Q&A: Education, Accessibility Is Key for Reproductive Health Care | APhA 2025

The landscape of reproductive health care has undergone significant transformation in recent decades, with pharmacists emerging as critical players in contraceptive access and education, according to Jasmine Cutler, PharmD, CPh, assistant professor in the department of pharmacy practice at the Taneja College of Pharmacy. What was once a profession primarily focused on dispensing medications evolved into a dynamic role where pharmacists serve as frontline health care providers, offering comprehensive guidance on birth control options, emergency contraception, and sexual health. This shift reflects broader changes in health care delivery, emphasizing patient-centered care, accessibility, and proactive health management.

As over-the-counter birth control becomes increasingly available and state regulations expand pharmacists' prescriptive authorities, pharmacists are uniquely positioned to bridge critical gaps in reproductive health care. They offer not just medications but crucial counseling, privacy, and nonjudgmental support to patients navigating complex contraceptive choices. From understanding potential adverse effects to providing culturally competent care, pharmacists are now integral to empowering individuals to make informed decisions about their reproductive health, particularly in underserved communities where access to comprehensive health care may be limited.

As over-the-counter birth control becomes increasingly available, pharmacists are uniquely positioned to bridge critical gaps in reproductive health care. | Image Credit: charnsitr - stock.adobe.com

Drug Topics: How has the role of pharmacists in reproductive health evolved in recent years?

Jasmine Cutler, PharmD, CPh: The role of pharmacists has greatly evolved over the years. Originally, birth control, which came out in the market around the 1960s, we just had a medication, and it was prescribed again by practitioners. Over time, pharmacists became really, really involved in helping with the selection of medication, with helping with managing [adverse] effects, and right now, pharmacists in several states are even able to prescribe birth control options for different individuals, whether they're tablets or pill forms or whether they're the patch or even the ring. So we've definitely come a long way over the years.

Drug Topics: What are some barriers that pharmacists could face with the expansion of their role in reproductive health?

Cutler: Different states have different policies as far as reimbursement for pharmacists. So that's going to be a huge barrier because with any type of business, it's going to be important for pharmacists in the business to stay afloat, so reimbursement fees may be an issue. Also, time restraints may be an issue with how to integrate that successfully into the workflow, and it may need some fine-tuning, even of the workflow itself and making appointments for patients. Also lastly, there's different pockets in which patients may be in what they call pharmacy deserts and may not have access to certain types of care. So those are some of the barriers.

Drug Topics: How can pharmacists address health disparities in reproductive health care through these services?

Cutler: So one huge thing that pharmacists can do, which I kind of mentioned before, is the fact that there's a lot of pockets, maybe where individuals will not have access to some of these services, so being able to ensure there's a pharmacy location in that area so that way patients will have access to some of these services. So, I think that's going to be very, very important. In addition, I think pharmacists are going to have a pivotal role in providing education to patients, especially with over-the-counter birth control options being available, to make sure patients are fully educated on the [adverse] effects of the medication and also what can occur if, in fact, they miss taking one of their tablets. So counseling is going to be very, very important. In addition, additional counseling points would also include making sure patients are aware of which contraceptive options will actually help prevent STIs [sexually transmitted infections] and STDs [sexually transmitted diseases] and which ones will not. So, just getting that information out there is going to be pivotal, as well as being able to ensure that patients are still getting their routine visits to their physician's office in order to prevent any cervical cancer for screening, and also, we should be proponents of that HPV vaccine.

Drug Topics: How can pharmacists connect patients with community resources for sexual and reproductive health services?

Cutler: I think, pharmacists, it's very important for us to be involved and not to play our own siloed roles, so being able to have collaborative communications with physicians, nurses, social work, also working with Planned Parenthood, is going to be very important. There are a lot of resources at the CDC website that are patient friendly, as well as there's a resource at Bedsider, which I think is really good for patients as well as for pharmacists, and in addition providing them access to information that is reputable and that is accurate. So, I think doing a presence within social media or even within high schools, within colleges, is going to be very important to ensure that people remain educated and that we don't end up with a bunch of false information that's going out into the public.

Drug Topics: How can pharmacists counsel a patient on the different types of OTC contraceptives available?

Cutler: I think it's going to be very important for a pharmacist, if we see maybe a patient in the aisle who has that inquisitive look, or if they come and speak to us, it's going to be important first to make sure that we talk to them in a noncoercive, nonjudgmental type environment. It's also going to be important to take into account privacy because a lot of patients may not want everyone to hear everything going on, so being just cognizant of that, also having cultural competence, and being aware of how to approach individuals and taking into account maybe their background as well, but making sure we're not bringing our own biases or thoughts into the conversation. I also think it's going to be very important to go over [adverse] effects of the medication, to go over any of the precautions, or any of those important counseling points, and be sure to just give them the education and let them make the total overall decision.

Drug Topics: What are the key points to cover when educating a patient about emergency contraception?

Cutler: When it comes to emergency contraception, there's a lot of points that you want to go over. First of all, you want to know exactly when was the time in which they had sexual intercourse, if they're on any type of medications currently because sometimes I've actually had patients come to me who are taking birth control and did actually not miss a tablet, but they still wanted to use emergency contraception, which wasn't really anything they really needed at the time, and it was because they weren't really educated to what emergency contraception is. So, being able to tell a patient exactly when you need it, when you possibly don't need it, just so patients won't have to incur costs or potentially take a medication that can increase nausea or [adverse] effects that they may have. I think it's also going to be important to let them know the exact time they need to take it. Also, if they do end up vomiting, they'll have to retake a tablet, and if they are sensitive to certain medications, it is going to be important, even prophylactically, to maybe give them an antiemetic or medication to decreased likelihood of nausea if, in fact, they end up vomiting or something after taking the emergency contraceptive. I think it's also important, again, to make sure patients know that emergency contraception will not protect against STIs or STDs, so it's going to be important for patients in that case to potentially get checked for some of that as well. Also, if you have a patient who's constantly coming in for emergency contraception, just for the general price of it, it may be good to at least give them other options that they can use for long-term contraceptive options and just make sure that we're providing this information in a noncoercive, nonjudgmental way and just give them all the information and allow them to make that decision on their own.

Drug Topics: How do you tailor your communication style to meet the needs of diverse patient populations?

Cutler: The best thing, I think, and the best approach, is to listen to the patient. So first of all, ask them, "What would you like me to help you with? Or what are you coming here today for?" And kind of getting information from them. I think the less you talk and the more you listen, the better the communication will go. I think it's also important to take out your own biases that you may have about a particular patient, particular culture, it's going to be very important to look at that patient as that patient and each patient individually.

Drug Topics: Is there anything else you would like to add?

Cutler: So one thing I would like to reiterate is the importance of being able to get this information out into the community. So, I think it's important for pharmacists and health care professionals to be advocates and also important to collaborate with other healthcare professionals. I know within any type of setting, it's really, really helpful to make use of your entire staff, including the technicians, if you are in more of a retail-type setting, making sure the front staff, everyone is aware of what's going on related to reproductive health, and honestly, I think it's also important to take note of the fact that some of these emergency contraceptives, some of the over-the-counter products are actually locked away or behind the counter, and some patients may not even know that they're being sold at a particular location, or they may be kind of scared or timid to even come and ask where some of these products are. So I think accessibility is important along with education, so I think they should go hand in hand.