Telemedicine may help women get access to birth control in the pandemic. Getty Images
  • Getting to doctors and pharmacies is just one barrier to getting birth control during the pandemic.
  • There have been supply chain interruptions for the medications, according to a United Nations Population Fund report published in April.
  • Not all states actually allow doctors to prescribe birth control without seeing a patient in person.

More people are turning to telemedicine for care during the pandemic, but there are still gaps in coverage.

Namely, women who can’t get birth control.

Getting to doctors and pharmacies is just one barrier to getting birth control during the pandemic.

There have been supply chain interruptions for the medications, according to a United Nations Population Fund report published in April.

And while some people can see a doctor via telemedicine visits, not all states actually allow doctors to prescribe birth control without seeing a patient in person.

At least five states have telemedicine restrictions that can make it difficult to get access to contraception.

Carrie Siu Butt, the CEO of the online birth control prescriber Simple Health, started a petition to lift telemedicine restrictions that are preventing women from accessing prescriptions.

“The coronavirus pandemic has… created a new set of challenges for people who need to fill birth control prescriptions,” Siu Butt said in a statement. “Because of this, patients are distressed or suffering in states like Indiana, Arizona, New Jersey, New Mexico, and Nevada, where telemedicine regulation is especially restrictive.”

Birth control barriers

“Early in the pandemic, some pharmacies ran out of medications,” recalled Dr. Madeline Sutton, an OB-GYN from Georgia. “Other pharmacies were closed during quarantines and promised to mail prescriptions. In many cases, mailed prescription medications did not reach patients in time.”

For some patients, Sutton had to call around to find open pharmacies so her clients could access their birth control.

“Proximity and transportation were sometimes an issue,” Sutton told Healthline. “These pharmacy-level challenges were not solved by telehealth options.”

Challenges to getting contraception vary from state to state.

In some states, you can get birth control directly from a pharmacy. In others, you must have a doctor’s prescription.

A June 2020 report from the Guttmacher Institute reported that 29 percent of white women, 38 percent of Black women, and 45 percent of Hispanic women were having a difficult time accessing birth control due to limits in appointment access.

Personal protective equipment (PPE) and staffing shortages have also contributed to making in-person visits difficult.

In addition, young women in crowded households may not have the privacy needed for telemedicine visits.

An August report published in the Health Affairs blog estimates that 4 million women who use sexual and reproductive healthcare will lose insurance due to losing their jobs.

As a result, publicly supported clinics will see a 21 percent increase in sexual and reproductive health patients, including a 54 percent increase in those without insurance.

“The pandemic has changed our approach to healthcare, and in particular it has highlighted the need to streamline access for a variety of healthcare services,” said Gillian Sealy, PhD, MPH, CEO of Power to Decide, a campaign to promote birth control options.

“With regard to contraception, telehealth has proved an effective option for women trying to access the healthcare they need while reducing provider visits. Unfortunately, access to telehealth services can be a significant challenge for women on limited incomes or living in rural areas where access to reliable internet is a challenge many cannot overcome,” Sealy told Healthline.

Fear of going online for care

For many people, telehealth is still unfamiliar territory. Some people are reluctant to try it — creating another barrier to care, Sealy adds.

“It has been more difficult to get any kind of medical care during the pandemic, especially at the outset, when all nonessential procedures and doctor visits came to a halt,” noted Cynthia C. Harper, PhD, a professor at University of California, San Francisco, who is part of the Beyond the Pill initiative to promote equity and access in women’s contraceptive healthcare.

“While products are still available, many health facilities across the country are facing challenges with PPE and testing supplies, as well as staffing issues and clinic funding difficulties,” Harper told Healthline.

Her team recently conducted a survey that found about half of health providers report it is more difficult to onboard and serve new patients, but many providers have now readjusted their clinic schedules so people who need to come in can do so safely.

Most patient counseling can be done via phone or video, which can free up clinics to see people who must have in-person care, Harper says.

Improving access

While some forms of birth control can be prescribed via telemedicine, others require an office visit, such as IUDs, which a medical professional must insert.

Harper notes that the Depo-Provera birth control shot is now available in a new formulation — Depo-SubQ Provera 104 — that patients can administer themselves at home.

Some clinics are making Depo-SubQ available for drive-thru or curbside pickup too.

Doctors are also informing women who desire to keep using an IUD or birth control implant (Nexplanon) that they can use the devices longer than labeling dictates.

Unlike NuvaRing, a new vaginal ring called Annovera can be reused for up to a year — another option that saves visits to the pharmacy, adds Dr. Mary Jane Minkin, a gynecologist and professor at Yale University in Connecticut.

“You should be able to get a prescription via telehealth. You really don’t need a pelvic exam to get contraception. Even women who have never used contraception should have accessibility,” Minkin told Healthline.

How to get birth control

Some states, such as California and Washington, allow women to get birth control directly from pharmacies.

Local family planning clinics, including Planned Parenthood, will be able to offer IUDs and the implant, Harper notes.

“Unemployment has soared, and with our employer-based health insurance system, people are not able to seek needed healthcare. The situation can be very difficult for people who want to prevent pregnancy during this time but are uninsured,” she said.

Those patients should look into visiting nonprofit family planning clinics.

Other resources include BCBenefits, a contraceptive access fund for people with low incomes dealing with access issues, including cost, lack of insurance, and transportation.

Sealy’s group offers an online birth control support network, Bedsider, which provides women with tools and information to access contraceptive care.

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