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Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs

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Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs



MMWR Vol. 63 / No. RR-4



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MMWR Recommendations and Reports
Vol. 63, No. RR-4
April 25, 2014
 
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In this report

Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs
Loretta Gavin, PhD, Susan Moskosky, MS, Marion Carter, PhD, et al.
MMWR 2014;63(No. RR-4)


This report provides recommendations developed collaboratively by CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services outlining how to provide family planning services. Such services include contraceptive services, pregnancy testing and counseling, helping clients achieve pregnancy, basic infertility services, preconception health services, and sexually transmitted disease services. The primary audience for this report is all current or potential providers of family planning services, including those working in services sites that are dedicated to family planning service delivery as well as private and public providers of more comprehensive primary care.


Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs

Recommendations and Reports

April 25, 2014 / 63(RR04);1-29


Prepared by
Loretta Gavin, PhD,1 Susan Moskosky, MS,2 Marion Carter, PhD,1 Kathryn Curtis, PhD,1 Evelyn Glass, MSPH,2 Emily Godfrey, MD,1Arik Marcell, MD,3 Nancy Mautone-Smith, MSW,2 Karen Pazol, PhD,1 Naomi Tepper, MD,1 Lauren Zapata, PhD1
1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
2Office of Population Affairs, US Department of Health and Human Services, Rockville, Maryland
3The Johns Hopkins University and the Male Training Center for Family Planning and Reproductive Health, Baltimore, Maryland



Corresponding preparers: Loretta Gavin, PhD, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Telephone: 770-488-6284; E-mail: lcg6@cdc.gov; Susan Moskosky, MS, Office of Population Affairs, US Department of Health and Human Services. Telephone: 240-453-2818; E-mail: susan.moskosky@hhs.gov.

Summary

This report provides recommendations developed collaboratively by CDC and the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS). The recommendations outline how to provide quality family planning services, which include contraceptive services, pregnancy testing and counseling, helping clients achieve pregnancy, basic infertility services, preconception health services, and sexually transmitted disease services. The primary audience for this report is all current or potential providers of family planning services, including those working in service sites that are dedicated to family planning service delivery as well as private and public providers of more comprehensive primary care.
The United States continues to face substantial challenges to improving the reproductive health of the U.S. population. Nearly one half of all pregnancies are unintended, with more than 700,000 adolescents aged 15–19 years becoming pregnant each year and more than 300,000 giving birth. One of eight pregnancies in the United States results in preterm birth, and infant mortality rates remain high compared with those of other developed countries.
This report can assist primary care providers in offering family planning services that will help women, men, and couples achieve their desired number and spacing of children and increase the likelihood that those children are born healthy. The report provides recommendations for how to help prevent and achieve pregnancy, emphasizes offering a full range of contraceptive methods for persons seeking to prevent pregnancy, highlights the special needs of adolescent clients, and encourages the use of the family planning visit to provide selected preventive health services for women, in accordance with the recommendations for women issued by the Institute of Medicine and adopted by HHS.

Introduction

The United States continues to face challenges to improving the reproductive health of the U.S. population. Nearly half (49%) of all pregnancies are unintended (1). Although adolescent birth rates declined by more than 61% during 1991–2012, the United States has one of the highest adolescent pregnancy rates in the developed world, with >700,000 adolescents aged 15–19 years becoming pregnant each year and >300,000 giving birth (2,3). Approximately one of eight pregnancies in the United States results in a preterm birth, and infant mortality rates remain high compared with other developed countries (3,4). Moreover, all of these outcomes affect racial and ethnic minority populations disproportionately (1–4).
Family planning services can help address these and other public health challenges by providing education, counseling, and medical services (5). Family planning services include the following:
  • providing contraception to help women and men plan and space births, prevent unintended pregnancies, and reduce the number of abortions;
  • offering pregnancy testing and counseling;
  • helping clients who want to conceive;
  • providing basic infertility services;
  • providing preconception health services to improve infant and maternal outcomes and improve women's and men's health; and
  • providing sexually transmitted disease (STD) screening and treatment services to prevent tubal infertility and improve the health of women, men, and infants.
This report provides recommendations developed collaboratively by CDC and the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS). The recommendations outline how to provide family planning services by:
  • defining a core set of family planning services for women and men,
  • describing how to provide contraceptive and other clinical services, serve adolescents, and perform quality improvements, and
  • encouraging the use of the family planning visit to provide selected preventive health services for women, in accordance with the recommendations for women issued by the Institute of Medicine (IOM) and adopted by HHS (6).
The collaboration between CDC and OPA drew on the strengths of both agencies. CDC has a long-standing history of developing evidence-based recommendations for clinical care, and OPA's Title X Family Planning Program (7) has served as the national leader in direct family planning service delivery since the Title X program was established in 1970.
This report provides recommendations for providing care to clients of reproductive age who are in need of family planning services. These recommendations are intended for all current or potential providers of family planning services, including those funded by the Title X program.


Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs 
Loretta Gavin, PhD, Susan Moskosky, MS, Marion Carter, PhD, et al.
MMWR 2014;63(No. RR-4)
 

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