Want birth control pills without visiting the doctor? There’s an app for that

Published 12:00 am Thursday, July 14, 2016

Here’s a short list of things you can do through an app on your cellphone.

Buy clothes. Order takeout. Read a newspaper. Watch a movie. Buy birth control pills.

For that last purchase, you don’t even need to visit your doctor first.

New smartphone apps and websites give women access to prescription birth control without ever having to visit a doctor.

The New York Times calls this mobile movement “a quiet shift” in how women obtain birth control, which can be a time-consuming, costly and even embarrassing process for some.

The Times found at least six private companies and nonprofits offering the services. Each works a little differently, but all allow a woman to answer health questions either through an online form or via video with a doctor or other medical clinician.

The physician reviews the information, writes a prescription and the woman can either pick up the pills — patches, rings and morning-after pills are also available — at the pharmacy or get them in the mail.

“This kind of access is certainly an improvement for some women who have access to the web and a smartphone,” Dr. Nancy Stanwood, chairwoman of the board of Physicians for Reproductive Health, told the Times when she learned of the services.

“Look, if I can order something on Amazon and they’re going to drone-deliver it half an hour later to my house, of course we’re going to think of better ways for women to get birth control.”

Public health experts told the Times they hope easier access like this will encourage more women to start, or restart, contraception, which in turn could reduce America’s rates of unintended pregnancies and abortions.

Birth control via apps also sidesteps a lot of political drama. The Obama administration ran into a buzz saw of controversy, for instance, with the controversial Affordable Care Act requirement that group health plans provide contraception to female employees at no cost.

Faith-based companies and groups revolted, arguing the requirement violated their federally protected religious freedom.

“The new services have so far sprung up beneath the political radar and grown through word of mouth, with little of the furor that has come to be expected in issues involving reproductive health,” the Times reported.

One of the apps is put out by Planned Parenthood, no stranger to controversy when it comes to women’s health issues.

The co-founder of another, called Nurx, told the Times that the company has “seen a ridiculous amount of traffic that we’re struggling to handle.”

Not all the companies accept insurance, and fees vary. Nurx, for instance, charges women who don’t have health insurance $15 a month for its birth control pills.

Many of the companies are trying to head off controversy by setting older minimum age requirements. For instance, Prjkt Ruby’s minimum age lines up with each state’s age of consent for sexual activity, typically 16 to 18, the Times reported.

Virtuwell will only write prescriptions for women ages 18 to 34. Lemonaid’s minimum age is 18, too.

“We are being especially conservative by choice,” Dr. Jason Hwang, Lemonaid’s chief medical officer, said.

The minimum age is “not based on clinical grounds; it was a political decision. We didn’t want people who might be under 18, who might still have parents who would get upset if we were making decisions for them.”

Critics of the apps, however, worry for other reasons. Some doctors are concerned that women who skip the physical exam don’t get the benefit of a physician checking them for other possible health problems, such as sexually transmitted diseases.

And while he praised the convenience of an app, Dr. Mark DeFrancesco, immediate past president of the American Congress of Obstetricians and Gynecologists, worried that women might skip seeing their doctors because they think the brief video interaction with a clinician is enough.

Many health experts argue that birth control pills should be available in the United States without a prescription at all, as they are in most other countries.

The “outdated practice” of requiring a doctor’s visit to get a prescription causes some women to take their pills less regularly, compromising their effectiveness, the doctors argued.

“It’s unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem,” said Kavita Nanda, an OB/GYN who co-authored her group’s opinion.

If the pill didn’t require a prescription, women could “pick it up in the middle of the night if they run out,” she said. “It removes those types of barriers.”

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