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

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Author/s: 
Curtis, K. M., Nguyen, A., Reeves, J. A., Clark, E. A., Folger, S. G., Whiteman, M. K.
Date Added: 
May 21, 2021
Journal/Publication: 
Morbidity and Mortality Weekly Report
Publisher: 
Centers for Disease Control and Prevention
Publication Date: 
May 21, 2021
Issue: 
20
Volume: 
70
Pages: 
739-743
URL: 
Update to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate
Type: 
Meta-analyses, Reviews, and Guidelines
Format: 
Article
DOI (1): 
10.15585/mmwr.mm7020a2
PMID (1): 
34014910
Keywords 
contraceptive
self-administration
contraception
decision making
MeSH 
Medroxyprogesterone Acetate
Contraceptive Agents
Surface Plasmon Resonance
Contraception Behavior
Patient Preference
decision making

RPR Commentary

Guidance from the CDC on self-administered depo-medroxyprogesterone acetate for contraception.  James W. Mold, MD, MPH

Abstract

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.

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