The table on the following pages summarizes the World Health Organization Medical Eligibility Criteria for Contraceptive Use.
These criteria are the basis for the Medical Eligibility Criteria checklists in most chapters of this handbook on family planning methods. These checklists are based on the 2-level system for providers with limited clinical judgment. The checklist questions address conditions in MEC categories 3 or 4 that the woman knows of. The boxes “Using Clinical Judgment in Special Cases” list conditions that are in MEC category 3. They can be provided if other, more appropriate methods are not available or acceptable to the client, and a qualified provider can carefully assess the specific woman’s condition and situation.
|Category||With Clinical Judgment||With Limited Clinical Judgment|
|1||Use method in any circumstances||Yes
(Use the method)
|2||Generally use method|
|3||Use of method not usually recommended unless other more appropriate methods are not available or not acceptable||No
(Do not use the method)
|4||Method not to be used|
Note: In the table beginning with Personal Characteristics and Reproductive History, category 3 and 4 conditions are shaded to indicate that the method should not be provided where clinical judgment is limited. Categories that are new or changed since the 2011 edition of this handbook are shown in dark type.
See conditions relating to vasectomy, male and female condoms, spermicides, diaphragms, cervical caps, and lactational amenorrhea method. See conditions relating to fertility awareness methods.
|Accept (A)||There is no medical reason to deny the method to a person with this condition or in this circumstance.|
The method is normally provided in a routine setting, but with extra preparation and precautions.
|Delay (D)||Use of the method should be delayed until the condition is evaluated and/or corrected. Alternative, temporary methods of contraception should be provided.|
The procedure should be undertaken in a setting with an experienced surgeon and staff, equipment needed to provide general anesthesia, and other backup medical support. The capacity to decide on the most appropriate procedure and anesthesia support also is needed. Alternative, temporary methods of contraception should be provided if referral is required or there is otherwise any delay.