Some Indiana lawmakers and health care professionals are continuing calls for better access to birth control, less than a month before the state’s near-total abortion ban takes effect.
After days of debate and testimony, state legislators passed Senate Bill 1 during the special session that ended earlier this month. It prohibits abortions in most cases, with exceptions only to save the life of the pregnant patient, if there are fatal fetal anomalies, or in cases of rape or incest up to 10 weeks.
Democratic state Rep. Rita Fleming said increasing access to birth control can help reduce the number of people seeking abortions. Since taking office in 2018, she’s pushed for measures that would allow pharmacists to prescribe certain types of contraceptives, without prior approval from a health care provider.
“I think this is a very pro-life legislation,” said Fleming, a retired OB-GYN from Jeffersonville. “If you believe in trying to decrease abortions, this is one…very effective way that you can do it.”
Most recently, Fleming proposed an amendment to a spending bill during the special session. It gained bipartisan support, but failed in the House by one vote, 48-49.
Current Indiana law prevents pharmacists from prescribing birth control. Instead, Hoosiers must get a prescription from their provider first.
Fleming’s amendment would have cut out that step by letting people access birth control directly from a pharmacy.
It would have allowed pharmacists to prescribe hormonal birth control pills and patches to people 18 and over. Pharmacists would complete a training program, screen patients for medication safety and refer them to a health care provider for a follow-up visit.
“Pharmacists are very well educated in this area, and they have extensive knowledge of medications, side effects, contraindications,” Fleming said.
Nearly half of U.S. states have already enacted similar laws, according to the nonprofit Power to Decide.
But in Indiana’s Republican-controlled legislature, attempts to increase access through pharmacies have gained little traction, with bills often not making it past the committee stage.
Fleming isn’t the only lawmaker who’s proposed the measure.
Republican state Sen. Sue Glick, of LaGrange, offered a similar bill during the regular session earlier this year and an amendment to the abortion bill, which she authored, during the special session. Neither received a hearing.
Fleming said limited access to providers can make it difficult for people to get birth control under the current protocol, especially in rural parts of the state. She said a low-barrier pharmacy option may also be better for people with substance use disorder.
Power to Decide, which aims to reduce unintended pregnancies, reports more than 428,000 Indiana women with low income live in counties with limited access to a health center that offers the full range of birth control options.
“It would be ideal if we had enough doctors and if doctors’ offices were open in the evening and on weekends and on holidays, because most of the reproductive-age women in this state, they work. And most of them work a day job,” Fleming said.
Several lawmakers spoke against Fleming’s most recent amendment. They argued that though it’s worth considering, the issue is complex and needs further discussion.
Republican state Rep. Brad Barrett, of Richmond, was among those who voted no.
“It’s a timely, timely subject,” Barret said at a hearing. “But I also think that this involves a lot more than it appears on the surface. I mean, there's scope of practice issues, there's liability issues. When we've scratched the surface on this before, it's only revealed deeper issues.”
Sen. Glick said in a message to WFPL News that she expects legislation to increase birth control access to be introduced again during the next session, which starts in January. She said she’s hopeful it will pass, when there’s more time for discussion.
The anti-abortion group Indiana Right To Life has lobbied against allowing pharmacists to prescribe birth control in recent correspondence with lawmakers.
WFPL News obtained a statement the group sent to some Indiana Republicans ahead of the special session that outlined 11 positions, including opposition to over-the-counter birth control. The group wrote that birth control should only be dispensed after a patient sees “a medical professional for individual counseling and assessment of risks and benefits of all forms of contraception.”
“The risks associated with birth control can be significant for some patients, depending on a variety of factors,” the statement read, in part. “It’s important that a woman taking drugs sees a doctor who knows the risks associated with them and also has access to a patient’s medical charts.”
Indiana Right To Life’s statement also included concerns that President Joe Biden’s administration will “creatively redefine abortion drugs, clearly intended to cause abortions, as birth control.”
Indiana Right to Life did not respond to a request for comment from WFPL News.
Veronica Vernon, assistant professor of Pharmacy Practice at Butler University, said pharmacists are qualified to prescribe birth control. She said they’re already responsible for ensuring patient safety with other medications.
“Your pharmacist is making sure that that prescription doesn't interact with any of the other medications or even herbal supplements that you're taking,” she said. “We ask about over-the-counter medications you're using, we ask about what chronic conditions that you may have.”
Vernon said now that more states are restricting abortion, lawmakers need to step up to ensure people have other options, including birth control.
Indiana legislators have not passed anything to increase direct access to birth control. But they did approve a measure during the special session to allow local health departments and other providers to receive grants to assist people who are seeking contraceptives.
If people can’t access abortions, Vernon said they should have ways to reduce the need for them.
“Increasing access to contraception has been shown to reduce the rate of abortions,” she said. “There's several other things that we need to get in place…related to supporting women through the whole spectrum of reproductive health care.”
Vernon said the legislation “is just one piece of the puzzle, so to speak, but an incredibly important piece.”
