Woman had to drive 100 miles round-trip to in severe winter weather to get prescription
By Laura Brown
BridgeTower Media Newswires
MINNEAPOLIS — Reproductive health advocates are sounding the alarm about possible limited or prohibited access to contraception after Dobbs v. Jackson Women’s Health Organization. But a case going to trial next month suggests that a threat to reproductive health care already exists in Minnesota.
The case arises out of a woman’s 2019 quest to get a pill prescribed by a doctor. Andrea Anderson is a mother of five. After spending time with her partner in January 2019, she realized that her regular contraception failed. Not planning to have any more children, Anderson contacted her doctor the next day to review her options. Her gynecologist prescribed ella, which is marketed as the most effective morning-after pill.
Emergency contraception pills are effective 95% of the time, according to the World Health Organization, when used within five days of sex. However, the pills are most effective when used as soon as possible after sex. The pills work by delaying or preventing ovulation. If there is a developing embryo or implanted blastocyst, the pill will do nothing to harm or interrupt those processes. Thus, if the goal is to prevent pregnancy, the pills must be taken soon, as implantation can occur as early as six days after ovulation.
Anderson had her medications filled at the Thrifty White pharmacy in McGregor, Minnesota, due to its proximity to her home. Residing in McGregor — which has a population of a few hundred people and is more than 100 miles north of Minneapolis — Anderson did not have many pharmacy options. In the past, Anderson had no issues with getting her prescriptions at Thrifty White. Anderson’s doctor sent the prescription to Thrifty White. Thrifty White told Anderson that ella would be ready for pickup the following day and would be covered by her health insurance. But when Anderson arrived to get her medication, she found out she would be unable to take it. Although Anderson first assumed that she would be unable to take it because of a negative interaction with another medicine she took, she subsequently learned she would not get her medication because the pharmacist had a personal objection to dispensing emergency birth control.
Although the pharmacist told Anderson that a different Thrifty White pharmacist might be able to dispense the medicine the next day, he informed Anderson that impending winter weather might prevent the pharmacist from being able to make it to work. He also let Anderson know that Shopko, the next closest pharmacy, would also not be worth trying. The pharmacist did not give Anderson any information about where she might be able to fill her prescription.
The next pharmacy Anderson tried was CVS, located in Aitkin, Minnesota, roughly a 20-mile drive. However, the pharmacist told Anderson that she could not fill the prescription due to not being able to find a wholesaler. The CVS pharmacist said that she called Walgreens in Brainerd — 50 miles southwest of McGregor — but that they also were unable to fill the prescription.
Anderson, now skeptical about the information she was getting from pharmacists in her area, called Walgreens. She says she called Walgreens herself and was surprised to learn that the CVS pharmacist had lied, and that Walgreens had actually reported that they could fill the prescription.
Anderson then faced a choice: risk an unwanted pregnancy or drive 100 miles round-trip in severe winter weather conditions to get to Walgreens. She chose the latter. The near-blizzard conditions made the trip take three hours. The temperatures and wind chill were below zero. Anderson also had to make the trip with her 2-1/2 year old son.
“Like anywhere, there are challenges to living in a rural area. But I never expected that they would include the personal beliefs of our local pharmacists or that they would hold — and wield — such enormous decision-making power over my life. The pharmacists I encountered ignored my health needs and my doctor’s instructions,” Anderson said.
Pharmacists’ refusal to dispense contraception is not uncommon. According to the National Women’s Law Center, there have been reports from at least 26 states of pharmacies refusing to fill prescriptions for birth control. Six states — Arizona, Arkansas, Georgia, Idaho, Mississippi, and South Dakota — have laws permitting pharmacists to refuse to dispense contraceptives based on their moral or religious objection. The Minnesota Board of Pharmacy created an extremely permissive exception for dispensing emergency contraception in 1999, allowing pharmacists to decline to fill a prescription so long as they give patients an alternative way to get the medication.
Plan B One-Step is the only emergency contraceptive drug currently available without a prescription. In many pharmacies, it is available alongside condoms. But some pharmacies have placed Plan-B behind the counter or in locked cases. This would require consumers to have to request a pharmacist or other staff release the medication to them, and they may be unhelpful depending on their personal beliefs.
Jess Braverman, legal director of Gender Justice, who is representing Anderson, says, “This is a good example of a situation where you can have a legal constitutional right, but it can be meaningless without access.”
Braverman believes that refusals will become more commonplace post-Dobbs: “We are going to see an increase in denials not just from pharmacists imposing their beliefs on their patients, but from pharmacists in states that are passing laws either targeting contraception explicitly or passing abortion bans that are so vague and broad that they seem to encompass contraception despite the fact that contraception is not abortion. We are also going to see patients be denied other medications, including life-saving medications, that may incidentally impact pregnancy outcomes.”
Part of the reason that Anderson struggled so much to get her medication was her location. Braverman says that increased restrictions will acutely affect pregnant people in rural areas, where access to health care is already limited.
“Pregnant people in rural areas have fewer options for pharmacies, hospitals, and doctor’s offices. It can be harder to physically access care,” Braverman said. “If the limited care available includes providers who disregard best practices and medical need and instead impose their religious beliefs on their patients, this further limits options.”
At the end of the day, Anderson was able to prevent an unwanted pregnancy due to luck and privilege.
“Ms. Anderson was lucky that she was able to ultimately find a pharmacy where she could get her medication, but she had to have a car, be able to afford gas, be able to bring her child with her, have access to a phone she could use to call around to figure out who has the medication. “Not everyone is going to be able to do that,” Braverman said.
