Update to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate

MMWR Morb Mortal Wkly Rep. 2021 May 21;70(20):739-743. doi: 10.15585/mmwr.mm7020a2.


U.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.

Publication types

  • Practice Guideline

MeSH terms

  • Centers for Disease Control and Prevention, U.S.
  • Contraceptive Agents, Female / administration & dosage*
  • Female
  • Humans
  • Injections, Subcutaneous
  • Medroxyprogesterone Acetate / administration & dosage*
  • Self Administration
  • United States


  • Contraceptive Agents, Female
  • Medroxyprogesterone Acetate