CDC Contraceptive Guidance for Health Care Providers
The American Congress of Obstetricians and Gynecologists (ACOG) endorses the U.S. SPR and encourages its use by Fellows. Understanding and Using the U.S. Selected Practice Recommendations for Contraceptive Use, 2013. Source: Obstet Gynecol. 2013;122:1132–1133.
Unintended pregnancy rates remain high in the United States. About 50% of all pregnancies are unintended, with higher proportions among adolescent and young women, women who are racial/ethnic minorities, and women with lower levels of education and income.1 Unintended pregnancies increase the risk for poor maternal and infant outcomes2 and in 2002, resulted in $5 billion in direct medical costs in the United States.3
About half of unintended pregnancies are among women who were not using contraception (birth control) at the time they became pregnant. The other half are among women who became pregnant despite reported use of contraception.4 Strategies to prevent unintended pregnancy include removing unnecessary medical barriers to contraceptive use, and helping women and men at risk for unintended pregnancy choose appropriate contraceptive methods and use them correctly and consistently to prevent pregnancy.
In 2010, CDC adapted global guidance from the World Health Organization (WHO) to help health care providers counsel women, men, and couples about contraceptive method choice. The U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 (US MEC), focuses on who can safely use specific methods of contraception, and provides recommendations for the safety of contraceptive methods for women with various medical conditions (such as hypertension and diabetes) and characteristics (such as age, parity, and smoking status).
The U.S. Selected Practice Recommendations for Contraceptive Use, 2013 (US SPR) provides guidance on how contraceptive methods can be used and how to remove unnecessary barriers for patients in accessing and successfully using contraceptive methods. The US SPR includes recommendations on when women can start contraceptive methods, what exams and tests are needed before starting a method, what follow-up is appropriate, and how to address side effects and other problems with contraceptive method use.
How to Use the US MEC and US SPR
Health care providers can use these documents when counseling patients about contraceptive choice, how to use contraceptive methods, and how to manage problems with contraceptive use. CDC has developed several provider tools, including summary charts, a US MEC wheel, and mobile tools for easy access to this guidance.
- Finer LB, Zolna MR. Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011;84:478–485.
- Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann. 2008;39:18–38.
- Trussell J. The cost of unintended pregnancy in the United States. Contraception. 2007;75:168–170.
- Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health. 2006;38:90–96.
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