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belgareth
03-15-2004, 06:50 PM
Wash. Lets Women Get

the Pill From Store
Mon Mar 15, 1:47 PM ET


By ERIN VAN BRONKHORST, Associated Press Writer

SEATTLE

- Step right up to the pharmacy counter, answer 23 questions and walk out with birth control pills. That\'s all it

takes for women enrolled in a study that is believed to be the first effort in the nation to offer hormonal

contraceptives at drugstores without a doctor\'s prescription.



The University of Washington project aims

to find out if women and pharmacists are comfortable with drugstore delivery of birth control pills, patches and

vaginal rings.


That doesn\'t mean women should stop going to the doctor for annual checkups to guard against

sexually transmitted diseases and other problems. But most medical organizations agree it is not necessary to have a

pelvic exam to get birth control pills and the like.


The best situation is for every woman to have immediate

access to medical care, \"but there are women who don\'t have access, and there are some barriers and

difficulties,\" said Dr. Robert Palmer Jr., an obstetrician-gynecologist on the study\'s advisory board. Palmer

is also state chairman for the American College of Obstetricians and Gynecologists.


The study is also embraced

by family planning and population control experts.


James Trussell, director of the Office of Population

Research at Princeton University, is hoping the idea will spread.


\"It\'s a terrific idea. Seeing a

pharmacist is just fine for these methods,\" he said, noting that half the pregnancies in the United States each

year are unintended.


\"Anything that is expanding access to people where and when they need it is a positive

thing,\" said Robert Harkins of Planned Parenthood of Western Washington.


More than 50 women have enrolled

since the study was launched Feb. 23 by the UW School of Pharmacy and Department of Obstetrics and Gynecology with

funding from the National Institutes of Health. Researchers hope to enroll 300 women.


Women 18 to 45 years old

can visit any of eight Fred Meyer or Bartell pharmacies in Seattle and its suburbs, complete a health questionnaire

and have their weight and blood pressure checked.


If they pass a good-health checklist, they can obtain three

months of birth-control pills or patches right away, and an additional nine months\' worth at a follow-up visit.

The price is $25 per visit plus the medicine. Insurance companies generally will not pay.


Washington state has

a long history of bold moves regarding women\'s health. It became the first state to legalize abortion through a

vote of the people when an initiative was approved in 1970.


And Washington was also the first to allow the

morning-after pill to be given out without a doctor\'s prescription. A University of Washington study in 1997-99

pioneered the practice ? and it spread. Emergency contraception now is available at pharmacists\' counters in

California, Hawaii, Alaska and New Mexico.


Trussell predicted this latest idea will be copied elsewhere, too.

The pharmacies involved report many callers asking about the project.


Lead researcher Jacqueline Gardner, a

pharmacy professor at UW, said the birth-control study was an outgrowth of her team\'s earlier work on access to

the morning-after pill.


\"The pharmacists were feeling frustrated when a woman came in for emergency

contraception and they gave it to her, they would say, `What do you plan to use?\' and lots of times they

didn\'t have a prescriber or a method in mind,\" Gardner said.


Pharmacists get eight hours of special

training and operate under a set of rules approved by a doctor ? an arrangement already permitted by the state for

other types of medicines.


They screen out women who are very obese, are heavy smokers or have high blood

pressure, a history of breast cancer, blood clots or other risk factors.

Most of the 50 women already enrolled

have previously seen doctors and used hormonal contraceptives but have not had easy access because of a recent move

or some other problem, Gardner said.

Pharmacist Don Downing, another researcher, said he believes women who do

not have doctors but need birth control are likely to be interested.

\"Pharmacies don\'t have tables with

stirrups on them and I think that\'s a bonus, and we\'re available after hours and weekends when most clinics

are not open,\" Downing said.

Two women shopping near Bartell\'s 24-hour pharmacy in Seattle told The

Associated Press they have mixed feelings about the program.

\"We don\'t want women being jeopardized in any

way taking medicine that is not monitored in some way,\" said Kim Daley, 27.

Danielle Levine, 23, said annual

checkups are important.

Common side effects of hormonal birth control are irregular bleeding, nausea, vomiting,

breast tenderness and swelling.

Dr. Elisabeth Evans, an obstetrician-gynecologist at Overlake Hospital Medical

Center in Bellevue, said birth control pills are very safe.

However, she said one advantage of seeing a doctor

is that a woman gets checked for sexually transmitted diseases, including human papilloma virus, which is a

precursor to cervical cancer.

\"I think personally the positives probably outweigh the negatives for women,\"

she said. \"I think it\'s hard for women to always go to the doctor to get a prescription for something that\'s

probably safer than aspirin.\"