As I said in my presidential address at the Annual Clinical Meeting in May, we need to address reproductive health and well-woman care at every single point of contact that women have in our health care system. If we are going to be successful in reducing the high rates of unplanned pregnancies in this country and all of the related maternal and infant health problems that go along with them, then we really only have one option: We must counsel and encourage all of our patients to use effective contraception.
The good news is that more women will have health insurance as the Affordable Care Act continues its roll-out. And under the ACA, more good news: Women now have access to all FDA-approved contraceptives without a co-pay. Coinciding with this, a new ACOG Committee Opinion in the November Obstetrics & Gynecology endorses the CDC’s US Selected Practice Recommendations for Contraceptive Use, 2013 (US SPR). The US SPR helps ob-gyns and other providers counsel our patients about how to use these contraceptives most effectively. This is a companion piece to the US Medical Eligibility Criteria for Contraceptive Use, 2010 (US MEC) that ACOG endorsed in a 2011 Committee Opinion. The US MEC provides guidance for determining which contraceptives are safe for women who have certain medical conditions.
The US SPR is arranged by contraceptive method and is easy to follow. It addresses a host of common as well as complicated issues related to contraceptive use that both doctors and patients may encounter. For instance, it provides guidance on which specific exams and tests we need to provide before prescribing a particular contraceptive method. It helps us advise our patients about exactly what do when they forget to take their daily birth control pill or are late in returning for their next injectable contraceptive. It also explains how to deal with side effects, such as breakthrough bleeding, and when and for how long to use backup contraception.
I think one of the many important points contained in the US SPR is that any contraceptive method can be started at any time during the menstrual cycle, as long as there is reasonable certainty that a woman is not pregnant.
I encourage you to read through and utilize both the US SPR and the US MEC. An eBook for the US SPR will be available soon. As I said at the ACM: Whether it’s a pill, patch, ring, injection, implant, insertable, or a ligation, we can address reproductive health for what it represents—an investment in our future.
Every Woman, Every Time. It’s up to us.
Subscribe to the ACOG President’s Blog to receive an email alert every time a new blog is posted.