Notice2021-17818
Updating CDC's Contraception Guidance Documents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use
Primary source
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Published
August 19, 2021
Issuing agencies
Health and Human Services DepartmentCenters for Disease Control and Prevention
Abstract
The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) announces the opening of a docket to obtain comment on CDC's contraception recommendations. Two guidance documents, U.S. Medical Eligibility Criteria for Contraceptive Use (US MEC) and U.S. Selected Practice Recommendations for Contraceptive Use (US SPR), provide evidence-based recommendations to assist health care providers when counseling patients on contraceptive choice and use. Updates to these guidance documents typically occur every 5 years. As part of the planning process for the next update, CDC is requesting public comment on content to consider for revision or addition to the recommendations and how to improve the implementation of the guidance documents. This action is necessary to consider multiple and diverse perspectives and ensure that the documents meet the needs of U.S. health care providers and the persons they serve.
Full Text
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<title>Federal Register, Volume 86 Issue 158 (Thursday, August 19, 2021)</title>
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[Federal Register Volume 86, Number 158 (Thursday, August 19, 2021)]
[Notices]
[Pages 46703-46704]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-17818]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Docket No. CDC-2021-0088]
Updating CDC's Contraception Guidance Documents: U.S. Medical
Eligibility Criteria for Contraceptive Use and U.S. Selected Practice
Recommendations for Contraceptive Use
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice with comment period.
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SUMMARY: The Centers for Disease Control and Prevention (CDC) in the
Department of Health and Human Services (HHS) announces the opening of
a docket to obtain comment on CDC's contraception recommendations. Two
guidance documents, U.S. Medical Eligibility Criteria for Contraceptive
Use (US MEC) and U.S. Selected Practice Recommendations for
Contraceptive Use (US SPR), provide evidence-based recommendations to
assist health care providers when counseling patients on contraceptive
choice and use. Updates to these guidance documents typically occur
every 5 years. As part of the planning process for the next update, CDC
is requesting public comment on content to consider for revision or
addition to the recommendations and how to improve the implementation
of the guidance documents. This action is necessary to consider
multiple and diverse perspectives and ensure that the documents meet
the needs of U.S. health care providers and the persons they serve.
DATES: Written comments must be received on or before October 18, 2021.
ADDRESSES: You may submit comments, identified by Docket No. CDC-2021-
0088 by any of the following methods:
<bullet> Federal eRulemaking Portal: <a href="http://www.regulations.gov">http://www.regulations.gov</a>.
Follow the instructions for submitting comments.
<bullet> Mail: [insert complete mailing address, including
mailstop]
Instructions: All submissions received must include the agency name
and Docket Number. All relevant comments received will be posted
without change to <a href="http://regulations.gov">http://regulations.gov</a>, including any personal
information provided. For access to the docket to read background
documents or comments received, go to <a href="http://www.regulations.gov">http://www.regulations.gov</a>.
FOR FURTHER INFORMATION CONTACT: Kathryn M. Curtis, Ph.D., Division of
Reproductive Health, Centers for Disease Control and Prevention, 4770
Buford Highway NE, MS S107-2, Atlanta, GA 30341. Telephone: 770-488-
5200. Email: <a href="/cdn-cgi/l/email-protection#b7c2c4dad2d4c4c7c5f7d4d3d499d0d8c1"><span class="__cf_email__" data-cfemail="4633352b23253536340625222568212930">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
Public Participation
Interested persons or organizations are invited to participate by
submitting written views, recommendations, and data. CDC invites
comments specifically on the following questions:
1. Are there existing US MEC or US SPR recommendations that CDC
should consider reviewing for possible revision, based on new evidence
or other justification? Please provide references to new evidence and
justification to support review of existing recommendations.
2. Are there new recommendations that CDC should consider adding to
the US MEC? This could include eligibility criteria for contraceptive
use among people with medical conditions or characteristics not
currently included in the US MEC. Please provide references to
supporting evidence, justification, and impact of new recommendations.
3. Are there new recommendations that CDC should consider adding to
the US SPR? This could include clinical practice recommendations to
address issues regarding initiation and use of specific contraceptive
methods not currently included in the US SPR. Please provide references
to supporting evidence, justification, and impact of new
recommendations.
4. Are there other issues that should be considered or suggestions
to improve implementation of the US MEC and US SPR recommendations to
help ensure equitable access to contraceptive services (such as better
ways of presenting the recommendations, additional job aids or tools
for providers, broader dissemination and implementation strategies,
inclusion of additional partners, etc.)? Please provide references to
supporting evidence or justification.
Please note that comments received, including attachments and other
supporting materials, are part of the public record and are subject to
public disclosure. Comments will be posted on <a href="https://www.regulations.gov">https://www.regulations.gov</a>. Therefore, do not include any information in your
comment or supporting materials that you consider confidential or
inappropriate for public disclosure. If you include your name, contact
information, or other information that identifies you in the body of
your comments, that information will be on public display. CDC will
review all submissions and may choose to redact, or withhold,
submissions containing
[[Page 46704]]
private or proprietary information such as Social Security numbers,
medical information, inappropriate language, or duplicate/near
duplicate examples of a mass-mail campaign. CDC will carefully consider
all comments submitted in preparation of the final document.
In 2017-2019 in the United States, 65% of women aged 15-49 years
used contraception; the most common contraceptive methods used were
female sterilization, oral contraceptive pills, implants and
intrauterine devices, and male condoms [1]. The majority (61%) of U.S.
women aged 18-49 years have ongoing or potential need for contraceptive
services [2]. Similarly, in 2010-2016, about 60% of men aged 15-44
years in the United States needed family planning [3]. Equitable access
to evidence-based, high quality care is critical to meeting the needs
of persons seeking contraceptive services, improving reproductive
autonomy, and reducing unintended pregnancy in the United States [2].
Since 2010, CDC has published evidence-based recommendations on
contraception provision. These recommendations are intended to assist
health care providers when they counsel patients about choice and use
of contraceptive methods, with the goal of reducing medical barriers to
contraception access. U.S. Medical Eligibility Criteria for
Contraceptive Use, 2016 (US MEC) comprises recommendations for the use
of specific contraceptive methods by persons with certain
characteristics or medical conditions, such as diabetes, hypertension,
and being postpartum or breastfeeding [4]. U.S. Selected Practice
Recommendations for Contraceptive Use, 2016 (US SPR) addresses common,
yet sometimes complex, issues regarding initiation and use of specific
contraceptive methods, such as examinations or tests needed before
starting a method and management of side effects [5]. Both guidance
documents are adapted from global guidance developed by the World
Health Organization (WHO) and are based on review of the scientific
evidence and consultation with national experts. CDC partners with
other federal agencies and professional organizations in the
development, dissemination, and implementation of the guidance
documents to improve access to contraception and quality of family
planning services.
CDC is committed to ensuring that the US MEC and US SPR
recommendations are reviewed and updated as new scientific evidence
becomes available. Working with WHO, CDC continuously monitors peer-
reviewed literature and updates recommendations as needed, with
comprehensive reviews approximately every 5 years. CDC is currently
planning for the next update of the US MEC and US SPR and will consider
public comments when determining the scope of the guidance update. CDC
is seeking feedback from health care providers, professional
organizations, community-based organizations, organizations that seek
to improve reproductive health, patient advocacy groups, and the
public.
The current US MEC may be found at the Supplementary Materials tab
of the docket and at <a href="https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html">https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html</a>. The current US SPR may be found at
the Supplementary Materials tab of the docket and at <a href="https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html">https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html</a>.
References
1. Daniels K, Abma JC. Current contraceptive status among women aged
15-49: United States, 2017-2019. NCHS Data Brief 2020:388;1-8.
2. Zapata LB, Pazol K, Curtis KM et al. Need for contraceptive
services among women of reproductive age--45 jurisdictions, United
States, 2017-2019. MMWR Morb Mortal Wkly Rep 2021;70:910-15.
3. Marcell AV, Gibbs SE, Choiriyyah I et al. National needs of
family planning among US men aged 15 to 44 years. Am J Public Health
2016:106;733-9.
4. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical
eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep
2016;65(RR-3):1-103.
5. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice
recommendations for contraceptive use, 2016. MMWR Recomm Rep
2016;65(RR-4):1-66.
Dated: August 16, 2021.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2021-17818 Filed 8-18-21; 8:45 am]
BILLING CODE 4163-18-P
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