There were 45 visits in which secret shoppers reported contraindications to using the Pill such as a history of blood clots or migraine with aura. In those cases, the companies followed medical guidelines 93% of the time.
How does that compare with traditional office visits? It’s a bit tricky to judge, according to Mehrotra.
“A limitation of this study is that we didn’t directly compare this with the care these same patients would’ve received at an office visit,” he said.
But, he added, based on past research, that 93% figure may actually be better than in-person care.
If that’s the case, there’s some sense to it, according to Mehrotra: A busy doctor may not always ask all the right questions, while a standardized online questionnaire would be consistent.
Still, the online approach has its shortcomings, Mehrotra added.
One concern is that women who use the services may not be aware of all the contraception options out there. Only two companies in this study offered information about long-acting contraceptives. Those include intrauterine devices (IUDs) and small implants placed under the skin of the arm; they have to be inserted by a doctor or nurse, but they are also the most effective forms of reversible birth control.
Susan Wysocki is a women’s health nurse practitioner and serves as a medical advisor to the American Sexual Health Association.
“One thing these companies could improve upon is information on long-acting reversible contraceptives,” Wysocki said.
She suggested that women who are interested in getting birth control online first do some research on all of their options, for example, through a trustworthy website like Planned Parenthood.
In general, though, women can feel comfortable getting their birth control through these services, according to Wysocki.
“Birth control pills are safe and effective when taken correctly,” she said. “But accessibility is an issue. These [companies] make reliable contraception available from the comfort of your home, and that’s a good thing.”
As for price, the study found that sites ranged widely. Most accepted health insurance, but uninsured customers would pay anywhere from $67 to $519 for a one-year prescription (including the cost of the visit). The average price tag was $313.