Missouri: Champions of Choice…for Pharmacists!

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Missouri: Champions of Choice…for Pharmacists!

Dr. Megan L. Evans

The Missouri State House overwhelmingly (115-43) approved an amendment that only further restricts Missourian women’s access to safe, effective contraception and medication abortion.

Recently, the Missouri State House overwhelmingly (115-43) approved an amendment that only further restricts Missourian women’s access to safe, effective contraception and medication abortion.  This amendment allows pharmacies and pharmacists the choice to carry Plan B and Mifepristone (RU-486), making it one of many other “conscience” laws that have popped up in other states.  Additionally, under this new amendment, consumers would not be allowed to sue the pharmacy for not carrying the medication they desired.  Although it says “any medication,” we all know what this is really about.  Another barrier for women and another attempt to undermine women’s right to choose and have access to all methods of safe contraception.  I don’t foresee pharmacists refusing to stock amoxicillin or Viagra because they are morally opposed to it.  Could you imagine the uproar if Viagra or Cialis wasn’t stocked? 


This might not affect women who live in the more urban areas of Missouri where there are a number of pharmacies to choose from, but imagine a woman who lives in rural Missouri.  Perhaps there is only one pharmacy in her region, and this particular pharmacy decides not to stock Plan B because Mr. Pharmacist believes EC is wrong and is personally against it.  Who really suffers in the end?  State Representative Mary Still stated “To implement a law like this, especially in a rural area, seems to me to put another road block before women…This is one more weapon of mass distraction that we see at a time where we should be paying attention to the real issues of the state.”  I partially agree with Representative Still and know what she is trying to say, but is family planning not a real issue?  Perhaps Missouri just has the best all around family planning package in the U.S. and, to the representatives, this isn’t a real issue?

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Fortunately, The Guttmacher Institute puts together fact sheets that illuminate how each individual state is stacking up when it comes to abortion care.  Overall, Missouri has lower abortion rates than the U.S. as a whole.  In 2005, there were 6.9 abortions per 1,000 women aged 15-44 in Missouri as compared to 19.4 abortions per 1,000 women aged 15-44 in the U.S.  However, abortion rates in the U.S. have been going down and have dropped 9% since 2000.  In Missouri, abortion rates have increased 6% since 2000.  In the U.S., 87% of counties have no abortion provider.  However, in Missouri, 96% of counties have no provider and the majority of Missouri women (68%) live in these counties. Currently, there are only 7 abortion providers in the entire state and three metropolitan areas in Missouri have no abortion provider.


Over a fourth of women receiving an abortion in Missouri have driven between 50-100 miles to the clinic.  This is particularly worrisome in that Missouri has a 24-hour waiting period law on the books.  Public funding is available for a woman’s abortion, but only if she is a victim of rape or incest or if her life is endangered (not her health). Private insurance doesn’t cover abortion unless a woman’s life is endangered (again, not her health). 


When it comes to contraceptive access, Missouri is somewhere in the middle in comparison to all other states in the U.S..  Guttmacher ranked Missouri 14th in laws and policies, 24th in public funding, and 37th in service availability.  Overall, they are smack in the middle at number 25 in the rankings. 


There are some great aspects to contraception access in Missouri.  For example, 92% of counties have at least one family planning clinic.  Due to their public funding for contraception, specifically for low income women, Missouri family planning clinics are able to prevent 25,300 unintended pregnancies each year!  In fact, most features of Missouri’s family planning policies received top scores from Guttmacher.  Well, all except minors’ consent law and access to emergency contraception.  Clearly, Missouri is not in a place to further restrict women’s access to contraception, specifically Plan B.  Decreasing access to Plan B and Mifepristone could have detrimental effects to women living in this state.  With abortion rates rising in Missouri, this is a poor legislative move. 

What purpose does this new amendment serve?  Who are the Missouri State House members representing? A handful of pharmacists who feel a bit sour about EC and RU-486 or the 1,211,350 women of child bearing age in Missouri?  Where is their representation and their voice when these restrictive bills are put through? 

I encourage you to write to the representatives in Missouri’s State House about your feelings of this new amendment.  It doesn’t matter if you live in Missouri or not.  These amendments are not just another road block for Missouri women, they are a barrier for all of us. 

State information can be found at www.guttmacher.org