COMMENTARY

Will Birth Control Apps Reduce Unintended Pregnancies?

Andrew M. Kaunitz, MD

Disclosures

September 06, 2016

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Hello. I'm Andrew Kaunitz, professor and associate chairman of the Department of Obstetrics and Gynecology at the University of Florida College of Medicine in Jacksonville. Today I'd like to discuss contraception.

While use of highly effective reversible contraceptives—specifically intrauterine devices and the implant—continues to grow among US women, the pill remains the mainstay of reversible birth control, with more than a quarter of women of reproductive age in the United States using oral contraceptives (OC).[1]

Traditionally, to start or continue OC, women have needed an office visit. In 2014, the American Congress of Obstetricians and Gynecologists (ACOG) voiced its commitment to increasing access to OC by encouraging over-the-counter availability.[2] However, a concern that some have expressed regarding over-the-counter access is that it might reduce insurance coverage for contraceptives.

Although over-the-counter access to OC has not yet become a reality in the United States, Oregon and California have recently enacted legislation enabling women to bypass clinicians by obtaining OC directly from pharmacists.[3] In Oregon, pharmacists can prescribe oral and transdermal contraceptives to women who are 18 years of age or older. For younger women, pharmacists can only continue contraceptives that have been prescribed by a clinician. Pharmacist participation in the contraception program is voluntary and, before prescribing contraceptives, pharmacists must complete a 5-hour training module.[4] ACOG expresses the concern that pharmacist prescription of contraceptives replaces one barrier (ie, physician prescription) with another.[5]

In the form of websites and apps, technology is also increasing access to short-acting contraceptives by making it possible to obtain a prescription without visiting a doctor's office. Some of these services accept commercial insurance as well as Medicaid. Examples include KwikMed, Lemonaid, Nurx, and Virtuwell. Planned Parenthood offers a similar service.[6]

Facilitating access should bring modern contraception to more US women. Perhaps in a future video, I'll be able to report whether easier access to birth control has reduced unintended pregnancies and abortions.

Thank you for taking the time to view this video. I am Andrew Kaunitz.

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