Update to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate

• Published in: MMWR. Morbidity and mortality weekly report Vol. 70; no. 20; pp. 739 - 743
• Main Authors: Curtis, Kathryn M, Nguyen, Antoinette, Reeves, Jennifer A, Clark, Elizabeth A, Folger, Suzanne G, Whiteman, Maura K
• Format: Journal Article Newsletter
• Language: English
• Published: United States U.S. Government Printing Office 21-05-2021; U.S. Center for Disease Control; Centers for Disease Control and Prevention
• Subjects: Access control; Acetates; Acetic acid; Activities of daily living; Birth control; Contraception; Contraceptives; Decision making; Empowerment; Evidence-based medicine; Full Report; Health care industry; Medroxyprogesterone; Medroxyprogesterone acetate; Observational studies; Patients; Pregnancy; Public health; Reproductive health; Self-administration; Systematic review; Womens health; United States > US
• ISSN: 0149-2195; 1545-861X
• DOI: 10.15585/mmwr.mm7020a2

U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR), adapted by CDC from global guidance developed by the World Health Organization (WHO), provides evidence-based guidance on contraceptive use for U.S. health care providers (1). During January-February, 2021, CDC evaluated the 2019 WHO recommendation on self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC) (2). CDC adopted the WHO recommendation on the basis of moderate-certainty evidence that self-administered DMPA-SC is safe and effective, and has higher continuation rates compared with provider-administered DMPA. The new U.S. SPR recommendation states that self-administered DMPA-SC should be made available as an additional approach to deliver injectable contraception. Provider-administered DMPA should remain available. Self-administered DMPA-SC is a user-controlled method that has the potential to improve contraceptive access and increase reproductive autonomy. Self-administered DMPA-SC should be offered in a noncoercive manner through a shared decision-making process between patients and their health care providers, with a focus on patient preferences and equitable access to the full range of contraceptive methods.