Abortion rates have dropped again in Colorado, and health authorities are crediting increased access to birth control statewide.
Pharmacists have written thousands of prescriptions for the birth control pill since 2017, when Colorado became only the third state in the nation to allow women to get prescriptions for oral contraceptives at the pharmacy instead of only from a doctor.
State and federal dollars are funding free and low-cost IUDs — intrauterine devices that prevent pregnancy for five years or more — for low-income women and teens who visit community health clinics across the state.
Another contributing factor: the so-called morning-after pill has been available over the counter at Colorado pharmacies since 2013.
“The goal has always been access,” said Gina Moore, assistant dean for clinical and professional affairs at the University of Colorado Skaggs School of Pharmacy. “We are just really pleased.”
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Nationwide, the number and rate of abortions have declined to the lowest levels since abortion became legal in 1973, according to the latest report from the Guttmacher Institute, which tracks abortion across the country. In Colorado, there were 12,390 abortions in 2017, the most recent year included in the report released this fall. That compares with 14,710 abortions in 2011.
Not all of those abortions were for Colorado women. An unknown number of women traveled from other states to have abortions here. Regardless, there was a 10% drop in the abortion rate for Colorado from 2014 to 2017 — that is 12.1 abortions per 1,000 women in 2014, compared with 10.9 abortions per 1,000 women in 2017.
It’s impossible to parse how much Colorado’s birth control protocol, which allows pharmacists to prescribe oral contraceptives, has affected abortion rates. But public health officials are thrilled with how pharmacies have put the 2016 state law to use.
The state health department isn’t keeping a tally, but it’s clear pharmacists have written thousands of prescriptions for birth control pills. King Soopers pharmacists alone have written more than 1,500 prescriptions since 2017. The Wardenburg Health Center on the University of Colorado campus in Boulder has written close to 400.
Albertsons and Safeway stores also allow their pharmacists to write the prescriptions, as do dozens of smaller pharmacies across Colorado, Moore said. (Walgreens does not participate.)
In Oregon, the first state to allow pharmacists to write birth control prescriptions, researchers found that the law averted more than 50 unintended pregnancies in its first two years and saved the state $1.6 million in public costs associated with medical care.
To write birth-control prescriptions, Colorado pharmacists must complete a four-hour, online training program. Women can obtain the pills within 10 or 15 minutes after walking into a pharmacy and filling out a one-page questionnaire, which asks whether they could be pregnant and their history of migraine headaches, strokes or high blood pressure.
For many college students, especially those who have moved away from home and their regular doctor, visiting a pharmacy to get the pill is far less daunting than making a doctor’s appointment for a pelvic exam.
At the health clinic at CU Boulder, young women who come in for the morning-after pill or birth control are offered several options, including an IUD in the center’s clinic. The IUD can prevent pregnancy up to 10 years. The pill is less reliable, since a woman must take it daily for it to work effectively.
The range of options has improved access for young women, said Sue Mead, pharmacy director at Wardenburg Health Center at the university. “It allows them more ease to obtain any birth control method,” she said. “There is no pressure.”
The clinic’s pharmacy sells about 70 morning-after pill packets per year, or up to about 15 per month in some school months, Mead said. The busiest day of sale is Monday, she said. The pill — a popular brand name is Plan B — prevents ovulation or fertilization of an egg. It works best within 24 hours of unprotected sex.
Moore, the pharmacy school dean, for a few years picked up holiday shifts at a pharmacy chain and found New Year’s Day was by far the busiest day for morning-after pill sales. “New Year’s Day was a banner day,” she said, recalling a line in the drive-thru first thing in the morning. “It would be crazy.”
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Perhaps even more than oral contraceptives, IUDs have contributed to the decline in abortions and unwanted pregnancies, public health officials said.
A landmark report from the Colorado Department of Public Health and Environment two years ago credited IUDs, which are T-shaped pieces of plastic inserted into the uterus, for a major decrease in unwanted pregnancies among teenagers.
The birth rate for girls ages 15 to 19 in Colorado dropped by more than half in an eight-year period, falling 59% from 2009 to 2017. The abortion rate among Colorado teens fell by 60% during those eight years.
Colorado spent $28 million in grant funds during those years to supply IUDs to 75 public health clinics in Colorado, including several inside high schools. Women and teens received 43,714 free IUDs from 2009 to 2016, thanks to a grant from billionaire Warren Buffett’s family.
The grant ended, but the state has maintained the program through state and federal funds, as well as the expansion of Medicaid through the Affordable Care Act. There are 29 contractors who work in 78 clinics throughout Colorado providing free and low-cost IUDs, said Jody Camp, manager of the family planning unit at the state health department.
The Guttmacher Institute report counted 32 facilities in Colorado that provided abortions in 2017. That was a drop from 36 in 2014.
Nationwide, 89% of counties had no clinics that provided abortions. In Colorado, 50 out of 64 counties do not have a facility that provides abortions, according to the institute.