In 2018, Madelyn Brown contacted her pharmacist for a fairly routine refill on her birth control pills.
Instead, she was met with hostility as the pharmacist ordered Brown to contact her gynecologist for authorization. Once she got in touch with the clinic, they refrained from ordering the refill because of how long it had been since her last checkup.
The nurses she spoke to made it abundantly clear — to get her coveted birth control pills, she needed to submit to a pap smear and a pelvic exam.
Her last checkup, while a year and a half ago, came back positively normal. She had no incidents or anything change in her life to justify undergoing such an invasive procedure except for this clinic’s birth control policy.
Brown’s story is unfortunately not a unique one. Approximately one-third of doctors require a pelvic exam before prescribing birth control. Some people may think annual pelvic checkups are a symptom of adulthood, something every woman must grit their teeth through in order to ensure they are the healthiest they could possibly be.
This is not the case, as a study in 2015 established annual pap smears are correlated to high false-positives for an abnormal pap smear. These false positives can be highly devastating for those who receive it as they delve into a world of financial hardship, worst-case scenarios and, of course, have to undergo more cervix-prodding procedures.
It isn’t to say women should never get a pelvic exam. If it is medically necessary for a woman, there is no doubt she should get one. The American Cancer Society recommends women not in the high-risk category get a pap smear every 3-5 years – any less and you risk the chance of getting a false positive. Even then, women can get a just as effective self swab kit if they find pap smears traumatizing or difficult to endure.
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The link between an annual checkup and oral contraceptives arose through the extremely sexist belief that if women could receive birth control without receiving a medically invasive examination, they would simply never do these checkups.
This is obviously problematic — believing women are not able to be responsible for their own bodies is something that needs to be addressed in the medical community. There should be no link between getting a pelvic exam or a pap smear and oral contraceptives.
The high rates of doctors mandating checkups are a testament to the pervasive nature of sexism in medicine and in society, which enabled the normalization of such a backwards procedure. Moreover, Medicare pays doctors $75 per screening pelvic exam, and some private insurance companies pay more, giving doctors a massive incentive to continue this practice.
“The real message of the survey results is for practitioners, who, based on these findings, need better awareness of current guidelines on birth control prescription,” Dr. George F. Sawaya, one of the researchers on the study, said.
Sawaya is right. It is long overdue doctors reverse policies stripping women of their rights to their bodies. Birth control is over the counter in at least 100 other countries and a few states in the U.S. Unfortunately, this does not include Wisconsin, where women living here can confirm this policy is rampant.
Creating additional burdens in accessing birth control is an incredibly counterproductive move. There is no real evidence that suggests birth control should even be prescribed — doctors do nothing to make the birth control process more safe or beneficial for women.
It is time to end this era of unnecessary medical procedures for the sole purpose of stripping women of their autonomy. Women have a right to not submit to procedures scientifically deemed unnecessary. Women should not need to bargain for a basic necessity — birth control.
Samiha Bhushan ([email protected]) is a freshman studying neurobiology and English literature.