Why would a doctor refuse to prescribe birth control pills?

Blood pressure: Elevated blood pressure, even when borderline, is for many doctors a reason not to prescribed hormonal birth control.

Hard to say.: I suspect the most common reason for this would be religious convictions. If there were contraindications to taking BCP's the doc should simply have discussed contraindications rather than "refusing." If religious concerns are the problem, the doc should refer you to another provider who can help you. Failing to do so would be unethical.

Risks vs benefits: Some experts in the field have argued that birth control pills should not be given to women who have migraines with aura, uncontrolled hypertension, multiple risk factors for heart disease, are smoking at age 35, have a history of blood clots or strokes or heart disease, have lupus, breast cancer, or cirrhosis (partial list). Some physicians do not have much experience with it, so prefer to refer.