May 2, 2012 — "Doctors regularly hold women's birth control prescriptions hostage" by requiring them to first have Pap tests and pelvic exams, which "research is increasingly showing are too frequent and often unnecessary and ineffective," Stephanie Mencimer writes in Mother Jones. She cites a 2010 study in Obstetrics & Gynecology that found 33% of doctors always require a Pap test and pelvic exam before prescribing hormonal contraception, while 44% regularly require them, "even though there's no medical reason for linking the two."
Mencimer notes that the latest guidelines from the U.S. Preventive Services Task Force recommend that women older than age 30 do not need a Pap test more than once every three years, unless they have certain risk factors. In addition, the American Congress of Obstetricians and Gynecologists has said it is safe to prescribe birth control pills "without a full-on exam," according to Mencimer.
"[A]ll this excess treatment has serious negative effects" because mandatory pelvic exams can deter women from seeking contraception, placing them at risk for an unwanted pregnancy, "which is far more dangerous than getting birth control pills without a pelvic exam," Mencimer writes.
Mencimer argues that the birth control pills should be available over-the-counter, which would produce "serious health care savings" and increase women's access. She cites a University of Texas study on women in Texas who are able to purchase birth control pills without a prescription from Mexican pharmacies. Daniel Grossman, an ob-gyn and senior associate at Ibis Reproductive Health who worked on the study, said the women in the study who purchased the pills at Mexican pharmacies "had very high rates of getting all the preventive screening tests, higher than the national average." The study also found that the women were more likely to use the pills continuously (Mencimer, Mother Jones, 4/30).