s sign-off, and research has shown women are capable of self-screening. Many apps also connect patients to health centers where they can get further care — and be counseled on other, longer-acting forms of contraception.
Already, most birth control prescription apps go beyond what medical standards demand when it comes to age restrictions and other safety measures. As they evolve, they should continue to prioritize safety over convenience. But given the frequency of unplanned pregnancy, these apps are exactly what the doctor ordered.
