CDC Reply

March 26, 2018

Ilene Richman, MSW, FAE
The Association of Fertility Awareness Professionals
FAprofessionals@gmail.com

Dear Ms. Richman and the AFAP Research Committee:

Thank you for your recent letter on suggestions for improving the presentation of information about fertility awareness-based methods for contraception from the Centers for Disease Control and Prevention (CDC). CDC recognizes fertility awareness-based methods as important options for women and couples wishing to prevent pregnancy and includes information about these methods in recommendations on contraceptive safety and provision and related resources for health care providers (1-4).

In these recommendations and related resources, we include the latest national estimates of the effectiveness of family planning methods, including estimates on pregnancy rates during perfect use (correct and continued use of a contraceptive method as directed) and during
typical use (as used typically, including incorrect or inconsistent use)(5). While these estimates are based in part on data from CDC’s National Survey of Family Growth (NSFG), CDC does not produce estimates of contraceptive effectiveness, but rather uses published national estimates (5), which are periodically updated.

We fully agree that providers need valid estimates of the effectiveness of the full range of family planning methods when counseling patients and hope that our understanding of method effectiveness will be improved by additional well-conducted studies. As new data on the effectiveness of family planning methods become available, including the two sources mentioned in your letter – the updated contraceptive effectiveness chapter in the next edition of Contraceptive Technology and the systematic review on fertility awareness-based methods effectiveness, we will review that information and update our materials as appropriate. We appreciate your specific and practical suggestions for incorporating more information about fertility awareness-based methods into our materials.

Thank you, again, for your letter. We appreciate your interest and feedback on this important public health issue.

Sincerely yours,
Kathryn M. Curtis, Ph.D.

Women’s Health and Fertility Branch
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion

  1. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65 (No. RR-3).
  2. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR 2016;65 (No. RR-4).
  3. Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs. MMWR 2014:63 (No. RR-4).
  4. Effectiveness of Family Planning Methods accessed at (https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/pdf/Contraceptive_methods_508.pdf)
  5. Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397-404.