oral contraceptive pill

More contraception? At what cost?

New protocol allows Colorado pharmacists to prescribe the pill without patients' physician

Therese Aaker

Access to birth control is about to get a whole lot easier for Colorado at the peril of women’s health, according to Catholic healthcare specialists.

After a bipartisan bill passed last year allowing the boards of medicine, nursing and pharmacy, in conjunction with the state health department, to create protocols that address public health needs, the first initiative to roll out will allow pharmacists to prescribe birth control to patients without their physician.

Simply by filling out a questionnaire, doing a blood pressure test and having a 10-15 minute consultation to ensure the patient is not already pregnant or suffering from other health conditions that would make taking the pill unsafe, oral contraceptives can be prescribed.

The protocol will go into effect sometime this spring once pharmacists are trained, according to the Denver Post. Colorado is the third state, after California and Oregon, to pass this initiative.

Dede Chism, executive director of Bella Natural Women’s Care, a healthcare clinic specializing in women’s health and fertility, stated that this protocol goes against “best practice.”

“Bella Natural Women’s Care takes a more natural and healthy approach…we do not prescribe or refer patients for artificial contraception,” Chism said. “One important reason for this is the many physical and emotional side effects that accompany the use of artificial contraception.”

“Contraceptive medications, whether they be oral or any other form, carry with them side effects that can vary from mild to fatal. Our pharmacist colleagues are truly experts in their field, and provide awesome patient education, but their expertise is not in the day-to-day care of a patient and management of their health circumstances,” Chism added.

Catholic pharmacist Valerie Haas agreed that easier access to the pill could prove to be more harmful to women beyond the moral scope.

“I think it’s horrible, moral issues aside,” said pharmacist Valerie Haas. “I’d never want my daughters to get [birth control] from pharmacists. It needs so much screening and monitoring to prevent serious side effects.”

While the protocol requires pharmacists to be trained, Haas is concerned about what that will look like and if the screening process will be enough to prevent complications from the serious side effects that could be potentially avoided with a physician’s monitoring.

“There are so many conditions to identify ahead of time and that need monitoring during use, and patients won’t know what signs to look out for,” Haas said. “Physicians have always been the gateway to assess side effects to make sure they’re using it safely.

“Honestly, I don’t know how pharmacists will have time…to [screen properly],” Haas added. “It could take 30 to 45 minutes to do it properly, and most pharmacists I know barely have time to go to the bathroom.”

Studies have shown that the pill can have serious side effects, and can increase the risk of breast cancer and blood clotting. Haas said that several serious underlying health issues would need serious screening, as contraceptives can complicate or worsen them if undiagnosed or untreated. Some conditions that would need thorough testing and treatment are depression, diabetes, hypertension, bone mineral density, kidney or liver impairment, lupus and endometriosis.

“Endometriosis is another important thing to know, but if it’s not diagnosed, it could be pre-cancerous, and putting more hormones [in your body] could make it worse and lead to potential cancer,” Haas said.

“I would want to be followed fully by a physician who can evaluate all those things in the office…if I had underlying issues that put me at risk. And I don’t know how a pharmacist will be able to comprehensively handle all of that,” Haas continued.

Lynn Grandon, director of the Respect Life office at the Catholic Charities in the Archdiocese of Denver, agreed that easier access to the pill can have damaging effects on women’s health.

“The more people can easily get it, the more women will see the physical effects of the pill, which are documented,” Grandon said. “I’m interested to see what this training will be for pharmacists.”

Grandon also noted the moral danger of contraception that will continue to damage culture as a result of easier access to the pill.

“It’s not just bad because contraception is bad, but if we look back on what’s happened in our society in the past 50 years, we’ve had serious damage in our own society. All the predictions of Pope Paul VI [in Humanae Vitae, “on human life”] came true, if contraception was introduced,” Grandon said.

According to the Denver Post, pharmacists are not required to participate, including those who have conscience objections, which is great news for Catholic pharmacists. In addition to training, pharmacists will also be required to have liability insurance and inform the patient’s doctor when prescribing birth control. Girls under 18 will not be eligible.

COMING UP: Sensitive locations, not ‘sanctuary’

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DENVER, CO - DECEMBER 11: Msgr. Bernie Schmitz preaches the homily during the announcement of Our Lady of Guadalupe Parish as a diocesan shrine on December 11, 2016, in Denver, Colorado. (Photo by Anya Semenoff/Denver Catholic)

With the election of President Donald Trump, many immigrants are uncertain of their future in America. The situation has ignited a national conversation about immigrants and their legal status.

The term “sanctuary” has been making waves in the headlines recently after Denver immigrant Jeanette Vizguerra sought assistance at a local Unitarian church for fear of being deported. The term itself has largely been adopted by the media to describe cities where immigrants cannot be questioned about their immigration status and locations where immigrants can seek refuge and be safe from arrest.

While the so-called “Muslim ban” has been garnering a lot of media attention, there’s another piece of the conversation that’s equally as pertinent; that of the immigrants who are already living in the U.S.; those who have fled their home country in search of something better, established their lives here — and many of which are of Latino descent.

The fear among many Latinos is still prevalent, as many wonder what will become of their residence here in the U.S. under a Trump presidency.

“For those here today illegally who are seeking legal status, they will have one route and only one route: to return home and apply for re-entry,” President Trump said in an Aug. 31 speech in Phoenix, Ariz.

The law doesn’t give definition to “sanctuary” but instead describes places where immigrants are safe from any sort of enforcement action by U.S. Immigration and Customs Enforcement (ICE) as “sensitive locations.” A 2011 memorandum distributed by ICE outlines that sensitive locations include, but are not limited to: schools, hospitals, churches, synagogues, mosques or other institutions of worship, the site of a funeral, wedding or other public religious ceremony and public demonstrations, such as a rally or march.

The memo states that enforcement actions are prohibited from taking place in any of these locations without prior approval by an ICE supervisor. In this event, supervisors are to “take extra care when assessing whether a planned enforcement action could reasonably be viewed as causing significant disruption to the normal operations of the sensitive location.”

The policy does, however, call for exigent circumstances in which enforcement actions can be carried out without prior approval. These include: matters of national security or terrorism, an imminent risk of death, violence or physical harm to any person or property, the immediate arrest of individual(s) that present an imminent danger to public safety, or an imminent risk of destruction of evidence material to an ongoing criminal case.

Should any of these situations arise, the memo instructs ICE agents to “conduct themselves as discretely as possible, consistency with office and public safety, and make every effort to lift the time at or focused on the sensitive location.”