Updated cornerstones of contraceptive care

Family planning is more than a health service. It saves lives, improves health outcomes, strengthens communities, and empowers people to decide if and when to become pregnant. For nearly thirty years, two guidelines from the World Health Organization (WHO) have been the foundation of this work: the Medical Eligibility Criteria for Contraceptive Use (MEC) and the Selected Practice Recommendations for Contraceptive Use (SPR).

This November, at the seventh International Conference on Family Planning, WHO and the UN's Special Programme in Human Reproduction (HRP) launched the 6th edition of the MEC and the 4th edition of the SPR. Updated with the latest evidence, they aim to make contraceptive care safer, more consistent and more responsive to people's real needs.

For the health service provider, the MEC answers the vital question: Is this contraceptive method safe for this particular individual given their past or present medical history (e.g. diabetes) and their physiological status (e.g. postpartum and currently breastfeeding)? The SPR provides guidance on how to use contraceptive methods safely and effectively. Together, they guide policymakers and program managers in ensuring that contraception is safe, effective, and rights-based.

A couple learning about the different contraceptive methods available to them in Kigali, Rwanda. © Yagazie Emezi/Getty Images/Images of Empowerment

"The release of the updated WHO MEC and SPR marks a transformative milestone in global reproductive health," said Prof Frank Louwen, President of FIGO. "They reaffirm the central role of science in enabling choice, equity and quality in family planning."

The new editions reflect significant advances made in our understanding of contraceptive methods. For instance, Progestogen-only injectables can now be safely offered immediately after childbirth, emergency contraception can be repeated within the same cycle and hormonal methods can be safely used by women taking PrEP.

Across countries, the impact of these tools is tangible. In Botswana, Bame Bame, a research nurse specializing in sexual and reproductive health, said, "I use the MEC almost every day. The Wheel and the App make it quick and convenient, especially when I am with a client. It reassures them, and it empowers clinicians like me with confidence that we are providing the best care possible."

Regarding the SPR, Sharon Uy, a family planning program manager in Samar Philippines, said "As a health service provider, the WHO Selected Practice Recommendations have transformed how I guide clients in choosing and using family planning methods. By complementing the MEC Wheel, they provide not just the 'who can use' but also the 'how to use', making counseling clearer, more confident, and client centered. They have simplified decision-making and allowed me to focus more on empowering clients through informed, evidence-based choices."

The true power of the MEC and SPR lies in how they are used. Policymakers can integrate the new guidance into training, supervision, and health system planning. Health workers can use the derivative products, like the MEC Wheel, the App and the Family Planning Handbook, to support informed, client-centred counselling. Academic and professional associations can help ensure that future generations of providers learn to deliver contraceptive care grounded in evidence and respect.

A doctor explains contraceptive options using a WHO Medical Eligibility Criteria wheel during a family planning consultation in Bara Kahu, Islamabad. © WHO / HRP / Saiyna Bashir

"In an era where science is increasingly questioned, the WHO MEC and SPR stand as vital safeguards," added Prof Alison Edelman of Oregon Health & Science University. "They provide a trusted foundation for evidence-based clinical care and empower public health programmes to adapt to local contexts."

Every person everywhere should be able to have access to high-quality contraceptive care grounded in science and choice. The choice should always be yours, and that choice should be informed by the best research and evidence.

"The updated WHO MEC and SPR reaffirm that every woman, man and young person has the right to make informed choices about their reproductive health, supported by the highest standards of scientific evidence. UNFPA welcomes these updated tools as essential instruments for advancing quality, rights-based contraceptive care - ensuring that guidance keeps pace with innovation, equity and the realities of diverse health-care settings", concludes Julia Bunting, Director of the Programme Division at UNFPA.

At a time when misinformation and misconceptions abound, the updated MEC and SPR are a step towards a future where every person can confidently make informed decisions to fulfil their fertility intentions. By adopting and implementing these recommendations, people can safely and effectively use contraceptive methods that best suit their needs.