Yet Another Political Blow: The Loss of Evidence-Based Contraceptive Care
By Preetha Nandi, MD, MPH, and Angeline Ti, MD, MPH
May 3, 2025
The ongoing purge of federal workers by the Trump administration has abruptly ended a major pillar for up-to-date, evidence-based information that clinicians across the U.S. and around the world rely on. The contraception research team at the CDC, which maintained the U.S. Medical Eligibility Criteria for Contraceptive Use (MEC) for the past 15 years, is gone.
The MEC and its partner publication, the U.S. Selected Practice Recommendations for Contraceptive Use (SPR), are some of the most widely viewed resources produced by the CDC, with hundreds of thousands of views and app downloads in the past year. These guidelines provide the gold standard of safety information to healthcare professionals so they can help pregnancy-capable individuals make informed decisions about contraception. This is especially important for those with underlying health conditions.
As a family physician and an ob/gyn who work in primary care and reproductive health, these guidelines are the bedrock of what we do. And now, we and our colleagues will be unable to turn to this vital resource for updates on appropriate contraceptive care.
Approximately two-thirds of women ages 15-to-49 currently use contraception in the U.S., and contraception use is nearly universal — 99% of all women will use contraception at some point in their lifetimes. These women include many with medical conditions or characteristics that can impact whether certain birth control options are safe. These guidelines help clinicians counsel individuals with chronic diseases, like diabetes and hypertension, to choose contraception that won’t increase their health risks while also meeting their reproductive goals and preferences.
These guidelines help new mothers choose the right contraceptive method in the postpartum period so they can care for their families and manage postpartum symptoms like bleeding, and prevent preterm birth in future pregnancies. Overall, the guidelines help reduce maternal mortality. For patients with complex medical needs — from those with newly diagnosed cancer to others with lifelong conditions like sickle cell disease — the CDC contraceptive guidelines can mean the difference between a person getting the treatments they need or experiencing devastating outcomes in their young lives.
Beyond supporting patients with pre-existing medical conditions, the guidelines also provide guidance on implementing high-quality, patient-centered contraceptive care for all. The most recent guidelines, updated in August 2024, rigorously examined the evidence for pain control during intrauterine device (IUD) insertion, and provided recommendations to support a patient-centered discussion about their preferred IUD experience. The updated guidelines also highlight the importance of contraceptive care for transgender and gender diverse individuals on testosterone who do not desire pregnancy.
No other organization can do this work. CDC has been uniquely positioned with the expertise and infrastructure to continually evaluate the evidence with scientific rigor, and to synthesize recommendations in ways that clinicians can use in practice. This work of translating the science into easy-to-use, high quality clinical guidance is well-respected among reproductive health clinicians and organizations in the U.S. and abroad. Without this, clinicians are at risk of using outdated or inaccurate information to inform their clinical care, putting patients’ lives and health at risk.
Any clinician that works in preventative care like we do would agree that…
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