A new North Carolina law allows women to get birth control pills and patches without a prescription. The bill was passed in August by the state legislature and signed into law by Gov. Roy Cooper Feb. 1.

Dr. Speaks is wearing a white lab coat over blue scrubs and is smiling into the camera.
Dr. Jaleema Speaks

Easier access to oral contraceptives and birth control patches is great news for women, said Dr. Jaleema Speaks, an ob-gyn at Novant Health WomanCare – Kernersville. But, she cautions, it may also mean that women will see a doctor less often, which puts them at risk of catching potential problems later than they might otherwise.

Speaks answers common questions on the new law and discusses the importance of continuing to see a physician or other provider on an annual basis.

What exactly does the new law do?

House Bill 96 allows certified pharmacists to provide hormonal birth control - pills and patches - to patients after a consultation.

The new law requires pharmacists who dispense hormonal birth control to:
  • Provide information about preventative care, including well-woman visits, testing information for sexually transmitted infections (STIs, often called sexually transmitted diseases, or STDs) and Pap tests.
  • Maintain a medication record in a patient profile.
  • Notify the patient’s primary care provider within 72 hours of dispensing. If a patient doesn’t identify a primary care provider, the pharmacist must direct the patient to information about free clinics and local health departments.

How soon can I get my birth control pills?

Not yet. Although the law went into effect Feb. 1, women cannot yet walk into a pharmacy and get hormonal birth control. The state health director must issue an order before the medication can be dispensed at the pharmacy level. That’s expected within the next few months.

What’s the goal of the new law?

Curbing unintended pregnancies, basically.

Speaks and the American College of Obstetricians and Gynecologists (ACOG) have long supported legislation to make hormonal contraception available without a prescription to increase women’s access to contraception. “There has been a national initiative to reduce the unintended pregnancy rate, which (at times and depending on location) can get as high as almost half of all pregnancies,” Speaks said. “So, while we always encourage women to establish a trusting relationship with a medical professional to help with important decisions, we don't think that should be a reason why women don't have ready access to birth control.”

Needing a new prescription for birth control was the impetus I needed to see my ob-gyn every year. Can I skip that appointment now?

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That’s not a good idea. While ob-gyns consider the new law good news, they also recognize that it could dissuade women from seeking medical care when they really need it. A pharmacist is not a replacement for a physician.

“If you do opt to bypass a doctor in obtaining contraception, make sure that you give your pharmacist your full medical history to help them direct you to what’s medically appropriate,” Speaks said.

And women should understand that this new ease of access doesn't mean that there aren't longer-acting and more effective birth-control alternatives that may suit their needs better. “Some of those alternatives are best discussed and best administered by a doctor or other provider,” Speaks added.

What about forms of birth control that aren’t pills and patches – IUDs, for instance?

You still need a doctor to access those. And they may be a better choice for some women. You can forget to take a pill or change a patch, rendering it less effective. There are other forms of birth control you don’t ever have to think about.

These long-acting types of birth control include intrauterine devices (IUDs) and Nexplanon, which is a birth control implant that goes in the upper arm. “These long-acting, but reversible, methods are actually recommended for adolescents and young women who want to very robustly prevent pregnancy,” Speaks said.

“Long-acting, reversible forms of birth control have very, very low failure rates because they are relatively hassle-free,” Speaks said. “They allow for return to fertility when they're discontinued, but women can enjoy three, five, up to 10 years of contraception without any maintenance versus having to take a medication.”

For women in search of an effective permanent, or hormone-free, option, physicians can offer tubal ligation and hormone-free contraception, such as a copper IUD. These are beyond the scope of what a pharmacist can provide.

If I bypass a doctor to get contraception, how will I know when to see a doctor?

Everyone should see a provider every year, even when they’re healthy.

Plus, there are times a doctor or other healthcare provider is needed. And there are services they can provide that a pharmacist is not equipped to. If a woman decides to see a pharmacist rather than a physician for birth control, she should be aware of warning signs that indicate she needs to seek immediate medical attention. She should see a doctor if she experiences:

  • Chest pain or shortness of breath
  • Severe headache
  • Pain or swelling in the leg
These symptoms can point to a possible blood clot. Women who are at highest risk for blood clots are smokers who are 35 and older and those who have uncontrolled high blood pressure or certain types of migraine headaches.

Any abnormal bleeding or pelvic pain should also lead a woman to consult with a healthcare professional.

Speaks reminds women that there’s no substitute for a trusted healthcare provider. “We provide different services – more than just contraception,” she said. “We can definitely offer a more expanded selection of contraception than a pharmacy can. Women who are hesitant to go to the doctor should know that birth control can be initiated without having a pelvic exam that they may be apprehensive about.”