Tennessee is on the verge of becoming one of the few states that allows women to buy hormonal birth control without first having to visit a doctor.
The idea is seen as a way to make birth control more widely available, and perhaps even reduce the number of abortions. But turning it into reality has taken a long time.
More than two years have lapsed since the Tennessee General Assembly passed a law enabling women to skip the doctor's visit. But for decades, the thought had been that hormonal contraceptives have lots of potential side effects, meaning a physician's consultation was essential.
And even though the thinking now is that they're relatively safe — especially compared to child birth — the idea that a pharmacist could simply dispense birth control pills or a patch without more oversight remains practically revolutionary.
"And it is," says Reggie Dillard, head of the Tennessee Board of Pharmacy. "It's breaking new ground and that was one of the reasons why it was a little longer for the task force to get together and develop the rules and regulations that we felt like we needed to have in order to be sure we were protecting patient safety."
The lengthy rule-making policy in Tennessee is not unusual. In fact, the few other states that have tried to eliminate the doctor's prescription have had similar experiences.
Regulators say that's because there's not much precedent. Though hormonal contraceptives have been available without a doctor's prescription in other countries for years, it wasn't until California got rid of the requirement in 2016 that women anywhere in the United States could get them without first seeing a doctor.
Since then, seven other states have passed legislation eliminating the mandatory doctor's visit. But several of those, including Utah, Maryland and Washington, D.C., are still working out how to do so.
One complication is that states, including Tennessee, can't technically make birth control available over the counter. Federal law requires hormonal contraceptives to remain with the pharmacists and for there to be a prescription on record. So the best states can do is make those requirements as simple to meet as possible.
And advocates say the barriers to buying birth control will be lowered in Tennessee. The rules in the works state that all women need to do to get hormonal contraceptives is fill out a health questionnaire and receive information about those potential side effects that once so vexxed physicians.
The new rules are expected to go into effect in mid-July, which means pharmacies could start selling birth control without a doctor's prescription shortly afterward.