On Wednesday, March 27, 2019, the Iowa Senate brought forth SF 513, a bill that would allow pharmacists to dispense hormonal contraceptives, which includes oral contraceptives, hormonal patch, and the vaginal ring without a physician’s prescription, consultation, or examination. California, Colorado, Hawaii, Maryland, New Mexico, Oregon, and the District of Columbia have passed similar bills in the last three years. Now in Iowa, the governor’s office is leading the charge to pass similar legislation.

 

SF 513 raises many concerns for women’s health and the state of Iowa. 

 

First, what is the need for this bill? Are women in Iowa unable to obtain hormonal contraceptives? Is there such a lack of access that we must remove a crucial safe guard for women’s health by removing the input of her doctor? SF 513 is a solution in search of a problem. 

 

Second, as raised during the debate by Sen. Robert Hogg (D-District 33) and Sen. Claire Celsi (D-District 21), hormonal contraceptives are hormonal treatments and therefore are accompanied with side effects and potentially long-lasting detrimental health effects. Potential side effects, as listed by Republican Sen. Miller-Meeks (the bill floor manager) (R-District 41), are blood clots, deep vein-thrombosis, stroke, and hypertension. Sen. Hogg rightly highlighted, “those are all very serious potential side effects.” Sen. Miller-Meeks failed to mention the additional side effects women may face: migraines, mood changes, depression, nausea, decreased libido, weight gain, missed periods, changes to eye sight, vaginal discharge changes, breast cancer, cervical cancer, liver cancer, decrease of bone density, yeast infections, potential infertility, and in some cases death. With all of these potential side effects, why is it deemed a good idea to bypass a woman’s medical provider when seeking these hormonal treatments? Iowa women deserve better.

 

SF 513 not only removes a physician’s examination and consultation, with no need for a prescription, but according to the bill, a woman is not required to follow up with her physician for 27 months after the initial dispensing (over two years!). This bill removes a medical doctor from the original conversation with a patient regarding hormonal contraceptives, and the doctor is kept out of the conversation, in most cases, after damage is already done. According to the Public Discourse, The Journal of Witherspoon Institute, “For women under thirty, the risk is [of being diagnosed with venous thromboembolism] increased thirteen-fold during the first year of use, when the risk for clot formation is highest.” Sen. Celsi, correctly noted that a pharmacist is a not a doctor. We put women’s health at risk when we remove critical safe guards like a woman’s relationship/consultation with her physician. 

 

Third, the original bill provided for immunity for pharmacists and the medical director from any liability. Let that sink in; if a pharmacist dispenses the wrong contraceptives or the wrong dosage, a pharmacist cannot be held liable. Iowa women deserve better.

 

Other concerns are as follows: the bill does not require any form of identification be presented, Planned Parenthood is in full support of the bill, and the bill calls for Medicaid to cover these self-administered hormonal contraceptives. 

 

Despite all these concerns, the office of the Governor has pushed forth with this legislation followed by 42 senators voting in favor of SF513 and only six senators voting against it. Six senators had the courage to resist the pressure from the governor’s office and vote against this bill. Sens. Carlin (R-District 3), Feenstra (R-District 2), Guth (R-District 4), Behn (R-District 24), Costello (R-District 12), and Whiting (R-District 1), should be applauded for protecting women’s healthcare. 

 

If the intention of SF 513 is improvement of women’s health, sadly, collateral damage of SF 513 could be women’s health. The Governor can do better. The women of Iowa deserve better. Again, why remove the care of a doctor where there is increased risk?

 

SF513 now moves over to the Iowa House. Please call or email your representative and ask them to vote no on SF513 and HF727, the companion bill to SF513. Let them know that the women of Iowa deserve better! The Capitol phone number is 515-281-3221.

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Author: Kathryn Kueter

Kathryn Kueter is the Concerned Women for America of Iowa Legislative Liaison