Utilizing pharmacists to bridge gaps in contraceptive care: New Mexico as a case study

Hormonal contraception, both daily and emergency use, has played a central role in reproductive care to prevent pregnancy, reduce the need for abortion, and manage medical conditions. Contraceptive access is a longstanding issue that carries personal, social, economic, and health-related consequences. Approximately 45% of all pregnancies each year in the United States are unplanned, with individuals of lower income experiencing rates 5 times more than those with higher incomes. Rural populations face additional challenges, including higher rates of adolescent pregnancy and limited access to care. New Mexico (NM) will serve as a central example in this commentary on pharmacy access to contraception, as 26 of its 33 counties are considered rural. NM has an adolescent pregnancy rate above national average and high uninsured and poverty rates. In 1993, NM became the first state in the United States to pass legislation authorizing specially trained pharmacists to prescribe under a collaborative agreement with a physician, an early and innovative step toward expanding care in underserved areas. Pharmacy access to contraception is aimed at increasing availability of contraceptives, though significant barriers remain. As these barriers grow across the nation, this commentary explores how pharmacist-led models, using NM as a case study, can be leveraged to improve access to contraception and broader health outcomes in all communities.