June 04, 2010
The Centers for Disease Control and Prevention has issued a set of recommendations for United States health care professionals to use when providing family planning counseling and services.
 
Dr. Herbert Peterson

Dr. Herbert Peterson

Herbert Peterson, MD, Kenan Distinguished Professor and chair of UNC Gillings School of Global Public Health’s Department of Maternal and Child Health, co-chaired the committee of more than 30 health professionals who met in Atlanta in February to consult with CDC regarding the guidelines.

 
Peterson also is professor of obstetrics and gynecology in the UNC School of Medicine.The report, U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, provides guidance on whether women and men with particular medical conditions or physical characteristics safely can use certain methods of contraception.

The recommendations, adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition, do not differ substantially from WHO’s recommendations.

 
Several important adaptations were made, however, for contraception use in the United States. These include special attention to contraception use for women with venous thromboembolism, valvular heart disease, ovarian cancer, uterine fibroids and for postpartum and breastfeeding women.
 
Unique recommendations also were added to the U.S. guidance for women with rheumatoid arthritis, history of bariatric surgery, peripartum cardiomyopathy, endometrial hyperplasia, inflammatory bowel disease and solid organ transplantation.
 
The recommendations in this document are intended to assist health-care providers when they counsel women, men and couples about contraceptive method choice.
 
“Based on scientific evidence and expert opinion, women of reproductive age with chronic diseases and other medical conditions can safely use most methods of contraception,” said Kathryn M. Curtis, PhD, of CDC’s Division of Reproductive Health and lead preparer of the report.
 
“Many health care providers have been uncertain to this point about the safety of contraceptives for women with some of these conditions – but these new guidelines will answer most questions that women and their health care providers have in this regard,” Peterson added.
 
The publication comes after a formal process involving systematic review of the scientific evidence and translation of the evidence into recommendations by experts in family planning, obstetrics and gynecology, and other specialties, including many CDC partners in reproductive health. Published recommendations appear in the May 28 issue of MMWR Recommendations and Reports. Recommendations will be updated regularly to reflect new published evidence.
 
Safe and effective use of contraception is important because unintended pregnancies, which account for approximately half of all pregnancies in the United States, can have negative effects for mother and infant.
 
Choosing a contraceptive may be more complicated for women with a medical condition, but the right choice is critically important to reduce health risks from unintended pregnancy.
 
This guidance helps provide a framework for these women to work with their health care provider to choose safe and effective contraception.
The report states that, in addition to safety, other factors – including effectiveness, availability, acceptability and personal preference – should be considered in determining the most appropriate contraceptive method. Women and men seeking contraception should discuss with their health care providers the full range of contraceptive options.
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The recommendations are available on the CDC MMWR website. A related CDC website will provide updates and supporting information to clinicians as needed.The World Health Organization’s programs and materials are also available online.
UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.
 

 

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