Patient Interest Remains High for Pharmacist-Led Reproductive Care

Especially in places with limited women’s health services and obstetrics/gynecology availability, there is both significant interest and need for expanding pharmacist-led reproductive health services, according to a study in the Journal of the American Pharmacists Association (JAPhA).¹

“From 2010 to 2022, a total of 238 rural and 299 urban hospitals lost their obstetric services while only 138 hospitals, mostly in urban locations, added them,” according to the UPenn Leonard Davis Institute of Health Economics.² “By 2022, more than half of all rural hospitals (52.4%) no longer offered obstetric care, up from 43.1% in 2010. Urban hospitals were not spared either, with 35.7% lacking obstetric services by 2022, compared with 29.7% a decade earlier.”

This clinical vacuum has turned the spotlight toward community pharmacists, who represent some of the most accessible health care professionals in the country.¹

The current JAPhA study evaluated patients’ perceptions and found that an overwhelming 89% of women aged 18 to 45 years were interested in receiving at least 1 pharmacist-delivered reproductive health service. This interest did not waver based on geographic access, with 90% of women living in areas with inadequate obstetric care and 88% of those in adequate-access areas expressing a strong willingness to utilize pharmacy-based care.

READ MORE: Scripted for Her: Misinformation in Reproductive Health

High Demand in Obstetric Care Deserts

Obstetric access and urbanicity are not interchangeable in today’s health care landscape. The study revealed that although all nonmetropolitan participants faced inadequate access, over half of the participants who lived in counties with inadequate obstetric services actually resided in metropolitan areas.¹

In these underserved communities, patients expressed the highest interest in specific clinical interventions, such as detailed medication reviews for safe use in pregnancy (77%), cardiovascular and hypertension screening (76%), vaccine administration (75%), and guidance on managing pregnancy-related nausea (75%).

Broadening Pharmacists’ Care Spectrum

Maternal health is a lifetime continuum that spans pregnancy prevention, preconception, pregnancy, and the postpartum periods. Because nearly half of all pregnancies in the US are unintended, waiting until a patient seeks traditional prenatal care is often too late to mitigate chronic health risks.^1,3

Pharmacists are uniquely positioned to intervene early by managing chronic conditions like hypertension and diabetes, screening for depression, and ensuring patients take folic acid supplements to optimize prepregnancy health.^1,3,4

However, translating patient interest into standard pharmacy practice faces significant baseline hurdles across different states.

In South Carolina, a study of community pharmacy staff revealed that despite pharmacists and technicians recognizing the local demand for these services, they suffer from pronounced knowledge and confidence gaps. South Carolina pharmacists reported the highest confidence in providing contraception but were significantly less confident in preconception, fertility, and postnatal care.⁴

For instance, a majority of respondents struggled to correctly identify postpartum alarm symptoms or define infertility. Similarly, an Ohio Northern University study found that although community pharmacies could serve as invaluable alternative clinics for women lacking transportation, only 35% of pharmacists practicing in maternity care deserts were even aware of their county's low-access status, while only 11% knew of the National Alliance of State Pharmacy Associations Maternal Health Service Set.^4,5

Overcoming Policy, Reimbursement, and Operational Barriers

The urgency for pharmacist integration is further compounded by a national maternal health crisis. The US suffers from the highest rate of maternal mortality among high-income countries, with over 85% of these deaths being entirely preventable.^2,4,6

This crisis is exacerbated by federal policy shifts, budget cuts to safety-net programs like Title X, and projected Medicaid reductions that threaten coverage for low-income women who represent the majority of births in high-risk communities.⁶

To bridge these expanding health care gaps, pharmacies must overcome substantial operational and systemic barriers. Both South Carolina and Ohio pharmacists highlighted workflow constraints, lack of private consultation spaces, limited access to patients’ electronic health records, and a lack of standardized clinical support tools as major impediments.^3-5

The lack of sufficient reimbursement pathways also prevents pharmacies from hiring the support staff necessary to offer clinical services beyond traditional dispensing.

Evidence shows that resolving these barriers yields profound public health and financial benefits. For example, in Oregon, the first state to authorize pharmacists to prescribe hormonal contraceptives, the policy change prevented dozens of unintended pregnancies and saved the state Medicaid program $1.6 million in public costs within just 2 years.³

By establishing collaborative referral networks with local physicians, securing insurance reimbursement for services, and boosting maternal health education in pharmacy curricula, pharmacists can fully step into their roles as accessible lifelines for maternal health.^3,4

“Patient interest, combined with the prevalence of modifiable risk factors, suggests that pharmacist-led reproductive health services could serve as a pragmatic, scalable strategy to improve maternal health access,” concluded the authors of the current study.¹ “Future work should evaluate implementation models, reimbursement pathways, and outcomes of pharmacist-led reproductive care, particularly in rural or underserved communities where access may be limited.”

READ MORE: Women’s Health Resource Center

REFERENCES

1. Stone RH, Reyome M, Webb S. Filling gaps in reproductive healthcare: women’s interest in pharmacist-delivered services in areas with limited obstetric access in Georgia. JAPhA. August 19, 2026:103503. doi:10.1016/j.japh.2026.103503

2. Seegert L. Over 500 U.S. hospitals have stopped delivering babies since 2010. UPenn Leonard Davis Institute of Health Economics. July 10, 2025. Accessed August 21, 2026. https://ldi.upenn.edu/our-work/research-updates/over-500-u-s-hospitals-have-stopped-delivering-babies-since-2010/

3. DiPietro Mager N, Bright D, Shipman AJ. Beyond contraception: pharmacist roles to support maternal health. Pharmacy (Basel). 2022 Nov 30;10(6):163. doi: 10.3390/pharmacy10060163

4. Davies A, Rudisell E, Ballou J, et al. Barriers, facilitators, and confidence to provide maternal health services in pharmacies in South Carolina. JAPhA. 2025;66(1):102996. doi:10.1016/j.japh.2025.102996

5. Pharmacists can fill gaps in maternity care. Ohio Northern University. May 5, 2025. Accessed August 21, 2026. https://www.onu.edu/news/pharmacists-can-fill-gaps-maternity-care

6. Psaki S, Kass D, Tobin-Tyler E. A dangerous shift in maternal health policy. TIME. April 30, 2026. Accessed August 21, 2026. https://time.com/article/2026/04/29/a-dangerous-shift-in-maternal-health-policy/