Contraceptive Pearl: Updated WHO Guidance on Contraception
Written by Angeline Ti, MD, MPH
Earlier this month, the World Health Organization (WHO) released the 6th edition of the Medical Eligibility Criteria for Contraceptive Use (MEC) and the 4th edition of the Selected Practice Recommendations for Contraceptive Use (SPR). Clinicians in the US may be familiar with the similarly named guidance, the US MEC and US SPR from the Centers for Disease Control and Prevention (CDC), but many US clinicians may not be aware that the CDC guidance was originally adapted from guidance frm the WHO.
The first edition of the MEC was published in 1996 with the intention of creating evidence-based guidance to help inform the provision of contraceptive care and to reduce unnecessary medical barriers to care.1 Epidemiologists at CDC and WHO applied principles of evidence-based medicine (a growing field at that time) to conduct literature reviews examining the safety of various contraceptive methods for people with medical conditions. Scientific experts, representatives from international agencies, and women’s health advocates convened to formulate recommendations, including creating the MEC categorization system in order to move beyond the binary of contraindications.
MEC Categorization System1
Following the creation of the MEC, WHO also published the SPR in 2002 to provide guidance around common contraceptive management questions. The intended audience for the MEC and SPR includes policymakers, family planning program managers, and the scientific community, who use these recommendations to guide policy, programming, and inform research priorities. The guidance is meant to be adapted to local contexts and populations and has notably been adapted for national guidance, such as in the US2 and the UK.3 To further support the implementation of high-quality family planning services, WHO has also created the “Decision-making tool for family planning clients and providers,” “Family planning: a global handbook for providers,” the MEC Wheel, and an app. To learn more about the latest edition of the MEC and SPR, register for this webinar on November 26! As the future of the US MEC and US SPR remains uncertain, clinicians in the US should also be aware of global guidelines that can inform evidence-based reproductive health care practice.
RHAP Resources:
Your Birth Control Choices Fact Sheet
Medical Eligibility Criteria for Initiating Contraception
Download and print our resources for free from our website or visit our store to buy physical copies!
Partner Resources:
Reproductive Health Hotline (ReproHH): A free, confidential phone service (1-844-737-7644) offering evidence-based clinical information for healthcare providers across the US who have questions related to sexual and reproductive health.
Medical eligibility criteria for contraceptive use, 6th ed.: This document is part of the process for improving the quality of care in family planning. Medical eligibility criteria for contraceptive use (MEC) presents current World Health Organization (WHO) recommendations on the safety of various contraceptive methods for use in the context of specific health conditions and personal or physiological characteristics.
Selected practice recommendations for contraceptive use, 4th ed.: This document is part of the process for improving the quality of care in family planning. Selected practice recommendations for contraceptive use (SPR) presents current World Health Organization (WHO) recommendations on how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate.
Medical eligibility criteria for contraceptive use, 6th ed.: The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support providing person-centered contraceptive counseling and services in a noncoercive manner.
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