Pharmacists’ Expertise in Contraceptive Counseling Amid Ongoing Challenges | APhA 2025
Jasmine Cutler, PharmD, discusses the unique expertise pharmacists possess in order to counsel patients seeking any type of contraceptive product.
Pharmacists are uniquely positioned to counsel patients on the use of all types of contraceptives, according to a session presented at the American Pharmacists Association 2025 Annual Meeting and Exposition.1 Despite several barriers to access and expansion of pharmacy services, pharmacists staying informed on contraceptive guidelines is crucial to ensuring improved reproductive health in the US.
“Lack of community awareness: Some people still don't know that pharmacists can't even prescribe birth control, which is a huge thing,” Jasmine Cutler, PharmD, said in her presentation titled Country Roads to Care: Pharmacists’ Role in Reproductive Health. “It's important to make sure you have a good protocol, [and] staff are aware and educated about what's going on, making use of the community, social media, your technicians—everyone that is there.”
Pharmacists have increased knowledge in helping patients looking to use emergency, routine, male, or female contraceptives. | image credit: (JLco) Julia Amaral / stock.adobe.com
The dispensing of contraceptive products and the counseling of patients using them have taken on new meanings within recent history. With several legislative changes and a new presidential administration taking over within the US, many pharmacists may be uncertain of their rights to prescribe and counsel patients on contraceptive use in specific states.
READ MORE: Q&A: Community Pharmacists Well-Positioned to Provide Injectable Contraception
“Uncertainty has emerged around people’s ability to access certain contraceptive methods, such as [intrauterine devices (IUDs)] and emergency contraceptive pills (often confused with medication abortion), which are erroneously believed by many to be abortifacients,” wrote authors of a KFF study.1
In her presentation, Cutler covered several barriers impeding pharmacists from either prescribing or counseling their patients looking to use emergency, routine, male or female contraceptives. She started by mentioning the 30 states that allow pharmacists to prescribe contraceptives and the various hurdles other states must navigate.
While some states, providers, and patients have greater access to contraceptives than others, the education of how these medications and products work is significantly important before pharmacists can even consider prescribing contraceptives or counseling patients on their use.
The Guttmacher Institute3 “provides a chart with the exact restrictions per state that includes the District of Columbia as well,” continued Cutler.1 “Some of them require training for pharmacists. Some require educational materials to be dispensed. Some require counseling, which of course, as pharmacists, we are required to counsel anyways, so that's kind of something that we already do. And then also, some of them require you to have screening tools.”
As Cutler mentioned the current state-by-state contraceptive requirements, she highlighted the increased ability pharmacists have to counsel their patients. With significant nuance across states on the legislative side of reproductive medicine, Cutler believes pharmacists can promote themselves as contraceptive counselors because of their patient-relationship experience.
She then discussed recent updates to the US Medical Eligibility Criteria (MEC) and Selected Practice Recommendations (SPR) for contraceptive use. “The 2024 US SPR and US MEC are evidence-based, person-centered clinical guidance documents and decision-making tools to support contraceptive counseling and method provision and management that support individuals’ reproductive well-being,” according to Bedsider Providers.4
These guidelines are provided by the CDC and regularly updated to ensure proper counseling of patients using contraceptive medications and products. The MEC is designed to offer guidelines specific to various patient populations and what types of contraceptives are best for them. The SPR, however, is more of a resource to help pharmacists and contraceptive counselors mitigate any potential harms or adverse events these products could cause for patients.
Finally, Cutler provided multiple case studies and recent evidence of pharmacists’ increased ability to properly counsel patients and improve their outcomes and adherence to contraceptive products.
“The interventions that were able to be made by the pharmacist highlighted the need for improved access to contraceptives,” wrote Sanders et al in a study published in the Journal of Pharmacy Practice.5 “Pharmacist-managed services in sexual and reproductive health can help fill this gap.”
Along with the Sanders et al study, Cutler presented recent findings from studies that explored the implementation of pharmacist-led contraceptive services, from counseling and prescribing to collaborative practice agreements that improved adherence, outcomes, and education.5,6
With the first prescription contraceptive approved by the FDA in 1960,1 there has been a history of guideline updates, regulation changes, dynamic patient populations, and many more changes impacting pharmacists’ role in counseling patients on contraceptives. Among so many options for male and female contraceptives in both emergency and non-emergency capacities, pharmacists must stay informed and keep each individual patient’s unique profile in mind when counseling their contraceptive use.
“Currently, there's 30 states that allow pharmacists to prescribe [contraceptives]. Barriers still exist for excluding pharmacists from expanding services. There's been the updates [to MEC and SPR]. There's the OTC norgestrel that's available, and it's important to put the patient first,” concluded Cutler.1
