May 3, 2018

Dr. Jones: What if you didn't have to go to the doctor's office to get your birth control prescription renewed? What if low-income women, that includes moms and students, had access to the most effective means of contraception? This is Dr. Kirtly Jones from Obstetrics and Gynecology at the University of Utah Health, and this is The Seven Domains of Women's Health on The Scope.

Announcer: Covering all aspects of women's health. This is The Seven Domains of Women Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: What would the world look like if every child was wanted and planned for with a mother in her very best physical, emotional, and financial health? We know that the health status of the mom and the early environment for the infant have long-lasting positive and negative effects on children and the adults that they will become. So planning your children to support their success is a good idea, huh?

It turns out that governments, state and federal, have a heavy hand in determining who gets birth control, what kind they get, and where they get it, and how much they pay for it. The states with the least access to family planning have the highest rates of unplanned pregnancies and the highest rates of maternal deaths. On the other hand, the states that offer women and families the greatest access to family planning do better.

This year, the state of Utah took a step in the direction of making contraception easier to get and more affordable for some women. Firstly, Utah now joins a few other states, including California, Oregon, and Colorado, in allowing women to get their birth control prescription renewed and refilled by a pharmacist. One factor in women having gaps in their contraceptive coverage is when their prescription runs out. They may have to go back and see the doctor or the nurse practitioner. This can be time-consuming, taking time off work or child care, and can be expensive.

Now, for women who've had a prescription by a licensed provider and the prescriptions can be renewed and refilled by a pharmacist, this makes it more convenient for women to continue on their birth control pills, patches, or rings. Just a few years ago, this idea would not have found favor in the Utah legislature, but the reality that unwanted and unplanned pregnancies are expensive for the state in the case of Medicare, covering the pregnancies and deliveries, and that the knowledge that women who get pregnant who aren't healthy have more expensive pregnancies, as well as more complications for their babies that are born, this got the legislators' attention this time.

The new law, which unanimously, I will say that again, unanimously passed the Utah legislature takes effect May 8th, 2018. Women will need to fill out a form at the pharmacy to assess their risks, and they'll need to check with a clinician every two years instead of every year.

At the same time, the governor also signed a bill to increase coverage for the most effective and expensive forms of reversible contraception. The most effective forms of contraception are long-lasting IUDs and implants. They may last for 3 to 12 years depending on the type, but can be removed at any time and fertility resumes very quickly.

The methods aren't so expensive on a month-to-month basis, but because all of the costs have to be paid upfront, many low-income women can't access these methods. Utah now joins many states and by including a Medicaid waiver to allow low-income women to have access to these methods on their Medicaid. Utah was only one of seven states that didn't have this waiver, and now it joins most of the states in the U.S. Of course, these methods require a trained health professional to place them, and many doctors don't know how. So the next job is to make sure that the many clinicians around the state have the knowledge to counsel women and the skills to provide them.

So Utah is in the forefront with the few, mostly blue states in the first bill that allows pharmacists to renew, for a year, a birth control prescription, and that is great. The state is catching up with most states with the second bill about Medicaid waiver. A great part of this news is that the legislators who wrote these bills that were passed were informed by young professionals at the University of Utah. The first bill was suggested by a pharmacy grad student at the University of Utah, and the second bill was proposed by a legislator who spent a lot of time listening to the rationale and ideas of a group of young clinicians and educators at the U. How great is that?

Wouldn't it be great if every baby born in our pretty, great state could be wanted and planned for by a mother in her best physical, psychological, and financial health at the top of her game in all of her seven domains of health? Did I say that already? It would be really great. And I've said great at least seven times in this broadcast, so I'm really excited.

Ladies, at the end of the day, it's really up to you. But now, it just got a little easier. And thanks for joining us on The Scope.

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