US Selected Practice Recommendations for Contraceptive Use, 2016 (US SPR)
The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and consultation with national experts who met in Atlanta, Georgia, during August 26–28, 2015. The information in this report updates the 2013 U.S. SPR (MMWR 2013;62 [No. RR-5]). Major updates include:
1) Revised recommendations for starting regular contraception after the use of emergency contraceptive pills.
2) New recommendations for the use of medications to ease insertion of intrauterine devices.
The recommendations in this report are intended to serve as a source of clinical guidance for health care providers and provide evidence-based guidance to reduce medical barriers to contraception access and use. Health care providers should always consider the individual clinical circumstances of each person seeking family planning services. This report is not intended to be a substitute for professional medical advice for individual patients. Persons should seek advice from their health care providers when considering family planning options.
Downloads and Resources
A limited amount of provider tools and MMWRs are available to order from CDC-INFO on Demand.
eBook: U.S. Selected Recommendations for Contraceptive Use, 2016
The US SPR eBooks are free for you to download to your Apple or Android mobile device. You will need an eReader app to display the eBooks on your phone or tablet.
US MEC & US SPR App
New app released in May 2022! Includes new US SPR recommendation on self-administration of injectable contraception. The US MEC and US SPR app is an easy-to-use reference for CDC’s contraception guidance for healthcare providers. The app is available for iOS and Android operating systems.
U.S. SPR Speaker Ready Slide Set
This slide presentation can be used by health care providers who want to increase knowledge about the U.S SPR.. The presentation and speaker notes can also be used or adapted to give presentations on the U.S. SPR. This material is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreciated. Powerpoint presentation available in ppt or pdf formats. If you would like to received continuing education credits, visit the training page. [PPT – 4.33MB] | [PDF – 2.09MB]
Teen Pregnancy Prevention Speaker Ready Slide Set
This slide presentation can be used by health care providers who want to increase knowledge about the U.S. MEC, U.S. SPR, and Teen Pregnancy Prevention. The presentation and speaker notes can also be used or adapted to give presentations on the U.S. MEC, U.S. SPR, and Teen Pregnancy Prevention. This material is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreciated. Powerpoint presentation available in ppt or pdf formats. If you would like to received continuing education credits, visit the training page. [PPT – 14.4MB] | [PDF – 5.51MB]
Print Version of the MMWR [PDF – 187KB]
Print version of the MMWR US Selected Practice Recommendations for Contraceptive Use, 2016
When to Start Contraceptive Methods and Routine-Follow Up – [PDF – 158KB]
This provider tool contains information from the US SPR into a one page document. It includes How to Be Reasonably Certain That a Women Is Not Pregnant, When to Start Using a Specific Contraceptive Methods, and Routine Follow-Up After Contraceptive Initiation.
What to Do If Late, Missed, or Delayed Combined Hormonal Contraception – [PDF 213KB]
This provider tool from the US SPR contains Recommended Actions After Late or Missed Combined Oral Contraceptive, Recommended Actions After Delayed Application or Detachment with Combined Hormonal Patch, and Recommended Actions After Delayed Insertion or Reinsertion with Combined Hormonal Ring.
Management of IUD when Pelvic Inflammatory Disease (PID) is Found and Management of Women with Bleeding Irregularities [PDF – 104KB]
This provider tool contains two diagrams presented in the US SPR. It includes the Management of Women with Bleeding Irregularities While Using Contraception and the Management of the IUD When a CU-IUD or an LNG-IUD User Is Found to Have Pelvic Inflammatory Disease.
Pages in this Report
- Table of Contents
- ›US SPR 2016
- How To Be Reasonably Certain that a Woman Is Not Pregnant
- Intrauterine Contraception
- Combined Hormonal Contraceptives
- Progestin-Only Pills
- Standard Days Method
- Emergency Contraception
- Female Sterilization
- Male Sterilization
- When Women Can Stop Using Contraceptives
- Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use, 2016
- When To Start Using Specific Contraceptive Methods
- Examinations and Tests Needed Before Initiation of Contraceptive Methods
- Routine Follow-Up After Contraceptive Initiation
- Management of Women with Bleeding Irregularities While Using Contraception
- Management of Intrauterine Devices When Users are Found To Have Pelvic Inflammatory Disease