that would be awesome.
i wish BC was over the counter in the US already.

that would be awesome.
i wish BC was over the counter in the US already.

A pretty good idea, possibly... It'll be interesting to see more discussion of this.

TMI about England's assessment process at pharmacies... I lived in England and have frequent yeast infections that can only be treated with 7 day cream. When I was in England 7 day was not available, only 3 day. So I had to use two. The cream is available without a prescription, but you have to talk to a pharmacist in order to make a purchase. So during the months that I had an issue I had to go to two separate pharmacies and convince two separate pharmacists that I was
1. certain it was yeast, and
2. knew how to use the medicine.

Given that I was already in an uncomfortable state, this was a huge imposition. It also felt paternalistic. I should have been able to walk into Boots and clear the shelves of yeast cream if I wanted to, and the requirement that a pharmacist approve my treatment was humiliating, annoying, and patronizing.

/TMI

Extrapolating my yeast experience to birth control... do we really want pharmacists functioning as gatekeepers for birth control, given the issues that are already arising with pharmacists refusing to provide prescriptions based upon their personal beliefs? It might be an issue.

Oh, great. More potential victims with which the parasites...uh, I mean lawyers, can prey and enrich themselves.

Remove the financial & legal liability from the pharmacists and drug companies or the prescriptions will dry up real quick out of fear for repercussions.

Or maybe the UK is not a civil lawsuit wild west, like here in the states.

Oh, great. More potential victims with which the parasites...uh, I mean lawyers, can prey and enrich themselves.

Remove the financial & legal liability from the pharmacists and drug companies or the prescriptions will dry up real quick out of fear for repercussions.

Or maybe the UK is not a civil lawsuit wild west, like here in the states.

It seems to me that this is only adding an option, and thus increasing access.

If you could ONLY get bc through a pharmacist, that would be another story.

As an aside, the bc situation in the US is infuriating - in DC, I spent $50 per pack! Now THAT is horrible access.

It seems to me that this is only adding an option, and thus increasing access.

If you could ONLY get bc through a pharmacist, that would be another story.

As an aside, the bc situation in the US is infuriating - in DC, I spent $50 per pack! Now THAT is horrible access.

I wonder if UK women will be faced with a price increase if BC eventually becomes totally OTC. In trying to research Plan B price jumps, I've seen frequent mention of the move to OTC.

It seems to me that this is only adding an option, and thus increasing access.

If you could ONLY get bc through a pharmacist, that would be another story.

As an aside, the bc situation in the US is infuriating - in DC, I spent $50 per pack! Now THAT is horrible access.

I think it sounds pretty cool -- as long as you can have the same sorts of consultations with the pharmacist about risks, smoking, side effects, etc. My worry: the only reason I ever remember to go in to get my yearly pelvic is that I run out of BC refills. If this problem isn't just a silly-me thing, it could mean that women aren't getting the pap they need every year.

More TMI (and OT): sgzax -- maybe you've heard of every cure in the world for your yeast problem, but have you tried a good strong daily probiotic? I went from once-a-month infections to maybe once a year, always coinciding with taking antibiotics. If you haven't tried it and want more info, let me know.

locomotivebreath1901: Lay off the lawyers. Being one myself, I know that for every bloodsucker out there taking advantage of clients and the system, there's another one who is advocating for women's rights, the indigent, the falsely accused, etc, and yes, suing doctors on behalf of people who were seriously harmed. I agree that some states need to reform their tort law, but removing all liability for pharmicists and doctors would leave patients who are harmed by the occasional bad pharmacist or doctor completely without protection. Every profession has its good and its bad members - there's a balance out there somewhere, I'm sure.

Having said that, I have great insurance and still have to pay $35/month for my BC because it's not considered a "preferred" brand and no generic exists yet. I agree with Ruby that unless prices come down, access will continue to be impeded by the price.

"the only reason I ever remember to go in to get my yearly pelvic is that I run out of BC refills"

I always hated how my BC felt held hostage to me going to the yearly exam... wait I still dislike this.

*Delurks.* I am a relatively new feminist - or, at least, I have only labeled myself as one for a little while.(Hugo recruited me when I took his Women's Studies class in the spring of 2006). I am still learning a lot about feminist theory, how it applies to Generation Y, etc. The more I read Feministing and other feminist blogs, the more I realize how feminist I truly am. It's a learning experience. :-)

Anyway, I also wanted to comment about the birth control issue. I never realized how easy it was for me to obtain a perscription for birth control. I live in a relatively progressive area (Los Angeles) and my dad has excellent health care. However, after I read your post, I was reminded that a lot of women have trouble getting birth control -- and this should stop! I am totally with England on this one.

-Mermade

*Delurks.* I am a relatively new feminist - or, at least, I have only labeled myself as one for a little while.(Hugo recruited me when I took his Women's Studies class in the spring of 2006). I am still learning a lot about feminist theory, how it applies to Generation Y, etc. The more I read Feministing and other feminist blogs, the more I realize how feminist I truly am. It's a learning experience. :-)

Anyway, I also wanted to comment about the birth control issue. I never realized how easy it was for me to obtain a perscription for birth control. I live in a relatively progressive area (Los Angeles) and my dad has excellent health care. However, after I read your post, I was reminded that a lot of women have trouble getting birth control -- and this should stop! I am totally with England on this one.

-Mermade

*Delurks.* I am a relatively new feminist - or, at least, I have only labeled myself as one for a little while. (Hugo Schwyzer recruited me when I took his Women's Studies class in the spring of 2006). I am still learning a lot about feminist theory, how it applies to Generation Y, etc. The more I read Feministing and other feminist blogs, the more I realize how feminist I truly am. It's a learning experience.

I also wanted to comment about the birth control issue. I never realized how easy it was for me to obtain a prescription for birth control. I live in a relatively progressive area (Los Angeles) and my dad has excellent health care. However, after I read your post, I was reminded that a lot of women have trouble getting birth control -- and this should stop! I am totally with England on this one.

-Mermade

The only issue I have with this is that women won't be going in for their yearly Pap. For many women (including most of my friends) this is the only regular checkup they have every year and the only real chance they get to discuss things with a doctor. I don't think a pharmacist is qualified to determine what kind of (or even if) BC would be right for each woman. The only way I would support this is that the initial prescription would have to come from a doctor.

AHH! Sorry about that! It's my first time commenting here. I am sorry about posting that three times.

I am all for more access to birth control. It should be free! However, I think it's important for women to be in the care of a doctor when taking any perscription.

I was a counselor in an abortion clinic and the doctor at the clinic (obviously pro choice) was having a fit that plan B was going over the counter. She said that the medicine in birth control can be very, very dangerous to women who are not supposed to be taking it-- i.e. those over 35, those who smoke, those with vascular damage or heart problems of any kind. it raises your blood pressure and can cause a heart attack.

now, of course many women don't have insurance or the money to go to the doctor-- that is a problem with the health care system in general which stands in the way of proper care for low income people, regardless of gender but especially women. It's also hard to swallow that men can walk on the moon but women still don't have adequate and safe birth control (i.e. pills that don't have such a risk of heart attack.) However, i would hate to see women being able to access BC over the counter, then having major complications because they didn't realize they were at risk.

I am all for more access to birth control. It should be free! However, I think it's important for women to be in the care of a doctor when taking any perscription.

I was a counselor in an abortion clinic and the doctor at the clinic (obviously pro choice) was having a fit that plan B was going over the counter. She said that the medicine in birth control can be very, very dangerous to women who are not supposed to be taking it-- i.e. those over 35, those who smoke, those with vascular damage or heart problems of any kind. it raises your blood pressure and can cause a heart attack.

now, of course many women don't have insurance or the money to go to the doctor-- that is a problem with the health care system in general which stands in the way of proper care for low income people, regardless of gender but especially women. It's also hard to swallow that men can walk on the moon but women still don't have adequate and safe birth control (i.e. pills that don't have such a risk of heart attack.) However, i would hate to see women being able to access BC over the counter, then having major complications because they didn't realize they were at risk.

I am all for more access to birth control. It should be free! However, I think it's important for women to be in the care of a doctor when taking any prescription.

I was a counselor in an abortion clinic and the doctor at the clinic (obviously pro choice) was having a fit that plan B was going over the counter. She said that the medicine in birth control can be very, very dangerous to women who are not supposed to be taking it-- i.e. those over 35, those who smoke, those with vascular damage or heart problems of any kind. it raises your blood pressure and can cause a heart attack.

now, of course many women don't have insurance or the money to go to the doctor-- that is a problem with the health care system in general which stands in the way of proper care for low income people, regardless of gender but especially women. It's also hard to swallow that men can walk on the moon but women still don't have adequate and safe birth control (i.e. pills that don't have such a risk of heart attack.) However, i would hate to see women being able to access BC over the counter, then having major complications because they didn't realize they were at risk.

My worry: the only reason I ever remember to go in to get my yearly pelvic is that I run out of BC refills. If this problem isn't just a silly-me thing, it could mean that women aren't getting the pap they need every year.

and

The only issue I have with this is that women won't be going in for their yearly Pap.

I share the concern about this, and I think someone else touches on it in being held ransom for BC pills.

When I was younger (probably up until my lower-to-mid 20s), this was the ONLY reason I went for my yearly.

I had no idea, really, what pelvics or paps checked for other than general "abnormality," and even then, I had no idea what that "abnormality" might mean (often times CANCER, which I was diagnosed with at 26.)

The sad state of the US is that we are not open about sexuality or sexual education. I think pap smears and the importance of them have finally started being discussed more openly due to the HPV vaccine.

I just really have mixed feelings about this. I know that, on the one hand, so many women (that I know) don't get on BC even though they want to b/c they don't want to deal with having a yearly exam, and are too embarrassed/ashamed /don't like the idea of someone looking at their cooter. I am talking GROWN ASS WOMEN in their 40s, as well as teens and young women.

I would be for OTC or even consulting with a pharmacist if I felt like society in general did a really really really good job about being open about sexual health by pounding the "get your yearly pap smear and pelvic, seriously, doctor's do not judge you and don't care what it looks like" into the brain.

I am all for more access to birth control. It should be free! However, I think it's important for women to be in the care of a doctor when taking any prescription.

I was a counselor in an abortion clinic and the doctor at the clinic (obviously pro choice) was having a fit that plan B was going over the counter. She said that the medicine in birth control (the same as that in plan B) can be very, very dangerous to women who are not supposed to be taking it-- i.e. those over 35, those who smoke, those with vascular damage or heart problems of any kind. it raises your blood pressure and can cause a heart attack.

now, of course many women don't have insurance or the money to go to the doctor-- that is a problem with the health care system in general which stands in the way of proper care for low income people, regardless of gender but especially women. It's also hard to swallow that men can walk on the moon but women still don't have adequate and safe birth control (i.e. pills that don't have such a risk of heart attack.) However, i would hate to see women being able to access BC over the counter, only to have major complications because they didn't realize they were at risk.

Mermade, I think something is up with the site, it always gives me an error when I post for the past week or so (but the post goes up anyway so I reload later). Site admins: please fix!! (Maybe you already are sorry if someone already mentioned this).

Anyway I think it is very important for women to get their pap and I don't skip mine (ok maybe I get it every 14-15 months...), but I don't think that implying to women "if you are having sex you must get the pap or you don't get the pills!" is quite... right... Trust Women, right? None of my dad's friends lecture him on only going to the Dr. every 5 years.

Oh and I just looked at my 'script ordering thing online and the damn stuff (Seasonique) would cost 140/91 day supply. WTF? How hard is it to make this stuff that it costs that much!!! And allergy medicine is $200/90 days!!!

Ye gods, why don't we have some sensible universal plan for this shit to prevent the overcharging.

*sorry for rambling, but so many things are just... gah!

OTC should be standard. If people (like me) want to risk cancer rather than submit to spreading their legs for a paternalistic medical industry, they should have that CHOICE. Remember choice? It goes beyond getting access to health care to refusing it too.

Holding pills hostage to a pelvic exam and pap is metaphoric medical rape.

I think I'd rather see better access to good quality affordable medical care rather than OTC BCPs.

During one visit to get screened for birth control pills, I expressed an interest in going on the pills nonstop because of unbearable periods. The nurse promptly said "Honey, periods like that aren't normal. You need to get checked out."

Lo and behold, I got checked out and I it turned out that I have Endometriosis, a condition that causes pelvic pain and infertility and can be aggravated by estrogen supplementation--you know, like they put in most birth control pills?

Birth control pills are nifty things and are a wonderful tool for health and empowerment, but they're not exactly the medical equivalent of tictacs.

I think I'd rather see better access to good quality affordable medical care rather than OTC BCPs.

During one visit to get screened for birth control pills, I expressed an interest in going on the pills nonstop because of unbearable periods. The nurse promptly said "Honey, periods like that aren't normal. You need to get checked out."

Lo and behold, I got checked out and I it turned out that I have Endometriosis, a condition that causes pelvic pain and infertility and can be aggravated by estrogen supplementation--you know, like they put in most birth control pills?

Birth control pills are nifty things and are a wonderful tool for health and empowerment, but they're not exactly the medical equivalent of tictacs.

Exactly geeky. Your example about no-one reminding your dad to go to the Dr is much more reasoned than my outburst, but I do resent the overmedicalizing and infantalizing of women in our culture.

Just to clarify; there's no issue with a price rise here. While a lot of people in the UK do pay a standard charge of £6.85 per item on a prescription, contraceptives are completely free. People in Wales do not pay prescription charges and they're about to be phased out in Scotland.

The title of this post is a little misleading--it's not really over the counter if they have to see a nurse, is it?
And while I'm all for increased access to birth control, I'm against it ever being truly over the counter. If you have high blood pressure or other health problems it can be dangerous.

"Holding pills hostage to a pelvic exam and pap is metaphoric medical rape."

I'm sorry, but that is just ridiculous. Some female cancers are estrogen receptive, which means that if you have breast, ovarian, or uterine cancer your pills can make it worse. So by getting those exams, you are making sure it's safe to have the pills in the first place.
That said, we have a consultation in our clinic that allows you to get pills with out an exam, but you have to be getting the exam at least every couple of years or so and you can't have had any lumps or problems.

Should the government set a limit on what can be charged for a medicine, birth control or anything else? Just what is "overcharging"?

If you don't want the medical solution, don't buy it. You might be just as safe and save money by counting days and using condoms, and then Plan B when a condom breaks.

Birth control pills are nifty things and are a wonderful tool for health and empowerment, but they're not exactly the medical equivalent of tictacs.

Excellent point. Just because they're safe for most folks when used as directed doesn't mean they're safe enough without some medical gatekeeping.

I lived in the UK for 2 years. Getting BC seemed Really easy. It's FREE to go to the docter who you tell you want BC. He says, OK. you go to the pharmacy with your prescription and they hand you BC without you paying anything.

I guess that this would clear up doctors time for other issues, but it was so easy to begin with I don't know how this will affect public usage.

I lived in the UK for 2 years. Getting BC seemed Really easy. It's FREE to go to the docter who you tell you want BC. He says, OK. you go to the pharmacy with your prescription and they hand you BC without you paying anything.

I guess that this would clear up doctors time for other issues, but it was so easy to begin with I don't know how this will affect public usage.

I love the plans. I work at a pharmacy and we get a couple of people each day asking for the morning after pill. We arrange for them to have a talk with the pharmacist, they fill out forms and their suitability for EC is determined, and the new plans will have the same happen for the contraceptive pill. People requesting it will have their blood pressure taken, questions about their family health history will be asked and the relevant forms will be filled out - it'll just be easier to see someone because no appointment is required.
Of course, there are the objectors - one person said that they 'might as well put the pills in jars and hand them out at schools' because pharmacists will be able to give the pill to underage girls without parental permission if they think they are responsible enough to use them, at minimum risk of developing side-effects and (perhaps) unable to use other forms of contraception - in other words, pharmacist's discretion. Which is in a similar vein to saying the HPV vaccine will make people promiscuous - if the girls are already having sex, then withholding the pill won't exactly stop them, will it?

I love the plans. I work at a pharmacy and we get a couple of people each day asking for the morning after pill. We arrange for them to have a talk with the pharmacist, they fill out forms and their suitability for EC is determined, and the new plans will have the same happen for the contraceptive pill. People requesting it will have their blood pressure taken, questions about their family health history will be asked and the relevant forms will be filled out - it'll just be easier to see someone because no appointment is required.
Of course, there are the objectors - one person said that they 'might as well put the pills in jars and hand them out at schools' because pharmacists will be able to give the pill to underage girls without parental permission if they think they are responsible enough to use them, at minimum risk of developing side-effects and (perhaps) unable to use other forms of contraception - in other words, pharmacist's discretion. Which is in a similar vein to saying the HPV vaccine will make people promiscuous - if the girls are already having sex, then withholding the pill won't exactly stop them, will it?

"So by getting those exams, you are making sure it's safe to have the pills in the first place."
Theoretically: BC becomes OTC. Painkillers, some allergy medicine, fever reducers, etc are also all OTC. BC may kill me with cancer if I don't know any better and don't get my checkups. Tylenol may kill me if I don't know that taking tylenol and having alcohol could annihilate my liver.
A nice reminder "please always get your yearly exam, these pills may cause reactions in your body such as 1, 2, 3, and cancer. Should not be used by smokers as can cause heart attacks" would work. This is not a "medicine" for a "disease" like penicillan, it's an anti-fertility treatment.

So warnings kind of like the MAOI inhibitor warnings and the "do not operate heavy machinery or drive" warnings would be in order. But I don't think women need protection from themselves. I trust women to read the label, to ask the pharmacy questions, and to attempt to act in their own best interest. Please don't protect me from myself.

Verite,

Just because it makes you uncomfortable to admit that not everyone wants to admit a speculum or an MD's hand into their vagina and trade that unwanted access to their body for a medication to prevent pregnancy, does not make it "ridiculous."

You ignore that I UNDERSTAND the contraindications of BC. I'm with geeky (again). Don't patronize me.

Maybe it's not invasive or problematic that it's coercive to you but it is to me.

I see from rereading your comment that you're in the medical business. It's hard to examine your assumptions when it's that close.

Verite:
In my experience, holding my pills hostage to a pelvic exam felt like REAL rape, not just metaphoric. I was just 18 when I got my prescription this summer. I told my gynecologist that I had never been sexually active, and I have extremely low blood pressure, and I’d get checked for cancer another time when I felt more comfortable, because I hadn’t known a pelvic test/pap smear would be expected and I wasn’t psychologically prepared. She made me have the pelvic exam anyway. She said she’d stop if I said it hurt, and it did hurt, she stretched out my hymen and it hurt a lot, and I said so, but she didn’t stop, os eventually I stopped telling her to, and afterwards I couldn’t stop crying. I almost got in an accident three times driving home because I was crying so hard. I’ve never felt more violated in my life.
I should have had the option of saying no. Or rather, when I said no, it should have meant no. It is flat-out wrong that women are forced to get exams for their birth control pills.

I live in the US and get my birth control prescription from a nurse -- well, certified nurse midwife, but she's considered a nurse for purposes of prescription. I've never needed an obgyn to be involved in signing off on it or examining me. I have had the pelvic exam and pap smear each time, though.

@Eloraine -- that's horrible, and I'd recommend changing doctors and explaining to the former one exactly why you are doing so. No doctor should ignore physical pain in their patients; I'll admit pap smears aren't the most comfortable procedure, but they shouldn't hurt THAT much.

I have to say, as an American who lived in the UK last year, that they have a pretty kickass birth control system. Not only are pills heavily subsidized, some prescriptions cost as little as a pound a month, but I got a very new fangled form that has only been approved in the US for about year, called implanon. It's a small plastic, progesterone only arm implant that works for three years. It costs hundreds over here, but was completely free with my student health. Now I don't have to take a daily pill or worry at all for three years, and I will definitely get another one when this one runs out.

I have to say, as an American who lived in the UK last year, that they have a pretty kickass birth control system. Not only are pills heavily subsidized, some prescriptions cost as little as a pound a month, but I got a very new fangled form that has only been approved in the US for about year, called implanon. It's a small plastic, progesterone only arm implant that works for three years. It costs hundreds over here, but was completely free with my student health. Now I don't have to take a daily pill or worry at all for three years, and I will definitely get another one when this one runs out.

Another concern about bc being prescription only and requiring the yearly checkup is the effect it has on students, who may or may not be able to make it to an insurance-covered (i.e. affordable) doctor when their prescriptions expire.

I had that experience this summer, and between the travel issues and scheduling, it took me two months to get ahold of a refill, which is just absurd. Things would have been much simpler if bc was over the counter. It's not like the risks are any greater than, say, cigarettes, and we trust people to make independent decisions about them all the time, no doctor necessary.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

I really like the idea of OTC BC. So many people do not have the insurance to go to a doctor. My fear then would be, are they going to hike up the price for OTC?

And I definitely agree about the holding your pills hostage/medical rape. I thought patients had the right to decline certain treatments and proceedures. I mean I see how and why they need to do the exams, especially if you are on BC and having sex, etc. But to hold the pills hostage is bullshit. I feel so sad for Eloraine's story. What the fuck.

Oh dear. Oops. Hitting refresh when your internet connection is poor is a bad idea. I'm so sorry guys for the zillion posts! :(

Oh dear. Oops. Hitting refresh when your internet connection is poor is a bad idea. I'm so sorry guys for the zillion posts! :(

Oh dear. Oops. Hitting refresh when your internet connection is poor is a bad idea. I'm so sorry guys for the zillion posts! :(

I keep thinking about it. This proposal is in the UK.

I would probably be more in favor of it in the US, or more likely to look on it favorably in the US, where you could make an argument that paying for a doctor's appointment represents a serious financial hardship and that in some circumstances, the risk of complications and contraindications for BCPs might not be as great as not having access to birth control at all.

But this is being suggested in a country with socialized medicine, so I must admit that I wonder if this is truly a decision being put forth in the interest of women's health or if it's a cost cutting measure.

Realistically, if an annual exam is no longer required for birth control, isn't that a great excuse to cut back on women's healthcare services?

In this country, some insurance companies will pay for ONE annual visit to the OB/GYNs. Wouldn't it be a boon to those insurance companies if they could declare covering that exam to be frivolous, a non-covered 'extra' expense?

Well, by the same token, declaring annual OB/GYN exams no longer necessary, a country with socialized medicine could make the argument that they could cut down on the number of OB/GYNs they choose to employ.

I'm just curious as to what direction this will take, if any.

Akeeyu, I see what you're saying, but I b/c the exam is important for more reasons than just clearing a woman for birth control, I don't think they could ever deem it unnecessary. It screens you for all sorts of cancers and other diseases. It can screen you for pregnancy, or pregnancy related conditions, menstrual issues...so much stuff is checked out during that one exam, and not all of it has to do with preventing pregnancy. Most of it, in fact, has more to do with making sure your body is functioning normally and that you aren't sick.

I think, if handled correctly, this would be a great opportunity for doctors in the UK to educate women why their annuals are important, and how they are connected to their health, and not just to birth control. If this were explained better, maybe they wouldn't have to hold the pills for ransom in the first place. B/c of health issues that were discovered as a result of my having regular OB/GYN check-ups, I rather look forward to my visits. Not that speculums are tons of fun, but I like knowing that I'm healthy, and I like having an expert confirm that for me.

My understanding is, though, that annual exams are important in their own right, and they're only tied to BC prescriptions because that's an excellent way to force women to get them every year. If BC was available OTC, the annual exams would still be necessary, but in the same way going to the dentist is necessary-- you should do it every year, but it's your own business and no one will deprive you of needed medicine if you don't.

I don't think insurance companies or the UK government could possibly make the argument that if BC is OTC, annual exams aren't necessary, since the purpose of the exam is to detect cervical cancer, not just to OK you for another year of BC. Especially since the early detection saves so many lives.

So, while I see your point, I'm not really worried, and I kinda wish it was OTC here. While I intellectually accept that eventually I have to get a pap smear, I don't think I could stand it if it was forced on me like the pelvic exam. I'm still figuring out how to deal with it, but a big thing is that it has to be within my control next time, which means I need to be able to choose when it happens, and it has to be to look for cancer, and not to get something I need.
I think it's paternalistic and inappropriate to impose something like this, even if it is clearly for my health benefit, because...my health is my business. If I want to endanger it for now, that's my choice.
(By the way, thanks for being supportive, guys; I kind of hadn't told anyone yet and it feels better having it out there.)

In Malaysia, BC and EC are OTC. (lol, lots of Cs) This is very surprising given that Malaysia is shockingly conservative in most other aspects and that sex is usually seen as sinful when it's not in marriage (there are people saying that condoms shouldn't be distributed freely because it would lead to less blood donations!!). When I asked my doctor for advice, he was a bit puzzled that I'd be asking because no one asks their doctor anymore, they just go and buy it! You could ask if you wanted, but it wasn't required.

In Australia you do need a prescription for BC, but not for EC. You do have to fill in a form (which declares that the pharmacist has explained to you how to take the meds and have given you an info sheet) but they don't harass you for it. It was a lifesaver for me.

I'm on the pill for period pain and I have never had a pelvic exam or a pap test. I'm a virgin and all the doctors I have seen said they weren't going to do those tests. Even if I were sexually active I get the feeling that they would respect my decisions and just make a suggestion that I have an exam ect.

I'm on the pill for period pain and I have never had a pelvic exam or a pap test. I'm a virgin and all the doctors I have seen said they weren't going to do those tests. Even if I were sexually active I get the feeling that they would respect my decisions and just make a suggestion that I have an exam ect.

Just a bit of clarification about access to BC in the UK. It is free, you can walk into your doctor's and ask for condoms, and birth control you request that your surgery can provide is without charge.

Smear tests are also free, but they are not mandatory. You get called for your first pap at 25, regardless of whether or not you are on the pill. I was on it for 5 years from the age of 15-20 without once having a pelvic exam, as I am under 25, I still haven't had one, although that does make me unusual. So by supplying the pill OTC there will be no price hike, and no issue with pelvic exams, because you will automatically be called for one.

However, it is more than a little paternalistic, and given that one of the major pharmacy chains and one large supermarket with pharmacies allows it's employees to not sell the morning-after pill, I think people may come across moralistic pharmacists who won't supply them.

I have been reading feministing for a while but I've only now worked up the courage to comment!
As a medical student I find this debate really interesting, and very relevant to how I, as a feminist, should consider my future actions as a doctor.
Eloriane, what happened to you was horriffic, and against absolutely everything that being a doctor should stand for. Maybe it is just youthful idealism but I believe that a doctor's primary duty, before any other consideration, is care for their patient - not just to treat a disease, not to force treatment on the patient, but to care for them in a way that accedes to THEIR wishes, no matter what the doctor's own personal opinions or prejudices.
Because of this it makes me sad (and a bit dubious about my future career!) that people see going to the doctor as a negative experience, 'holding them hostage', rather than an informative and helpful encounter, where they can express their concerns and have those concerns addressed according to their wishes. Rather than simply removing the doctor from the equation when it comes to birth control, maybe we should look at why people don't want to visit the doctor, and to address that - to make a doctor's visit not something to be dreaded, but a positive experience, not so much to be looked foward to (i don't think theres anything in the world that could make a smear test less unpleasant!!) but something that gives satifaction, comfort and reassurance about all health issues, whether you go in with a specific issue or not.

I have been reading feministing for a while but I've only now worked up the courage to comment!
As a medical student I find this debate really interesting, and very relevant to how I, as a feminist, should consider my future actions as a doctor.
Eloriane, what happened to you was horriffic, and against absolutely everything that being a doctor should stand for. Maybe it is just youthful idealism but I believe that a doctor's primary duty, before any other consideration, is care for their patient - not just to treat a disease, not to force treatment on the patient, but to care for them in a way that accedes to THEIR wishes, no matter what the doctor's own personal opinions or prejudices.
Because of this it makes me sad (and a bit dubious about my future career!) that people see going to the doctor as a negative experience, 'holding them hostage', rather than an informative and helpful encounter, where they can express their concerns and have those concerns addressed according to their wishes. Rather than simply removing the doctor from the equation when it comes to birth control, maybe we should look at why people don't want to visit the doctor, and to address that - to make a doctor's visit not something to be dreaded, but a positive experience, not so much to be looked foward to (i don't think theres anything in the world that could make a smear test less unpleasant!!) but something that gives satifaction, comfort and reassurance about all health issues, whether you go in with a specific issue or not.

I live in the UK, and when I needed to buy plan B, I ended up having to go to see 3 different pharmacists before one would sell it to me, because the others had "moral objections". What made me angriest about this is that they got their assistants to tell me, they didn't even have the courage in their convictions to tell me about their judgments about me to my face. Although I think that this is good news in principle, I worry that accessing bc will be difficult because of these same "moral objections".

I live in the UK, and when I needed to buy plan B, I ended up having to go to see 3 different pharmacists before one would sell it to me, because the others had "moral objections". What made me angriest about this is that they got their assistants to tell me, they didn't even have the courage in their convictions to tell me about their judgments about me to my face. Although I think that this is good news in principle, I worry that accessing bc will be difficult because of these same "moral objections".

I live in the UK, and when I needed to buy plan B, I ended up having to go to see 3 different pharmacists before one would sell it to me, because the others had "moral objections". What made me angriest about this is that they got their assistants to tell me, they didn't even have the courage in their convictions to tell me about their judgments about me to my face. Although I think that this is good news in principle, I worry that accessing bc will be difficult because of these same "moral objections".

I've just moved back to the UK after living in Philly for 5 years. This particular legislation is UKcentric. The price of BC will not change because under the current system it is free. Also, Pap smears are performed every 2 years in the UK as opposed to yearly in the US.

I've just moved back to the UK after living in Philly for 5 years. This particular legislation is UKcentric. The price of BC will not change because under the current system it is free. Also, Pap smears are performed every 2 years in the UK as opposed to yearly in the US.

Actually, you get called for your first cervical smear at age 20.

"The price of BC will not change because under the current system it is free"

But the only reason it is free is because it is obtained by prescription. In the UK, you do not pay for ANY prescribed medicine, but you pay a prescription charge for most. However, any medicine which you buy without a prescription has to be paid for in full.

One of the exceptions to prescription charges is that you do not pay them for contraceptives (the other exceptions are mainly people on low incomes and vulnerable groups such as children, pregnant women and new mothers, and those over 65).

This means that if you bought your BC pills without a prescription you would have to pay for them, so I can't really see why anyone would choose to do this.

I know that the idea of allowing nurses to prescribe certain medecines has been suggested before now, and I wonder if that is what this would actually be. It would still be a prescription, but since the checks that are made, like blood pressure, are pretty routine, they could be done by a nurse rather than a doctor.

Incidentally, the same prescription charge excemption applies to condoms. You can get them free on prescription, although most people just pay for them either because they are not aware that they are available free on prescription, or because they would find it too embarrassing to have to discuss with the doctor how many they would need per month!

When I lived in the UK, the doctor there told me that they recommended that women get pap smears/pelvic exams every three years, not every year. Was this unique to my doctor? Because if it's not, then this doesn't seem like a measure that's about freeing women from having to get an exam to get pills, but probably is a cost-cutting measure, as Akeeyu says.

I lived in the UK for 2 years. Getting BC seemed Really easy. It's FREE to go to the docter who you tell you want BC. He says, OK. you go to the pharmacy with your prescription and they hand you BC without you paying anything.

No it's not FREE. You pay for it by different means and times. The payments may be less visible (taxes, employer insurance payments-and therefore less salary) but you are paying for it.

people see going to the doctor as a negative experience, 'holding them hostage', rather than an informative and helpful encounter, where they can express their concerns and have those concerns addressed according to their wishes.

It's not necessarily that it's a negative experience. It's just that using birth control as a way to force women to go to the doctor is paternalistic, whether women enjoy it or not. Here's an example of that, I went to the doctor to get my yearly birth control refill. She saw that I hadn't had a pap smear in the past year, and told me she would only give me a prescription for three months, and I could only get the rest after I'd come in for a pap smear. She was holding my birth control hostage to my pap smear. Now, I'm one of those apparently rare women who doesn't mind pap smears at all, and I'd been planning to make an appointment to go anyway, but it still grated. It's treating women as children ("No playing outside until you've cleaned your room" "No birth control until you've had your pap smear") rather than adults who are capable of making their own medical decisions.

As for health risks, etc., the proposal isn't to make this something you can grab off the shelf, like Asprin. It's still something you get from a pharmacist, behind the counter. (So it would probably still be free for UKers). And you still have a consult, it's just with a pharmacist or the pharmacy nurse rather than a doctor. They still explain to you about blood pressure risks, the risk of smoking on the pill, side effects, etc.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

Hi there,

I'm a UK citizen and I live in England.

Any contraception is free *on prescription* in the UK - you go to your gp (family doctor) or Family Planning Clinic, get your prescription, tick a box on the back labelled 'Non-chargeable contraception' or something, take it to a pharmacy and the pharmacist dispenses it, for free. You have to see the practice nurse every six months for a re-fill and during the consult, the nurse will take your blood pressure and (possibly) weigh you and ask about smoking - they are reluctant to prescribe the combined pill to women over a certain BMI, because of the link with heart disease.

There is no link with the pap smear, although the nurse might take the opportunity to check if you're due one and book you in. You'd still get the pill if you refused the smear because it's not linked. The smear isn't offered every year unless you've previously had an abnormal one, I think. Women aged 25-49 get offered one every three years, then it's every five years until you are 65. The smear is free. Other than that, nobody ever does a pelvic exam 'routinely' - only if there's good reason to do so. During my last pregnancy I only had one pelvic exam, and that was when I actually asked for it during labour because *I* wanted to know how dilated I was...

You do have to pay for over the counter (OTC) (ie not prescribed) drugs. Emergency contraception is free on prescription, but costs around £26 (about $50?) OTC and the pharmacist is required to ask certain questions. You must be over 16 to buy emergency contraception OTC. See http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=827 and http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentID=141 It says in the fpa link that some pharmacies (I'm guessing in low income areas with high rates of teenage pregnancy) will give emergency contraception for free.

I'm guessing that there will be a charge for the pill if you buy it OTC. It seems like a strange proposal to me - obviously, a time critical drug like emergency contraception needs to be as widely available as possible - but given that it's (relatively) easy to get an appointment for a pill re-fill (lots of gp surgeries offer early morning or evening appointments now), it's *free* and there are clear health risks associated with taking the pill long-term which need monitoring, why would you *buy* it OTC? I would be concerned if under-16s could buy it - if you're under 16, you're very unlikely to be in a long-term monogamous relationship, so you should be using condoms as a barrier contraceptive to protect yourself against stds. I have two daughters - I would rather the opportunity for an irresponsible condom-hating 16 year old boy to pressurize my 14 year old daughter into using the pill *instead*, didn't exist...

tbh, contraception and (to a certain extent) abortion are nothing like as big an issue in the UK atm - I would be astonished if I was refused any kind of contraception on any grounds other than a serious health concern, the various types of contraception are covered in the compulsory National Curriculum in schools, and even if your own gp feels unable to deal with your abortion request, they are obliged to refer you on to someone else who can help. It's not a non-issue, but it isn't a tinder-box either.

oh god I'm so sorry, I kept getting Internal server error 500 over andd over...off to crawl under a rock somewhere...

No it's not FREE. You pay for it by different means and times. The payments may be less visible (taxes, employer insurance payments-and therefore less salary) but you are paying for it.

Whatever. OK, it's not free. They pay for it in taxes, but they don't get inferior service if they pay less in taxes and they are covered even when unemployed. Sounds like a world of freaking luxury to me. At least it's superior to a system in which all tax money is funnelled to war profiteers and poor people regularly die of curable conditions because they don't have access to adequate health care. I know I'd feel pretty freaking free if I didn't have to worry about losing my health coverage with my job, even if it did mean that tax money was used to make that possible. Priorities my friend. Some people are willing to pay to subsidize war profiteers. I'm willing to pay for a world worth living in.

At least it's superior to a system in which all tax money is funnelled to war profiteers and poor people regularly die of curable conditions because they don't have access to adequate health care. . . .Priorities my friend. Some people are willing to pay to subsidize war profiteers.

Apples and oranges. You don't really think we'll have less war or less war profiteering if we change how we pay for medical care, do you? I'm not really arguing against a change, I just want people to recognize that changing the payment method doesn't mean that we would get the services for free.

Whether changing the payment method leads to better health care my or may not be true. Most of the government single payor systems do include rationing of certain types of care. For example, when I blew out my knee exercising in my 40's my employer provided insurance paid 80% of the reconstruction cost. I spoke with English doctors while I was recuperating and they told me at my age I would not have been eligible for the surgery in England at my age (I could still walk and work without the surgery.) Maybe rationing is acceptable if it means people not getting care now would get it.

"Maybe rationing is acceptable if it means people not getting care now would get it."

bingo.
and don't forget that people who really wanted procedures that the govt considered unnecessary and have the means could always pay for that stuff themselves. i mean, we are the richest country on the planet, i think we could afford to provide not just good but great health care to everyone living here.

"Maybe rationing is acceptable if it means people not getting care now would get it."

bingo.
and don't forget that people who really wanted procedures that the govt considered unnecessary and have the means could always pay for that stuff themselves. i mean, we are the richest country on the planet, i think we could afford to provide not just good but great health care to everyone living here.

"I see from rereading your comment that you're in the medical business. It's hard to examine your assumptions when it's that close."

She certainly could have been more sensitive. I was not trained to speak that way or judge clients that way.

But the only comment I will make is that a viewpoint on this matter should not be disregarded only because someone is in the health care field. Unless their salary is directly connected* to how much business they have, I trust most professionals have a sincere desire to maintain people's health. Otherwise, I would never have gotten into it.

* To show you from the other side what bias really means, in Japan it was all but impossible to get the Pill for the purpose of contraception, it was prescribed for menstrual regulation. Even now that the law is changed, and the low dose Pill with fewer side effects are available to those who ask for it, it still costs about $3,000 a year, because it not covered by national health. (Or abortion or childbirth - pregnancy is not a "disease," after all, says government.)

Why such an uphill battle in Japan for all these decades? Because the medical establishment, dominated by educated, wealthy, older males very close to the political establishment, want to preserve a MAJOR source of their income (say, $800 each) - abortion AS bc. They have successfully argued that the availability of the pill will lead to a decline in use of condoms (the most popular method of bc in Japan) and a rise in HIV, while touting all the possible side effects, based on results from the old, high dose pill. That outcome can logically follow, but concern for public health or women's health is NOT their motivation.

So not only is the Pill very expensive, women are conditioned to be wary of it, and it is not advertised mainstream, so they almost never seek it out. No real change from before. Thus, the "abortion" doctors won, in a very "anti-choice" way.

By chance, I don't know, how closely are private clinics in the US connected to the pro-choice movement?

Whether changing the payment method leads to better health care my or may not be true.

I guess it depends on whether or not you're the person with asthma who can't get a hold of any inhalers and winds up in the ER every six months. If you're that person, then it sure as hell does lead to better health care.