DC AAP Offers Recommendations

To DC Council on Access to Contraception Legislation

Dr. Krishna Upadhya, Chairperson of the DC AAP Adolescent Health Working Group, testified on behalf of DC AAP in support of Bill 21-707, the Access to Contraceptives Amendment Act of 2016.  Dr. Upadhya is an adolescent health medicine doctor with over 10 years of experience providing contraceptive care to adolescents and young adults in addition to conducting research on the topic.  Dr. Upadhya testified that the bill is a reasonable approach, in combination with other efforts, to expand access to hormonal contraceptives and promote maternal and child health in DC.

Dr. Upadhya explained that clinical encounters with a physician enable patients to receive high-quality comprehensive contraceptive counseling and expanded contraceptive method choices.  However, many patients experience barriers to visiting clinicians in the office either routinely or at particular times when they may be in need of a health care service.  Women who are often most vulnerable, including Non-English speakers and women who are uninsured, are more likely to face these barriers.  Thus, there is a benefit to providing access to contraceptive methods, when feasible and safe, in non-clinical settings.  Dr. Upadhya stressed that because of the limitations on what can be offered through pharmacist access, implementation of the proposed legislation should mandate that pharmacists dispensing contraception also provide high quality, medically accurate information about all FDA approved contraceptive methods along with information about where the methods can be obtained. Additionally, information about the risks of sexually transmitted infections, including HIV, and materials promoting condom use, are also critical and must be made available given the very high rates of these infections in the District.

Finally, Dr. Upadhya emphasized that providing access to contraceptives through pharmacists may be a piece of the strategy to improve maternal and child health in DC, but that it is unlikely to significantly reduce rates of teen births.  For a variety of reasons, it is unlikely that teens will seek care directly from a pharmacist.  In order to promote optimal service for any teens who do, however, it is also critically important that implementation require pharmacies to train their staff and develop policies regarding District laws on adolescents’ right to consent for contraceptive care and governing confidentiality along with other aspects of teen friendly services.