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Tennessee is inching toward making birth control pills available with a single visit to a pharmacy.
State lawmakers voted over a year ago to eliminate the requirement that women first see a doctor before getting oral contraceptives. But even though Tennessee law has changed, pharmacies haven't been given the final go-ahead to put it into action.
Health officials say the task of drafting final rules has been complicated.
They'd aimed to have them ready by this summer, but balancing federal regulatory requirements and existing laws means it's not quite as simple as making birth control pills available "over the counter," like aspirin or cold medicine.
"A lot of times, when these bills are passed, they do get the publicity, and it is important that people know about them," says Reggie Dilliard, executive director of the Tennessee Board of Pharmacy. "But we can't get the rules moved much faster than what we're doing right now."
Letting pharmacists dispense oral contraceptives — without receiving a doctor's prescription — has gained widespread support. Medical associations and reproductive rights groups support the move, arguing birth control pills have been proven to be safe, and many countries already allow it.
"It really does introduce a lot more availability and breaks down the barriers of obtaining oral contraception," says Justin Kirby, a pharmacist with Perkins Drug & Gifts in Gallatin. He was part of the legislative team from the Tennessee Pharmacists Association that lobbied lawmakers to change Tennessee law.
Even some opponents of abortion have been supportive, noting that preventing unplanned pregnancies could reduce the number that are terminated.
But federal legislation freeing up pharmacists to dispense birth control has faltered, and the Food and Drug Administration has resisted efforts to make birth control available over the counter.
So even in Tennessee, women will have to answer some questions about their health before they can receive birth control pills at the pharmacy, and they'll have to get clear warnings of potential side effects. Pharmacists will also have to write prescriptions that they'll fill out themselves — mainly so there's a record to be kept on file.
Because of those hurdles, Tennessee is on track to be only the fourth state to allow pharmacists to dispense birth control without a doctor's prescription. California, Oregon and Colorado are the others. Washington state also has a limited program.
It's complicated enough that California spent 18 months writing its rules. And Tennessee could take just as long. Dilliard says the Board of Pharmacy hopes to have rules ready for public comment this fall.
That would put Tennessee on track to make birth control pills available without a doctor's prescription at the end of this year or early next year.
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