Pharmacist Prescribing Expands Into Women's Health

You’ve already been doing it. You’ve been doing it all along. But now, pharmacists in the US have a bold opportunity to fully own the contraceptive prescribing process, make it more efficient, and make it a better experience.

We’ve all stood there in the community pharmacy and heard key and critical questions that women ask, such as, “What do you mean by a backup method?” or “When should I start these new pills?” We’ve all given answers so frequently that responses likely seem rehearsed and reflexive. Answering these questions feels good, because we quickly and thoroughly address a problem in a meaningful way for a patient. And this isn’t new—we’ve all been supporting women’s contraceptive care for decades.

Conversely, we’ve also all stood there in the pharmacy and heard, “What do you mean I’m out of refills? I need this!” or “I can’t get an appointment with my gynecologist for 7 more weeks. Isn’t there anything you can do?” Responses to these questions can feel deeply frustrating because a pharmacist’s training thoroughly prepares the pharmacist to know what the right answer is, but historically legal and logistical hurdles often blocked direct action.

Pharmacists have always advocated fiercely by calling prescribers with a request to write the needed prescription, but no matter how persuasive the pharmacist, there is rarely an instant solution offered to a patient in the same way that a prescriber can simply prescribe. We continue to solve our patient’s problems, just as we have for decades, but we are often limited to inefficient workarounds. Until now.

Pharmacists in most states across the US can now prescribe various hormonal contraception products,^1-3 joining our pharmacist peers in certain jurisdictions in countries including the United Kingdom, Canada, Australia, New Zealand, and South Africa, who also have such privileges.⁴ Rather than, “Let me call your gynecologist and see if they will prescribe X for you,” pharmacists in many states can now simply say to most women, “I can prescribe that for you.” No more waiting for a call back to add refills. No more telling a patient they must wait for an office visit to initiate therapy. The pharmacist’s degree, knowledge, and setting didn’t change, but a legal hurdle was removed, and now pharmacists in many parts of the US can provide immediate, efficient, and thorough care for women that need it.

Although we should celebrate the victory here for our patients to more often receive reproductive health care in community pharmacies, let’s also not let a victory lap distract from the need still in front of us. Unfortunately, US community pharmacist uptake to prescribe contraception has been modest at best in the first few years after gaining the ability to do so.⁵ Furthermore, we must raise awareness among the general public that community pharmacists are now able to provide such services.^3,6,7

In addition, maternity care deserts are a rapidly growing problem across the US.⁸ Hospitals and maternity units are closing, and even if those units are still open, there is a shortage of obstetricians to work in those spaces.⁸ Quite problematically, lacking preconception, maternal, and postpartum care leads to adverse outcomes that even include an increased risk of pregnancy-related death.⁹ Pharmacists can help fill gaps in maternity care deserts or low-access areas through specific service provision:

• Contraceptive care is the first obvious answer, but implementation hurdles, such as adequate reimbursement for services, remain despite new legal allowances.^3,10 To support women’s health care, to improve access, and to assist with the financial viability of community pharmacies, among many other reasons, pharmacists must truly own the prescribing process and demand the efficiency and experience that our patients deserve. We must break the historical dispensing-only mold and fully embrace prescribing.
• STI testing/care and postexposure prophylaxis/pre-exposure prophylaxis prescribing may be a very logical expansion of reproductive health care provision,¹¹ leveraging the pharmacist’s experience with other anti-infective prescribing for acute infections (eg, group A streptococcus, influenza, or COVID-19 and preventive care services (eg, vaccinations). Additional advances recently approved in the US for human papillomavirus (HPV) screening for HPV (ie, self-collection tests that can be utilized in pharmacies and at-home self-collection tests) provide opportunities for pharmacists to also help close gaps in cervical cancer screening.¹²
• Care referrals work synergistically with pharmacist contraception prescribing. For example, pharmacists may prescribe a hormonal contraception product while a patient is being referred to/waiting for a long-acting reversible contraception (LARC) appointment and can even help to prepare the patient’s expectations and understanding of the LARC itself.

Pharmacists across the US are already routinely providing immunizations, folic acid, and prenatal vitamins to support women’s and maternal health, and many others go even further, providing fertility and pregnancy planning support; management of potentially teratogenic medications; and screening and referral for intimate partner violence or social health needs, among other services. In fact, the National Alliance of State Pharmacy Associations has developed an evidence-based “Maternal Health Service Set for Pharmacists,” which collates a list of services pharmacists may provide to reproductive-age women based upon recommendations from the Women's Preventive Services Initiative and US Preventive Services Task Force.¹³

Now that most US pharmacists can offer our patients simpler processes for obtaining contraception products through pharmacist prescribing, let’s come together and fully own the prescribing process in which we’ve been entrusted, fill public health gaps, and provide more comprehensive women’s health care for our patients. Only then will we achieve the vision set forth by the International Pharmaceutical Federation for pharmacists to improve women’s and maternal health by “work[ing] within the full scope of pharmacy services appropriate in their country.”¹⁴

References:

1. National Alliance of State Pharmacy Associations. Pharmacist prescribing: Hormonal contraceptives. Accessed on February 27, 2026. https://naspa.us/resource/hormonalcontraception/
2. Guttmacher Institute. Pharmacist-prescribed contraceptives. Accessed on February 27, 2026. https://www.guttmacher.org/state-policy/explore/pharmacist-prescribed-contraceptives
3. KFF. Pharmacies as an access point for expanding contraceptive care. Accessed on February 27, 2026. https://www.kff.org/womens-health-policy/pharmacies-as-an-access-point-for-expanding-contraceptive-care
4. Ali ZZ, Assifi AR, Skouteris H, Pirotta S, Hussainy SY. Community pharmacists improving equitable access to contraceptive methods: A commentary. Int J Clin Pharm. 2025;47:477-483. doi:10.1007/s11096-025-01870-x.
5. Rak S, Strasser J, Schenk E, Steenland MW. Contraceptives at the counter: Pharmacists prescribed a fraction of overall contraceptives, 2022. Health Aff (Millwood). 2025;44:1411-1416. doi:10.1377/hlthaff.2025.00224.
6. Luli AJ, Tran N, Ataya A, Rafie S. Patient screenings for preconception health interventions at a community pharmacy. Pharmacy (Basel) 2020;8:181. doi:10.3390/pharmacy8040181
7. Gomez AM, Rafie S, Garner-Ford E et al. Community perspectives on pharmacist-prescribed hormonal contraception in rural California. Contraception 2022;114:10–17. doi:10.1016/j.contraception.2022.05.013
8. March of Dimes. Nowhere to go: Maternity care deserts across the U.S. Accessed on February 27, 2026. https://www.marchofdimes.org/sites/default/files/2024-09/2024_MoD_MCD_Report.pdf
9. Fontenot J, Brigance C, Lucas R, Stoneburner A. Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States. BMC Pregnancy Childbirth. 2024;24:350. doi:10.1186/s12884-024-06535-7
10. Center for American Progress. Fact sheet: Common challenges and recommended solutions for implementing pharmacist prescribing of contraceptives. Accessed on February 27, 2026. https://www.americanprogress.org/article/fact-sheet-common-challenges-and-recommended-solutions-for-implementing-pharmacist-prescribing-of-contraceptives/
11. National Academies of Sciences, Engineering, and Medicine. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. The National Academies Press; 2021. doi:10.17226/25955
12. National Cancer Institute. FDA approves HPV tests that allow for self-collection in a health care setting. Accessed on February 27, 2026. https://www.cancer.gov/news-events/cancer-currents-blog/2024/fda-hpv-test-self-collection-health-care-setting
13. National Alliance of State Pharmacy Associations. Maternal health service set for pharmacists. Accessed on February 27, 2026. https://naspa.us/resource/maternal-health-service-set-for-pharmacists/
14. International Pharmaceutical Federation. FIP Statement of Policy: The effective utilization of pharmacists in improving maternal, newborn and child health. Accessed on February 27, 2026. https://www.fip.org/file/1582