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Over-the-counter birth control bill advances in Iowa House

The bill, which has just passed out of subcommittee, would allow people to buy over-the-counter birth control from a pharmacist.

DES MOINES, Iowa — A bill in the Iowa House that would allow people to buy over-the-counter birth control from a pharmacist has passed out of subcommittee, with hopes to make it past the first legislative funnel. 

Opponents of the legislation have health concerns, while others praise the potential for easier access. 

Some opponents have health concerns while others praise easier access.

“Many women don’t have the time sometimes to get to their physician," said Rep. John Forbes, D-Urbandale, speaking in favor of the bill. 

On the other hand, Maggie DeWitte, the executive director of Pulse Life Advocates, an anti-abortion advocacy organization, says the bill hurts women. 

“You hear so often about these kinds of decisions, especially in the abortion situation, that this should just be between a woman and her doctor," she said. "Well, in this case, we’ve left the doctor out."

DeWitte believes the bill doesn’t include enough doctor oversight. The bill would make it so women must sign off that they’ve had a follow up by month 28. 

Forbes explained that a pharmacist will give the person using birth control paperwork to sign and the patient will check off if they've had a follow-up. They will not need proof from the health care professional that did the follow up for this paperwork. This paperwork is needed in order for the pharmacist to give the patient more birth control. 

“There’s a lot of safety concerns,” DeWitte said.

She pointed to potential side effects such as depression, blood clots, links to breast cancer and more.

According to a 2021 article by UCLA Health, researchers do not yet agree on whether or not there's a link between breast cancer and the pill. The pill does, however, slightly increase your chance of getting cervical cancer. On the other hand, it could significantly reduce your risk of getting ovarian cancer. 

A 2018 article on the National Cancer Institute's website states that, while there isn't much concrete proof of the connection between oral contraceptives and cancer, there has been consistent evidence that the pill increases the risks of breast and cervical cancers while decreasing the risks of some other cancers such as ovarian and endometrial cancer.

When asked about health concerns, Forbes pointed to the screening process the bill would require.

“The pharmacist would have a screening questionnaire provided to each patient and they would sit down and talk to them about their medical history, take their blood pressure to make sure their blood pressure is in the right range,” he said.

Forbes said that the screening process will allow pharmacists to weed out bad candidates. He added that pharmacists are well-trained with drug therapy. There will also be a training program for pharmacists who offer birth control. 

Another layer to DeWitte's argument against the bill ties in with abortion. She believes that life begins at fertilization. If birth control doesn't work as intended, an egg can be fertilized. However, due to how the pill impacts the body, the fertilized egg will not (or will rarely) attach. Because of this, that fertilized egg will not be able to grow into a fetus. Forbes confirmed that this is a medically accurate description of the process. Because DeWitte believes that life begins at fertilization, she sees this as an abortion. 

Some people have voiced concerns over how birth control being available over-the-counter could impact costs. Forbes believes that won't change.

"When it goes over-the-counter and a pharmacist will be dispensing this out of their pharmacies, pharmacists will then be able to bill their insurance company for that service and so, just like right now, most women don't pay any copay for birth control pills," he said. "The same thing will hold true when a pharmacist dispenses and prescribes oral contraceptives to a woman."

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