Table 4.
Proportion and prevalence ratios of health care providers reporting select contraceptive methods as safea for women with specific characteristics or medical conditions during Phase 2 (after guidance), by use of the USMEC in practice (n=1460).
| USMEC characteristic or medical condition | USMEC classification | Reported method as safe | ||
|---|---|---|---|---|
| Use USMEC in practice (%)c | Do not use USMEC in practice (%)c | aPR (95% CI)d | ||
| IUDs for adolescents | 1 or 2b (Safe) | 82.8 | 73.3 | 1.03 (0.90, 1.16) |
| IUDs for immediately postpartum women (<10 min after delivery of placenta) | 1 or 2b (Safe) | 56.8 | 30.1 | 1.62 (1.18, 2.21) |
| IUDs for postpartum women (10 min after delivery of placenta to <4 weeks postpartum) | 2 (Safe) | 64.3 | 48.6 | 1.20 (0.96, 1.50) |
| IUDs for nulliparous women | 2 (Safe) | 94.6 | 93.4 | 1.00 (0.94, 1.06) |
| IUDs for women with uterine fibroids | 2 (Safe) | 82.2 | 81.1 | 1.01 (0.89, 1.15) |
| IUDs for women with HIV | 2 (Safe) | 80.9 | 59.9 | 1.30 (1.08, 1.57) |
| DMPA for adolescents | 1 or 2b (Safe) | 95.9 | 94.2 | 0.99 (0.94, 1.05) |
| DMPA for breastfeeding women <1 month postpartum | 2 (Safe) | 88.8 | 86.2 | 0.99 (0.90, 1.08) |
| DMPA for breastfeeding women ≥1 month postpartum | 1 (Safe) | 95.3 | 94.2 | 0.99 (0.94, 1.05) |
| DMPA for women with obesity (BMI ≥30 kg/m2) | 1 or 2b (Safe) | 89.6 | 89.5 | 0.97 (0.88, 1.07) |
| DMPA for women with history of bariatric surgery | 1 (Safe) | 93.0 | 79.6 | 1.19 (1.06, 1.34) |
| DMPA for women with IBD | 2 (Safe) | 89.1 | 83.3 | 1.10 (0.99, 1.23) |
| COCs for breastfeeding women ≥1 month postpartum without other risk factors for VTE | 2 (Safe) | 83.3 | 73.4 | 1.11 (0.98, 1.26) |
| COCs for women with obesity (BMI ≥30 kg/m2) | 2 (Safe) | 72.3 | 77.8 | 0.90 (0.77, 1.04) |
| COCs for smokers aged ≥35 years | 3 or 4b (Unsafe) | 8.0 | 7.4 | 1.16 (0.47, 2.85) |
| COCs for women with a history of bariatric surgery via malabsorptive procedures | 3 (Unsafe) | 51.1 | 56.2 | 0.90 (0.72, 1.12) |
aPR, prevalence ratio; BMI, body mass index; CI, confidence interval; COCs, combined oral contraception; DMPA, depot medroxyprogesterone acetate; HIV, human immunodeficiency virus; IBD, inflammatory bowel disease; IUD, intrauterine device; USMEC=United States Medical Eligibility Criteria for Contraceptive Use; VTE, venous thrombosis.
For analyses, we grouped USMEC classifications 1 and 2 to represent “safe” and USMEC classifications 3 and 4 to represent “unsafe”. As defined, USMEC 1, a condition for which there is no restriction for the use of the contraceptive method; USMEC 2, a condition for which the advantages of using the contraceptive method generally outweigh the theoretical or proven risks; USMEC 3, a condition for which the theoretical or proven risks usually outweigh the advantages of using the method; USMEC 4, a condition that represents an unacceptable health risk if the method is used.
Depending on the level of the condition. For more detail, see https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.htm?s_cid=rr6503a1_w.
Unweighted numerators; weighted percentages.
Use of USMEC in practice (yes versus no), adjusted for provider type, time since completion of formal clinical training, proportion of female patients of reproductive age who pay for their visit using Medicaid or other assistance, and proportion of female patients of reproductive age of racial or ethnic minority background.