Practice Guidelines

CDC Updates Recommendations for Contraceptive Use


Am Fam Physician. 2017 Jan 15;95(2):125-126.

Key Points for Practice

• Women should wait at least five days after taking ulipristal for emergency contraception before starting or continuing their hormonal contraception.

• When performing IUD insertion, routine administration of misoprostol is not recommended.

• Before IUD insertion, bimanual examination and cervical inspection should be performed to determine uterine size and position.

• Before starting combined hormonal contraceptives, blood pressure should be measured.

From the AFP Editors

Almost one-half of pregnancies are unintentional, with one-half of these in women not using a contraceptive method when conception occurred. Adolescents and young women, those who are racial or ethnic minorities, and those with lower levels of education and income are more likely to become pregnant unintentionally. Guiding women and their partners in selecting an appropriate contraceptive method and ensuring its correct and consistent use can help with prevention.

The Centers for Disease Control and Prevention (CDC) first published the U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) in 2013 to provide direction for safe and effective use of contraceptive methods. These guidelines update the 2013 report.

Using the Guidelines

The guidelines are arranged by contraceptive method and discussed in order from highest to lowest effectiveness. It should be noted that recommendations do not comment on every aspect of use, but instead provide the best evidence available for issues that commonly occur. In general, initiation, follow-up, and management of problems are discussed for each method, with the recommendations listed first, followed by comments and evidence summaries.

The U.S. Medical Eligibility Criteria for Contraceptive Use, which can be found at, contains recommendations for women who require additional contraceptive guidance for medical reasons. Charts and algorithms that summarize the

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Practice Guidelines published in AFP is available at



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Jan 15, 2018

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