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MMWR Morb. Mortal. Wkly. Rep. · May 2021
Practice GuidelineUpdate to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate.
- Kathryn M Curtis, Antoinette Nguyen, Jennifer A Reeves, Elizabeth A Clark, Suzanne G Folger, and Maura K Whiteman.
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
- MMWR Morb. Mortal. Wkly. Rep. 2021 May 21; 70 (20): 739-743.
AbstractU.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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