CDC Contraception Guidelines
The Reproductive Health Access Project has finished updating the Medical Eligibility Criteria for Initiating Contraception based on the 2024 CDC Medical Eligibility Criteria (MEC) and Selected Practice Recommendations (SPR) for Contraceptive Use. This is a reference tool for clinicians who want to check a patient’s medical eligibility for initiating various forms of contraception as they relate to absolute and relative contraindications. Updates include new recommendations for breastfeeding, postpartum, postabortion, obesity, major surgery, deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, cirrhosis, liver tumor, sickle cell disease, and solid organ transplantation (Appendix A).
Notable updates include:
- Recommendations on contraceptive use among people with chronic kidney disease on dialysis or with nephrotic syndrome
- Modified or re-categorized conditions and characteristics, like postabortion, surgery, deep vein thrombosis or pulmonary embolism
- Hormonal contraceptive use for people with sickle cell disease was increased from a MEC category 2 to category 4, reflecting thrombosis risk.
- Accounting for new formulations of contraceptive methods, like the drospirenone progestin-only pill and vaginal pH modulator.
Notable changes to the SPR to enhance contraceptive care include:
- Expanded pain relief options during IUD placement: The SPR emphasizes that all patients should be counseled about potential pain during IUD insertion. It recommends developing a person-centered plan for pain management and includes topical analgesics like lidocaine gels, creams, or sprays. Misoprostol is not recommended for routine use for IUD placement.
- Expanded treatment options to manage bleeding irregularities with contraceptive implants: Recommendations include the use of antifibrinolytic agents, such as tranexamic acid, and selective estrogen receptor modulators (SERMS, e.g. tamoxifen).
- Importance of unbiased, patient-centered contraceptive counseling and care for transgender and gender-expansive individuals using testosterone who may still be at risk for pregnancy. This recommendation is particularly important to highlight as the Trump administration’s executive orders may cause the CDC to modify their public-facing guidelines to remove evidence-based information related to the needs and experiences of transgender and gender-diverse individuals.
- Support for self-administration of injectable contraception: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) should be made available for self-administration. Increasing access to self-injectable contraception can empower people to manage their contraceptive needs on their own terms.
To learn more about these updates and others to the MEC and SPR, you can review our September 2024 Contraceptive Pearl, Updated CDC Contraception Guidelines, and review the resources below.
At the time of this publication, the CDC has reinstated the 2024 MEC and SPR to its website without any edits. On our resource page, we still have links to downloadable PDFs of these guidelines, reference charts, and appendices.
A number of incredible activists have saved clinical guidelines, reports, and datasets on family planning, sexual health, vaccine schedules, youth healthcare, LGBTQI+ care, and more. Find them here:
https://pegasushealthjustice.c
https://jessica.substack.com/p
https://birthcontrolpharmacist
https://archive.org/details/20
As the new Trump administration continues to try and censor evidence-based information from critical public health agencies, like the CDC, RHAP remains committed to being a trusted source of information, resources, and support for our community.
RHAP Resources:
Your Birth Control Choices Fact Sheet
Medical Eligibility Criteria for Initiating Contraception
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