Fiona Downey

This past summer, Oregon legislators passed two laws that vastly expanded womens’ access to birth control. House Bill 2879 allows pharmacists, rather than doctors, to prescribe birth control to women over the age of eighteen, regardless of whether they’ve had a prior prescription. It also gives Oregon pharmacists the ability to prescribe birth control methods to women under eighteen, though only if they’ve previously had a prescription from a physician. The second law, House Bill 3343, requires insurance companies to provide coverage for 12-month supplies of birth control, as opposed to the current standard of 30- to 90-day spans.

These new laws mimicked recommendations from a University of California – San Francisco study indicating that increased birth control pill prescription-length leads to fewer unintended pregnancies. According to the study, when prescription lengths are shorter, there is a greater risk of a woman missing numerous days of pills or potentially an entire month, thereby reducing the effectiveness of the contraceptive. When women were given a yearly supply, the study found rates of an unexpected pregnancy were reduced by 30 per cent.

Dealing with the trials and tribulations of obtaining and using birth control in Ontario is something my female peers and I discuss and complain about – often. When it comes to receiving a birth control pill prescription, most women I have spoken to will acquire, at most, a six-month dose. Depending on their health plan, many have to pay up front before claiming the cost back later. It can often be a cumbersome process. So, naturally, when I heard about the enactment of these progressive laws in Oregon, it made me wonder whether a similar initiative could be possible in a Canadian province. To me, and the friends I relayed the information to, it seemed like a policy change that would be feasible in—and beneficial to—every Canadian province.

As I researched the viability of such laws, considering health risks and insurance regulations, I discovered that my novel idea was not so forward-thinking after all. Oregon, it turned out, was (intentionally or not) following in Canada’s footsteps. As it happens, pharmacists in Ontario are able to prescribe six-month refills of birth control, given that a patient has a previous prescription from a doctor. I was absolutely shocked. How could I have been so misinformed?

My initial reaction was to ask my peers. I spoke to fifteen different women, all of whom live, or had lived, in Ontario. None of them knew there was an easier way to access birth control in the province. I found this incredible. How could numerous well-educated women (some of whom have backgrounds in health studies or parents in the profession) be unaware of this? Furthermore, if I, as a woman living in Toronto with access to student health coverage, find that obtaining a prescription is time-consuming and tiresome, how much more difficult is it for those in remote regions of the province, those without insurance, and those without easy access to patient-centered healthcare? This ease of accessibility should be properly advertised in order to provide women with comprehensive knowledge of the options before them and make it clear just how easy obtaining a prescription can be.

Wherever I searched, however, I found no evidence of this. My last-ditch effort was to research Ontario’s new sexual education plan, to see if the options for access were at least discussed there. Unfortunately, I was once again disappointed. While the program does delve into the topic of contraceptives, it is not clear how comprehensively accessibility is covered.

Birth control access, and in a larger sense access to health care in general, is a topic of great importance. When discussing sexual health, access to birth control is an integral part of the conversation. Providing young women with the options (and restrictions) for them is a necessary part of sexual education. If contraceptives are going to be effective, women must not only know the options before them, but how health plans and insurance coverage work, so they are able to get the best care possible. They should know that any doctor who denies them access to birth control is required to recommend them to another doctor who will. They should know the risks of missing a month of their prescription.

As a result of this roller-coaster of research, I have two policy recommendations for Ontario going forward. Primarily, it’s time to spread the word – if access to birth control is easier than it appears, let women know! This can take the form of simple things like updating health and government websites, educating young women, or posting advertisements in clinics. Second, I think it’s time we took a lesson from down south (and slightly west) and lobby for increasing pharmacist prescription limits to a year. Not only will this further facilitate ease of access, but will help get the word out that pharmacist prescriptions are an option. And hey, clearing these frustrated women from clinic waiting rooms will actually save the province some serious cash- so how dangerous can it be to give women more control over their own bodies?

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Fiona Downey is a 2017 Master of Public Policy Candidate at the University of Toronto. She holds a Bachelor of Arts in political studies from Queen’s University. Her interests lie in women’s health policy, civic engagement, urban policy, and human rights. When not reading or writing about policy, Fiona enjoys playing field hockey and exploring Toronto.