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Physicians refusing to prescribe birth control

8K views 163 replies 50 participants last post by  sleepies 
#1 ·
Thought it couldn't get any weirder?

Quote:
Lacey's pharmacist and Kelley's doctors are among hundreds, perhaps thousands, of physicians and pharmacists who now adhere to a controversial belief that birth control pills and other forms of hormonal contraception--including the skin patch, the vaginal ring, and progesterone injections--cause tens of thousands of "silent" abortions every year. Consequently, they are refusing to prescribe or dispense them.
http://www.prevention.com/cda/featur...-7342,00.html?
 
#127 ·
I knew of an ob/gyn practice that was Catholic based, and wouldn't prescribe any b.c. This particular practice was very supportive of natural childbirth, had a terrific midwife there, and had doulas come in and work on Friday's so it was quite popular with both Catholics and non Catholics.

I honestly didn't think a whole lot about the morals of it due to their being natural birth-friendly...
 
#128 ·
I just thought I'd throw this out there:

My mom had a primary care who refused to prescribe Meridia (before it was known to be dangerous) because she felt that fat pills are not the answer to weight loss. It was her own personal opinion.

More recently, my mom's allergist refused to prescribe a nebulizer to her. She has severe asthma and kept ending up in the ER where they would give her a...nebulizer treatment. The doc just felt that it wasn't necessary. I happen to know that she was almost begging for the nebulizer because she was tired of the ER. On the other hand, my daughter was in the ER one time for a respitory virus and they sent us home with a nebulizer.

I think it's safe to say that Dr.s already make medical decisions based on their personal feelings and motivations. From what has been said here, it seems that there is a demand for both Dr.'s that prescribe BC and perform abortions and those that don't.

Of course, I understand that there is more to the issue, but I think that it would be naive of us to assume that docs' make deicisions for their patients in a vacuum, without thier own beliefs and biases.
 
#129 ·
So many people are mentioning Drs and pharmacies (businesses), while ignoring the issue of individual pharmacists chosing not to fill a prescription that is in stock, I wanted to repeat what kama'aina mama said

Quote:
But Lilyka it is not actually that simple. In some cases the pharmacy does carry it and women are counting on getting their 'scrip filled as usual... but "ooops! Sorry, the pharm on duty right now won't fill YOUR prescription." The pills are there, the scrip is legit... but you have to wait til shift change or til tommorow or whatever.
 
#130 ·
Quote:
My mom had a primary care who refused to prescribe Meridia (before it was known to be dangerous) because she felt that fat pills are not the answer to weight loss. It was her own personal opinion.

More recently, my mom's allergist refused to prescribe a nebulizer to her. She has severe asthma and kept ending up in the ER where they would give her a...nebulizer treatment.
I feel differently about these two situations and just wondered if anyone else was "there with me" so to speak. W/the first it is a family doctor and treating obesity could fairly, IMO, be considered a specialty. I would not expect to recieve *that* type of service from a family practitioner (nor would I expect chemo, or anything like that). If your mom wanted that perscription it was, IMO, her responsibility to visit a weight loss clinic (or whatever)

With the allergist, though, nebulizers are a STANDARD form of treatment, esp for people w/frequent ER visits. In fact, I think most allergists would consider that *neglegent* of the doctor (along the same lines of refusing an epi-pen!). That doctor owed your mother the curtesy of either a referral to another associated doctor who would treat her differently, giving her the perscription, or being up-front about a refusal to do a standard form of treatment.

This, IMO, is related to OB/GYNs. I have no problem w/pediatricians, opthamologists, cardiologists, etc... refusing to write perscriptions for hormonal birth control without warning. That is not a standard practice for them. OBs/GYNs, meanwhile, do a lot of business in yearly women's care which a primary focus of is, generally, birth control. And if you are not going to support what is probably The MOST common form of BC for those in monogamous relationships, you need to volunteer that information BEFORE an appointment is even scheduled.

Pharmacies as well. If they are no longer going to carry a commonly requested medication, they need to put big signs up about it so people can vote with their $ and take their business elsewhere w/plenty of warning.
 
#131 ·
I think it is completely reasonable for the OBs not prescribing BC pills to let the patients know up front.

In regards to individual pharmacists refusing to fill BC prescriptions, basically- the store (say my friend who works for Walmart) would have every right to fire the pharmacist in that situation. I believe some stores have done that, while others always have 2 pharmacists working. I seriously doubt any chain pharmacy is going to give up the business that they would lose by not making the pill readily available, I just do not see that ever happening.
 
#132 ·
"I think it is completely reasonable for the OBs not prescribing BC pills to let the patients know up front."

I completely agree. I think it should be posted (if the pharmacy generally sells a decent amount of that pill already) and it should say either "we don't sell XYZ" or "Pharmacist B does not sell the Pill, but we'd be happy to help you with another form of BC or between the hours of X-Z, when another pharmacist will be in."
 
#134 ·
My OB does not prescribe the pill. He is also one of the few in town who has a clue about what NFP is. He is very pro-natural birth. He has a very low c-section rate and gives about 1 episiotomy per year (in a very busy OB practice - he had 10 deliveries the week ds was born and that was as of Thursday). Among the doulas in town, he is known as the "midwife with a penis." If you want to have a natural birth in a hospital - no drugs, no interventions - he's your man. Those are many of the reasons why I am a very loyal patient.

I used to take the pill for "medical reason" (aka cramps) but have found other ways to treat that condition without using the pill. I now practice natural family planning (NFP) which is basically very effective birth control without the health risks of options such as the pill. I have sex whenever I want with the understanding in mind that there may be certain consequences if I have sex at a certain time of month (and thus I can choose not to if I wish).

With NFP, not only can you avoid conception, you can also treat infertility and avoid miscarriages without expensive drugs or medical procedures. Again, my OB is one in town who is sought out for his understanding of the female reproductive system when it comes to fertility.

So no, he does not prescribe the pill. However, he does offer a wealth of alternatives and treatments that you rarely find with other doctors. Natural birth is very important to me, and there are very few doctors in our town that I would trust as an OB like I trust my OB.

I find it very interesting that so many people here are so adamant about natural childbirth that they are willing to have their babies at home rather than subjecting themselves to treatment by a doctor but at the same time get upset when a doctor is very "natural" minded and along with that refuses to prescribe the pill. Isn't that a contradiction?
 
#135 ·
how can you treat infertility with NFP? If you are not ovulating, it does no good to track your ovulation. How does it prevent miscarriage? Why do you think my homebirth was because I don't like doctors? What do doctors even have to do with natural childbirth? Male Doctors? I think that having a baby with a male doctor in a hospital is a contradiction to love of natural birth.

But I really don't understand what this has to do with the subject on hand: why doesn't your doctor prescribe birth control? Religious reasons? Are you that religion? Would you see him if you were not? Is there other places in your town to get a BC prescription?

Victorian
 
#136 ·
Infertility can be treated with NFP by teaching women when they are fertile so they can time sex accordingly. As for preventing miscarriage, if you are pregnant and you temperatures start to drop, a miscarriage is imminent but can still be prevented if it is due to hormonal reasons. Many women go through three or four miscarriages before find out they need hormones, and my doctor is quick to treat with hormones because that can be diagnosed somehow using NFP. Those are only examples - I'm no expert.

I don't know why he doesn't prescribe the pill - I haven't asked him. Yes, there are other doctors in town. I've been to some of them and they have no clue about NFP and cannot discuss diagnosis based on the symptoms manifested by things tracked with NFP. They also do routine episiotomies and have high c-setion rates. Even if you go with a midwife, if you end up needing a doctor, the ones that are at the midwife clinics in this town are one you don't want to end up with. They do way more interventions than necessary and have terrible bedside manner when it comes to how they treat their patients. I would much rather have a "midwife with a penis" who can do the whole thing rather than worrying about having to deal with some jerk if my midwife is not what my birth requires.

But really, if doctor's can choose not to delivery babies in whirlpool tubs (which we would like), can't they also choose not to prescribe the pill (which we might not like)? We are the patient - we don't tell them how to practice. We simply find doctors who practice with the mindset we like...and I have found one of those. Personally, I LIKE not being pressured to take the pill. Have you ever read the entire insert? I know the print is tiny, but once you finish the insert, you may find that you're taking more risks by being on the pill than you would be to have an episiotomy or an elective c-section.

As for natural childbirth, I mean no drugs and no interventions. My doctor is the only one who will deliver in a birth tub - the other doctors make the women get out if they have labored in the tub when it comes time for birth. Like I said, his c-section and episiotomy rates are very low. If you want to have a natural birth in a place where more help is available IF you NEED it, it's the way to go. Where I live, midwives are not legally allowed to attend home-births so that is not an option unless you go to a lot of trouble.
 
#137 ·
Quote:

Originally Posted by BelovedBird
What's the big deal if Doctor chooses not to offer a sepecific service? Don't you want doctors to be discerning in what they do ("no, I will not perform an elective c-section on you at 38 weeks so that you can be healed enough from the birth to keep the vacation plans you made with your friends last year" or "no, I will not give you ritalin for your 5 yr. old just because all your friends say he should be on it") I have swiched doctors SO many times because I did not agree with the kind of care they gave. Not all doctors are all things to all patients. You have to find the doctor that is right for you. Don't you? There could really be a problem and i am not understanding it... Is there really a legal standard of what the dr. has to give you a prescription for, when? Why not just have all bc be otc, then?

the pill is not only for contraception but also for acne treatment or irregular cycles.So how can one NOT care?
 
#138 ·
Quote:

Originally Posted by DebraBaker
You have your rights and the doctor has her rights.

Would you want someone to be compelled to do something he felt was killing?

Debra Baker

then what about all the medication that can cause birth defects? Will we stop getting those,too..because we might be pregnant?
 
#139 ·
Quote:

Originally Posted by Kinipela79
Didn't read the article but just wanted to say - if you don't want birth control that may or may not cause a fertilized egg to implant to be given to women - then you had better be ok with more abortions. I consider myself "prolife" but maybe I'm not. I don't know. I just don't believe that "prolife" people can sit and yap about how "we need to stop abortions" but then not support birth control options that are there for women. Can't talk about women being irresponsible and not keeping their legs closed if dr.s/prolifers/whoever withhold birth control.

totally agree.limiting birth control choices leads to more abortions.Youc an't have it both ways!
 
#140 ·
Quote:

Originally Posted by MissinNYC
I see a big difference btwn refusing a certain prescription because of it's moral implications, and refusing based on the PERSON or their gender, race, etc. Refusing just because they have a problem with you yourself is obviously not okay. But I feel it's a "slippery slope" (God, I hate that term!) and that we cannot force doctors or pharmacists to do things they feel truly are morally wrong. Forcing someone to (from their perspective) commit an abortion is wrong, if that person truly feels abortion is wrong. And it's condescending and cruel, I think, to say "oh well Hell doesn't exist, don't worry about it" to a person who believes they will be eternally punished for this act.

I would not support doctors being forced to do any procedure they have personal problems with. Doctors are human beings, not automatons. JUst as they should not be forced to circ, or vax, or euthanize, or whatever, if they feel it's wrong, and not in the best interest of the patient.

i wonder if you'd still say this after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.
 
#141 ·
Quote:

Originally Posted by huggerwocky
i wonder if you'd still say this after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.
Whoa!


I just asked my father for clarification on this as he is a practicing Jehovah's Witness. The JW ER doc would not administer a blood transfusion to the patient. The doc would treat the patient otherwise normally but another doc or a nurse would have to administer the transfusion. According to my dad the JW doc would have to have some sort of declaration of that in his file so that the rest of the medical staff would be aware of that and act upon it.

I guess the best analogy would be asking a Orthodox Jewish waiter for ham slices with your omelette in a restaurant.

JW's know that their stance on transfusions has risks and so would never make that decision for an uninformed adult. They might feel poorly for the person afterward and pray for them but that is all. JW's feel that a person must give informed consent to be able to refuse a transfusion.

They will make that choice for their children but as a parent it is their right to choose treatment for their children. Much like it is our right to choose treatment for our children. Like refusal to vaccinate. I know, world of difference, but the principle of choice remains the same.

Sorry to jump on you about that but your statement was in error and had to be corrected. Please don't send me PM's about the right or wrongness of the JW stance on blood. I am not a JW anymore. I am just telling you how it is from their viewpoint.
 
#143 ·
Quote:

Originally Posted by TiredX2
But, devils advocate here: the people taking this stance consider hormonal birth control to effectively BE an abortion.

I'll never understand that! I yet have to see studies showing me that the birth control pill leads to an abortion IF after a remote chance yous till get pregnant.I personally know of many women who,despite the pill got pregnant and had the baby anyway.
 
#144 ·
Quote:

Originally Posted by Penalt
Whoa!


I just asked my father for clarification on this as he is a practicing Jehovah's Witness. The JW ER doc would not administer a blood transfusion to the patient. The doc would treat the patient otherwise normally but another doc or a nurse would have to administer the transfusion. According to my dad the JW doc would have to have some sort of declaration of that in his file so that the rest of the medical staff would be aware of that and act upon it.

I guess the best analogy would be asking a Orthodox Jewish waiter for ham slices with your omelette in a restaurant.

JW's know that their stance on transfusions has risks and so would never make that decision for an uninformed adult. They might feel poorly for the person afterward and pray for them but that is all. JW's feel that a person must give informed consent to be able to refuse a transfusion.

They will make that choice for their children but as a parent it is their right to choose treatment for their children. Much like it is our right to choose treatment for our children. Like refusal to vaccinate. I know, world of difference, but the principle of choice remains the same.

Sorry to jump on you about that but your statement was in error and had to be corrected. Please don't send me PM's about the right or wrongness of the JW stance on blood. I am not a JW anymore. I am just telling you how it is from their viewpoint.

ahm, I didn't intend to send you any PNs about your belief, you entitled to believe what you want to.

and where do I stand corrected? he would not order blood transfusion which is what I said.
 
#145 ·
Well, since I'm graduating next summer as a nurse practitioner, and I will be prescribing drugs for my patients, I guess as an ethical practitioner I shouldn't prescribe Viagra to unmarried men. I mean, while we're being so moralistic about it.

Because, as we all know, since, as a practitioner, I have control over who gets drugs and who doesn't, I get to impose my morals on my patients.

I mean, it's not like we have the LEGAL RIGHT to reproductive choices...

Oh wait a minute... WE DO.

As providers of health care we are not above the law. 1) Informed consent: in order to do a proper informed consent process with our patients we are mandated to provide information on all alternatives even if we don't like them. 2) It is not my job as a practitioner to decide for another person whether or not they can exercise their legal rights. If I don't like a law, then I can write to my congressional representatives, I can get involved in the process, but in the meantime I don't have the right to interfere in someone exercising their rights. 3) While I can opt out of prescribing certain drugs, that information needs to be provided right up front and that does not release me from the obligation of providing information on the alternatives, including the ones which may seem repugnant to me. Informed consent is nothing without the information.

(I am concerned about the previous argument regarding practitioners/doctors refusing to prescribe meds for HIV+ or STDs or whatnot, calling it "god's will" or some such nonsense. That's just scary. I hope we never create that kind of exclusionary behavior as a culture, although I realize it's out there in smaller communities already.)

p.s. I was not saying that Viagra is a reproductive choice, although it looks like that was what I was saying. I was just using it as an example of 'moralistic' medicine.

p.p.s. I wouldn't be prescribing Viagra anyway... I'm a women's health specialist
 
#146 ·
Why is Viagra being compared to bc? I don't get it. Viagra is for sexual function. Birth control is to impair fertility. Perscription birth control has a possible abortifacient secondary action. (PP even says that *both* forms of the pill can do that, and they are certainly not anti-bc).

The MD's who don't perscribe bc have an objection to it's secondary function of making the uterine lining hostile to a conceptus. Those who believe life begins at conception would also feel that by perscribing any bc with that function would make them responsible for phsyical harm and death of another human being. I don't know of any who would refuse to perscribe something to assist a woman's sexual function. I've never heard that idea even in the most wild rantings of the most conservative nutcase websites. In my folk's case, all thier patients know they are very conservative, and if they want counsel (which is what many come in for! Just wanting a listening ear and some advice), they know which doctor in the practice will provide them with what they want to hear. If they want to hear the benefits of abstinence until marriage, traditional family, the stop-smoking/drinking/shooting-up-or-you'll-loose-your-wife-and-kids speech, or some other such thing, they ask for my parents. If they want birth control, or a check-up and no lectures, they schedule with someone else.

Oh, and i think I remember someone asking much earlier in the thread if there was a list of doctors who don't perscribe bc????
There is. "One more soul" publishes a booklet with names and addresses of NFP-only physicians in the USA, some of Canada, and some other places. Just thought that might be of interest.
 
#147 ·
because men get viagra covered by their insurance companies, but women have had to fight to get bc covered.

its.. well... stupid. cover the stuff that enables people to have sex but don't cover what would prevent the natural consequences of said sex.

Nor are menstrual supplies. They should be covered, or at least tax free. But they aren't.
 
#148 ·
Quote:

Originally Posted by huggerwocky
ahm, I didn't intend to send you any PNs about your belief, you entitled to believe what you want to.

and where do I stand corrected? he would not order blood transfusion which is what I said.
No, you said

Quote:
after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.
That is a lot different from simply not ordering a blood transfusion. For instance he could order a blood expander or drugs to stimulate the production of new cells from marrow, etc. etc.

As for me, I get hurt. Plug me in doc, make it type O. Okay?

As to the issue at hand. I think I would remind the pharmacist or doctor that Roe v. Wade is still the law of the land and by refusing to fill that scrip the least that may happen to them is the loss of their license to practice.
 
#149 ·
Penalt,
OK, so the ER doctor in question wouldn't actually administer the blood. Which is really no big deal, because i have never actually seen a doctor or surgeon actually administer the transfusion him/herself. Would the JW MD write or give the verbal order for blood? What if he or she works in a busy trauma ER and a patient needs blood, but the two other doc's are busy with other patients?

In a truly emergent situation, where every second is a decade, who writes the order?
 
#151 ·
Quote:

Originally Posted by sweetbaby3
Penalt,
OK, so the ER doctor in question wouldn't actually administer the blood. Which is really no big deal, because i have never actually seen a doctor or surgeon actually administer the transfusion him/herself. Would the JW MD write or give the verbal order for blood? What if he or she works in a busy trauma ER and a patient needs blood, but the two other doc's are busy with other patients?

In a truly emergent situation, where every second is a decade, who writes the order?
I knew you were gonna ask that.


Actually the whole answer I got from my dad was kinda surprising to me. I am half thinking of talking to the elders of the local congregation, some of which remember me from my mom's funeral, about this. So I can get a direct answer from the local folks who liase (liase, is that a word?) with the hospitals on stuff like this.

I don't know who would do what in a split second matter. I would think that the hospital, knowing about the doc's self-imposed restrictions would make sure that their bases were covered in a situation like this. At least I sure hope they would.

I think I will talk to the local elders and get this cleared up. Its been 14+ years since I pounded the pavement with a fistful of Watchtowers. Things have changed with them.

We cross posted?

Does that mean I have to get you flowers, sweetbaby?
 
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