Hoosier women don’t need to visit a physician to get easy access to birth control thanks to a website that recently launched in the state.
Nurx, based out of California, officially rolled out in Indiana on Aug. 29. Through the website, women can fill out a quick health survey and receive a prescription for the birth control of their choice and have it shipped to their door.
The company started in January of 2016 and is now available in 15 states and Washington D.C.
Lauren Snyder, head of operations for Nurx, said the reasons behind the program are simple.
“We’re looking to really empower and educate users to really take control in their health care,” Snyder said. “One way to do that is to provide these services to women across the country who have a lot of barriers to access birth control.”
Jessica Knox, medical director for the company, said one of the burdens Nurx helps relieve is the annual pap smear. According to the Centers for Disease Control and Prevention, women with normal pap screening results can be seen every three years rather than every year, yet still many women across the country are visiting a doctor each year just to get birth control.
Another burden is the cost of doctors’ visits and the birth control itself, so Nurx offers birth control for as low as $15 to patients who are uninsured. For those who are insured, several options are covered. There is no shipping fee or a fee for a consultation.
“Cost is a really important access point,” Knox said. “We want patients to be able to access care.”
Before Nurx can launch in a state, the company makes sure it’s following a state’s laws, ensuring that it can prescribe directly to women and ship to their homes.
“It’s sort of a multi-step process,” Knox said. “First, we have to make sure that the state allows telemedicine, and then allows telemedicine in a way that we provide it, meaning there’s no live conversation or video chat that happens between a doctor and a patient.”
Though many patients can simply create an account, choose their birth control and have it shipped directly to them, Knox stressed that each patient is personally reviewed by the physician team.
“Every single patient who comes through Nurx is personally reviewed by a licensed physician, nurse practitioner or physician’s assistant,” she said. “It’s never just ‘here’s a prescription, have a great day.’” The response since the Indiana launch has been overwhelming, Knox said.
“We’ve gotten a really positive response from Indiana,” she said. “Indiana was not one of [our] largest populations, so we thought it would be one of our quieter launches, but we’ve been getting swamped with requests.”
One of the reasons many of their clients even consider the program, she said, is the convenience. Some women work during hours that make it difficult to get to a doctor, and others live in areas miles away from someone who can prescribe birth control.
“We’re trying to remove the hoops because they’re frankly unnecessary for women,” Knox said.
Patients who would like to speak with a doctor can still request to do so through Nurx, but instead of meeting in person, they’ll talk over the phone. And there are some women for whom Nurx is not a good option because they need more specialized medical attention. The Nurx team hopes the program will appeal to most women across the country.
“It’s very heartwarming to see that we’re able to make an impact in breaking down those barriers,” Snyder said.
One group they can’t target in Indiana is teens. Indiana law requires that teens have the consent of their parents to get birth control, and while parents could technically speak with Nurx physicians over the phone, it’s difficult to verify parental consent, Knox said. The only other state Nurx works with that has similar laws is Texas. In all other states in which the program is available, they can work with teenagers, and Knox said that’s overall a good thing.
“When children cannot access these kinds of services or education … we know they’re having sex anyway,” Knox said. “They’re doing it without tools to protect themselves. I wish everybody would agree that we’re all better off and our young people are better off having information and safe tools.”
ROOM FOR CONCERN
Kristin Adams, President and CEO of the Indiana Family Health Council, said the Affordable Care Act has helped relieve some of the burdens with regards to birth control. Insurance plans are required to cover contraceptives, though there are some women are still not covered, such as those who work at religious institutions that claim an exemption.
There is room for concern, though, Adams said.
“We have a lot of communities that have limited provider access, and we have federally provided health centers and community health centers, but we have a lot of rural communities that have no access to basic health care, let alone reproductive health care,” she said.
Websites like Nurx, which also offers an app, seem like the next step in providing birth control, Adams said, making it easier for women to have access to birth control.
“A pap smear does not equate to the need for birth control,” Adams said. “That’s why this app is really taking it to the next level. It used to be, you had to get a pap smear to get your birth control, but now those two are not one and the same. The implementation is finally catching up with the science.”
She added that the app could mean fewer unintended pregnancies for Hoosier women and, as a result, fewer abortions.
“With this, we would anticipate hopefully that the unintended pregnancy rate would go down, and we wouldn’t have the negative consequences of unplanned pregnancies, and we would hope to see abortions go down,” she said.
She pointed out a higher correlation between unintended pregnancies and infant mortality, especially for women who have not had 18 months between pregnancies and those who were not healthy when they became pregnant.
“The more we plan our pregnancies, the better outcomes we have for both mom and baby,” Adams said.