Safe initiation of many contraceptive methods requires an accurate assessment of whether
a woman may already be pregnant. Upon initial thought, routine administration of pregnancy
tests would seem to be the easiest way to assess pregnancy status. However, pregnancy
tests may not be available in every setting, are associated with some cost and have
limitations in detection, particularly for very early or recent pregnancies. The US
Centers for Disease Control and Prevention (CDC) developed contraceptive guidance,
adapted from that of the World Health Organization, which is intended to provide evidence-based
guidance on contraceptive provision and reduce barriers to access and use of contraception.
According to the US Selected Practice Recommendations for Contraceptive Use (US SPR),
health care providers can evaluate certain criteria related to pregnancy risk before
initiating contraception [
[1]
]. These criteria are easy to assess, are likely already administered in routine practice
and are highly accurate for excluding pregnancy [
[2]
]. The US SPR was first issued in 2013 and recently updated in 2016. While no changes
were made to the criteria for excluding pregnancy, there may be challenges in interpretation
and implementation. The intent of this commentary is to explain the rationale underpinning
the current US SPR recommendations [
[1]
] and contribute to the dialog on removing barriers to immediate contraception initiation
[
3
,
4
].To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: February 15, 2017
Accepted:
February 5,
2017
Received in revised form:
February 3,
2017
Received:
November 18,
2016
Footnotes
☆Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Identification
Copyright
Published by Elsevier Inc.
