This tutorial demonstrates the basic features of the CDC Contraception app, referencing
the U.S. Medical Eligibility Criteria for Contraceptive Use, MEC, and the U.S. Selected
Practice Recommendations for Contraceptive Use, SPR.
There are links to the full version of these documents in the app, and the CDC Division
of Reproductive Health website.
The U.S. MEC contains recommendations for contraceptive methods for women with select
medical conditions or characteristics.
These guidelines are intended to assist providers in counseling patients, in combination with
their clinical judgment and a patient’s values and preferences.
When you open the app, you can search the U.S. MEC by selecting MEC by Condition or
MEC by Method.
U.S. MEC recommendations are divided into four categories.
Category 1 - There is no restriction to use that contraceptive;
Category 2 – The advantages of using the method generally outweigh the risks;
Category 3 - The risks of the method generally outweigh the advantages; and
Category 4 – There is an unacceptable health risk for using that method with that specific
condition.
For some conditions, there are different recommendations for initiating a method and continuing with
that method if a patient is already using it when she develops the condition.
For example, if a patient has a current chlamydial infection, IUDs are designated as Category
4 and should not be used.
If the patient is diagnosed with chlamydial infection while using an IUD, continuing to
use an IUD is designated as Category 2.
The U.S. SPR is an evidence-based source of clinical guidance that answers common contraceptive
management questions.
To access these recommendations, click SPR on the main menu, then select a contraceptive
method.
The app will display relevant topics, like contraceptive initiation, medically indicated
exams and tests, and follow-up care.
In the main menu, you will find Provider Tools where you can access clinical guidance charts
for topics like How to be Reasonably Certain that a Woman is Not Pregnant and Late or Missed
Combined Oral Contraceptives.
Let’s talk through a hypothetical patient to demonstrate how to use the app in a clinical
setting.
A 19-year old nulliparous woman with a BMI of 35 and migraine without aura comes to your
office for a wellness visit.
She is interested in starting contraception.
She is considering birth control pills because she has used them before.
You open the CDC Contraception app and navigate to the US MEC by condition page.
You can select up to three conditions to compare recommendations.
Choose the sub-conditions that match the patient’s history.
For this patient, you want to see recommendations for age, obesity, and headache.
Then select Continue.
The recommendations for each condition you selected are now displayed.
You can move between the conditions by clicking the left and right arrows.
Combined hormonal contraceptives, or CHCs, are Category 1 for age and Category 2 for
both obesity and migraine without aura.
Considering these recommendations, CHCs are a relatively safe option for this patient.
For more information on a specific recommendation, you can see the Clarifications, Evidence,
or Comments by clicking the row, number, or plus sign for a given condition and method.
The patient tells you she has not been sexually active since her last menstrual period, which
was two weeks ago.
You want to know how to counsel her on when to start her contraceptive pills.
From the U.S. MEC recommendations page, you can view the U.S. SPR by selecting the SPR
button, OR you can return to the Main Menu and select SPR.
Choose Combined Hormonal Contraception and Initiation.
The U.S. SPR recommends that CHCs can be initiated at any time if it is reasonably certain that
the woman is not pregnant.
For more information, click Box 2 to confirm that it is safe to start the patient on pills
today since she has not had sexual intercourse since the start of last normal menses.
For more information or assistance, please check out the in-app menu or visit the CDC
Division of Reproductive Health website.