Keeping Guidance Up to Date

At a glance

This page describes the approach CDC uses for keeping the 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) up to date. The U.S. MEC comprises recommendations for health care providers for the use of specific contraceptive methods by persons who have certain characteristics or medical conditions.

Overview

As with any evidence-based guidance document, a key challenge is keeping the recommendations up to date as new scientific evidence becomes available. Working with WHO, CDC uses the CIRE system to ensure that WHO and CDC guidance is based on the best available evidence and that a mechanism is in place to update guidance when new evidence becomes available.[16] CDC will continue to work with WHO to identify and assess all new relevant evidence and determine whether changes in the recommendations are warranted. CDC will completely review U.S. MEC periodically. Updates to the guidance will published in CDC's Morbidity and Mortality Weekly Report (MMWR) and posted on the CDC website (https://www.cdc.gov/contraception/hcp/contraceptive-guidance).

As part of the process to update these recommendations, CDC identifies gaps in the evidence for the recommendations considered. Evidence is often limited on the safety of contraceptive methods among persons with certain characteristics or medical conditions. Generalizability of the published evidence to all persons seeking contraceptive services presents a challenge because of biases about who might be included in studies on contraceptive safety. New, high-quality research on contraception that addresses priority research gaps inclusive of diverse populations can further strengthen these recommendations and improve clinical practice.

References

  1. Curtis KM, Nguyen AT, Tepper NK, et al. U.S. selected practice recommendations for contraceptive use, 2024. MMWR Recomm Rep 2024;73(No. RR-3):1–77.
  2. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep 2016;65(No. RR-4):1–66. PMID:27467319 https://doi.org/10.15585/mmwr.rr6504a1
  3. World Health Organization. Medical eligibility criteria for contraceptive use. Geneva, Switzerland: World Health Organization; 2015. https://www.who.int/publications/i/item/9789241549158
  4. World Health Organization. Selected practice recommendations for contraceptive use. Geneva, Switzerland: World Health Organization; 2016. https://www.who.int/publications/i/item/9789241565400
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  6. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016;65(No. RR-3):1–103. PMID:27467196 https://doi.org/10.15585/mmwr.rr6503a1
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  10. American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women, Contraceptive Equity Expert Work Group, and Committee on Ethics. Patient-centered contraceptive counseling: ACOG committee statement number 1. Obstet Gynecol 2022;139:350–3. PMID:35061341 https://doi.org/10.1097/AOG.0000000000004659

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  11. American Public Health Association. Opposing coercion in contraceptive access and care to promote reproductive health equity. Washington, DC: American Public Health Association; 2021. https://www.apha.org/Policies-and-Advocacy/Public-Health-Policy-Statements/Policy-Database/2022/01/07/Contraceptive-Access
  12. Holt K, Reed R, Crear-Perry J, Scott C, Wulf S, Dehlendorf C. Beyond same-day long-acting reversible contraceptive access: a person-centered framework for advancing high-quality, equitable contraceptive care. Am J Obstet Gynecol 2020;222(4S):S878.e1–e6. PMID:31809706 https://doi.org/10.1016/j.ajog.2019.11.1279
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  14. World Health Organization. Framework for ensuring human rights in the provision of contraceptive information and services. Geneva, Switzerland: World Health Organization; 2014. https://www.who.int/publications/i/item/9789241507745
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  16. Mohllajee AP, Curtis KM, Flanagan RG, Rinehart W, Gaffield ML, Peterson HB. Keeping up with evidence a new system for WHO’s evidence-based family planning guidance. Am J Prev Med 2005;28:483–90. PMID:15894153 https://doi.org/10.1016/j.amepre.2005.02.008
  17. CDC. Updating CDC’s contraception guidance documents: U.S. medical eligibility criteria for contraceptive use and U.S. selected practice recommendations for contraceptive use. Atlanta, GA: US Department of Health and Human Services, CDC; 2021. https://www.govinfo.gov/content/pkg/FR-2021-08-31/pdf/2021-18769.pdf
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  21. Armstrong MJ, Rueda JD, Gronseth GS, Mullins CD. Framework for enhancing clinical practice guidelines through continuous patient engagement. Health Expect 2017;20:3–10. PMID:27115476 https://doi.org/10.1111/hex.12467
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  26. Reproductive Health National Training Center. Contraceptive counseling and education eLearning. Washington, DC: US Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of Population Affairs, Office on Women’s Health; 2022. https://rhntc.org/resources/contraceptive-counseling-and-education-elearning
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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); Division of Reproductive Health