Iowa lawmakers again consider contraception without a prescription

DES MOINES — A proposal to make birth control available through a pharmacist — without a physician’s prescription — is once again being considered by Iowa lawmakers.

Democratic state lawmakers generally have been supportive of the proposal for years, and Gov. Kim Reynolds, a Republican, has been proposing it since her 2018 campaign. Previous legislative attempts have met with varied levels of support from state lawmakers, but never made it to Reynolds’ desk for her signature.

The tallest hurdle has been in the Republican-led Iowa House, which started the latest legislative attempt with a subcommittee hearing Monday at the Iowa Capitol.

Supporters say the measure would provide better access to contraception for women, thus leading to fewer unplanned pregnancies and reliance upon government assistance programs. Opponents cited concerns for women’s health, especially when a physician is not involved.

Rep. Devon Wood, a Republican from New Market, heard many of those arguments during Monday’s hearing. Wood said she believes that debate has been good for the legislative process and that it will produce an improved bill.

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Wood said that while she cannot make predictions, she is optimistic this is the year the proposal will pass the House and ultimately be signed into law.

“Having this input over the last few sessions is really good to have when continuing the conversation. I really think it helps us hone it to what is the root of what we’re trying to get to here,” Wood said. “And for me … it’s where folks are going to go when they’re looking for this option.

“If I’m a woman who’s chosen to pursue this, I want to know that in addition to my doctor, there is a another person that is in the medical community that I can have these conversations with when asking how it may interact with some of the medications I’m taking. Our pharmacists are an important part of this conversation already, but I’m really glad that we’re looking at this option as an access point for folks.”

All three members of the subcommittee panel — Wood, fellow Republican Rep. Barb Kniff McCulla, of Pella, and Democratic Rep. Timi Brown-Powers, of Waterloo — signed off on advancing the proposal, House Study Bill 642, on for consideration by the full House Health and Human Services Committee.

During testimony on the proposal, a lobbyist for the Iowa Pharmacy Association told lawmakers that pharmacists are well-educated and equipped to work with a woman on contraception, and a lobbyist for the Iowa Medical Society endorsed the bill, saying it strikes the right balance between increasing access and maintaining oversight.

Opponents included representatives of groups opposed to abortion rights, including Pulse Life — who called some forms of contraception “pre-implantation chemical abortion” — the Christian conservative organization The Family Leader and the Iowa Catholic Conference. They expressed concerns for women’s health, citing some studies that have suggested links between contraception and increased cancer rates.

According to the National Cancer Institute, most of the research exploring potential links between contraception and cancer have been observational studies, which cannot definitively establish that contraceptives cause cancer. However, according to the institute, those studies have provided consistent evidence that risks of breast and cervical cancer increase in women who use oral contraceptives, while the risks of other cancers — ovarian, colorectal and endometrial — have decreased.

The American Cancer Society has a similar analysis: that women who use hormonal contraception have a slight increase in the risk of breast cancer, but a moderate and long-term reduction in the risk of some types of ovarian cancer and endometrial cancer.

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