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: Why icons still matter to a modern world

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Icons have existed from the time of the early Church and grew in popularity over the years as an aid in prayer and worship — but today, icons are often seen as irrelevant to our modern world because of their perceived rigidity and austerity.

But it hasn’t died out, and there’s a reason.

In Denver, instructor Laurence Pierson, a former nun in the Community of Beatitudes, teaches a course at the Botanic Gardens called “Sacred Doorways — Byzantine Iconography,” which is the only icon painting class in the greater Denver metro.

Pierson attributes the long-surviving tradition of icons to the same reason the Church still exists.

“Tradition has great value, and if it’s an art that’s survived so many centuries, that’s because there is a great value to it, and it’s not only the tradition, it’s that mainly, it’s rooted in the Gospel,” Pierson said.

In an article called “Sacred Icons,” painter Aidan Hart quotes John of Damascus, who said of icons, “What the written Word proclaims through letters, iconography proclaims and presents through colors.”

Laurence Pierson, left, is a former nun of the Community of the Beatitudes who has been teaching an iconography class at Denver Botanic Gardens called “Sacred Doorways.” It is the only icon painting class in the greater Denver metro area. (Photo provided)

It is the same story of the Gospel, presented in art rather than word, and as the Gospel is timeless, so is the art of icons. And while they may look austere, that’s not something to be afraid of, nor is it irrelevant in our modern time.

“Even though an icon might look austere, it actually drives us beyond superficial emotions — they want us to go deeper. It’s a deep joy,” Pierson said. “I think you have to be quiet and go deeper. In the spiritual life, our ascetic aspect doesn’t have to be forgotten, and sometimes there is an ascetic aspect, and our human condition needs to be redeemed.”

“It’s a medium that has to be rediscovered, and there is so much potential,” Pierson added.

Sacred doorways and symbols

The deep spirituality of icons is part of what has preserved them throughout the roughly 2000 years that they’ve been around. Hart explains that icons are “not just pictures to look at, but are a door to heaven, a way of meeting those who dwell there.”

Hence the name of Denver’s class, “Sacred Doorways.” The material use of the paintings are a way for us to pass through the material world and into a knowing of the holy people depicted. This is just the tip of the spiritual meaning of icons.

The specific look of the icons: the elongated nose, the wide eyes, the dimensions and perspectives, are all intensely symbolic.

“Icons do not depict outward appearances, but reflect something of invisible, spiritual realities. In fact, all good art does this,” Hart said.

“An artist isn’t just someone who puts colors [on a canvas],” Pierson said. “An artist reveals the reality of this world, which sometimes isn’t possible to see. And icon painting is revealing this invisible reality and making it visible with lines and colors.”

Icons do not depict outward appearances, but reflect something of invisible, spiritual realities. In fact, all good art does this.”

So what are icons revealing through their symbols?

Here are just a few insights from Hart:

– Inverse perspective: “There is a number of perspective systems used in icons. With inverse perspective, the lines converge on us, the viewers. This serves to include us in the action depicted,” Hart said. “A sacred event in the past is still acting on us today, ‘Today Christ is risen.’”

– Flatness: “It helps us pass through the icon to the person and events depicted. The aim…is not to replace the subject depicted, but to bring us into living relationship with them,” Hart said.

– Anatomy: “The eyes and ears of people are often enlarged, and the nose elongated. This is to show that the saint is someone who contemplates God, who listens to him, who smells the fragrance of Paradise,” Hart said.

The spiritual process

Pierson has been painting icons for 25 years and teaching for 18. Following the rich tradition of the painting style is the first step of entering into the “spiritual journey” of painting an icon, Pierson said.

“It’s very important for me to get rooted in Byzantine tradition, especially because it’s an art that comes from the Eastern world,” Pierson said. “You have to be very careful not to distort ancient tradition but also find a way to speak to our modern world, so it’s a very delicate balance. For me, that’s crucial, to find this balance.”

“[Painting] has to be a solitary experience because you have to pray, but for me, it’s important to be anchored in a community and liturgical life,” Pierson said.

Pierson, who is commissioned to paint icons for the community often, begins with research and prayer, both to whom the icon is depicting and for the person who will receive the painting. Then the painting begins, which is an intense, multi-layered process.

The art of painting icons is far more than just a creative process; it’s a deeper spiritual journey that requires a lot of prayer, Pierson says. (Photo provided)

First, a binder, which is what the pigment adheres to in order to stay on a board, is created. The binder consists of egg yolk mixed with an equal part of water. This is mixed with the paint pigment and a few drops of water, creating the egg tempera medium with which icons are traditionally painted.

Next, guiding lines are traced into a gesso-covered wooden board and then engraved with a tool. Then, paint is added, layer by layer, beginning with dark colors and finishing with lighter colors. “It is as though the iconographer begins with darkness and death, and ends with light and resurrection,” Hart said.

The final stage is writing the saint’s name; then the icon is blessed by a priest and venerated. The working time varies, but it is a very long process, taking up to a year.

Revealing a Presence

The act of painting is something Pierson discovered she needs for her life to flourish — “essential,” even.

With icon painting, it “combines art and the vertical connection to God,” Pierson said.

And the connection to God is experienced deeply throughout the painting journey.“There is a journey — there’s a time you feel discouraged or bored. Even though you don’t feel it, you live by faith, trusting what you do has meaning and will bear fruit,” Pierson said. “With iconography, there is a Presence.”

“This whole painting journey teaches you about yourself, it takes patience — it takes time. You cannot finish an icon painting in a few hours. You have to trust the process. You have to trust someone else is inspiring you, even though it might not perfect. It’s all very like our spiritual life. It teaches us all that in a very practical way,” she added.