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Letter 8: Letter from Natalie


Dear Annie,


I wish that things could be different- your death came far too soon, and it

breaks my heart to know that it could have been prevented. Your family has

inspired me, by turning this unimaginable loss into a campaign for

awareness and change. I have learned so much from their work, and I

frequently find myself thinking about your story.


Over the past couple of days, I've noticed that several news media outlets have published pieces about a recent public health venture that prescribes women birth control via apps on smart phones. After learning about you and your family, these articles immediately caught my attention and I felt compelled to write to you.


From reading these articles, I learned that users of these apps enjoy the convenience of getting birth control prescriptions at the local pharmacy or delivered to their homes, without having to take time off from work or school to travel to a doctor's appointment. Instead, women answer a series of questions about their health online or by video, and a doctor reviews this information.


While I am strongly in favor of making contraception more accessible for all women, these apps make me worry. I understand that a doctor's appointment can be very inconvenient, but it is impossible to overstate the importance of these visits. These appointments let patients and doctors engage in a dialogue, and allow physicians to perform physical exams and other tests that might be important factors in deciding whether or not to prescribe a certain medication. Annual check-ups let a patient and their doctor revisit previous prescriptions and check for worrisome symptoms. 


To me, the convenience of these apps is not convincing enough to set aside the potential health risks. The suggestion that birth control pills can be distributed by anyone other than an in-person physician is concerning, given the risks. A doctor's appointment is an important source of patient education. It is crucial that physicians be knowledgeable about the drugs that they are prescribing. An appointment with a patient is the physician's chance to inform her of the risks and benefits of her various birth control options, and an opportunity for the patient to ask questions. Annie, your story is a tragedy, and I am concerned that other young women could be harmed by these apps. Without this in-person doctor-patient interaction, other women could be prescribed risky forms of birth control without the proper education or thorough evaluation of other health risks.


Thank you again for all that you and your family have taught me - I am determined to continue spreading awareness and push for change.




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