OK everyone, my two cents in this old debate.
One of the major reasons to require an annual exam for the Rx of OPCs is that, for many women, this is the ONLY well women care they receive. The exam consists of more than just a pap smear, it includes a full physical.
I disagree that an annual exam is a particular barrier to contraceptive use (one hour, once a year!) - bigger barirres are the myths surrounding OCPs, the lack of OCP coverage by many health insurance policies, and the misuse of OCPs.
Persons on medicare/aid/welfare and various other programs get the exam and OCPs at no cost.
I think the "morning after pill" should be readilly avalible over the counter, as there is little to no risk - even for the smoker.
Yes, the PDR lists the absolute contradictions; however, there are relative contradictions - especially for smokers over 35. that is not included in the PDR, nor does it include evidence or references. The PDR is printed by the pharm companies, and is basically "politically correct".
Two better resourses for information on OCPs are Hatcher's "Contraceptive Technology" or Dickey's "Managing Contraceptive Pill Patients." These are the definitive "bibles" on the subject.
ANYWAY - like i said - my two cents
PAC, RNC CNM, presently in an innercity Chicago women's health clinic
PS sorry about my spelling