Maternal Child Survival Program India-MCSP Medical Eligibility Criteria for Contraceptives

This document serves as a detailed guidance for determining whether a family planning method can safely be given to a woman with a certain medical condition. The MEC categorizes medical conditions into four categories, with clinical judgment playing a significant role in determining the suitability of a contraceptive method for a client. Category 1 conditions have no restrictions for the use of the contraceptive method, and the method can be used in any circumstances. Category 2 conditions have advantages that generally outweigh the risks, and the method is generally recommended. Category 3 conditions have risks that usually outweigh the advantages of using the method, and the use of the method is not usually recommended. Category 4 conditions have unacceptable health risks if the contraceptive method is used, and the method is not to be used. The MEC for Combined Oral Contraceptives (COCs) lists conditions that fall under categories 3 and 4, including hypertension, smoking and age 35 years or older, anticonvulsants and Rifampicin, up to 6 months postpartum in breastfeeding women, breast cancer, migraine and age 35 years or older, and Systemic Lupus Erythematosus (SLE). The MEC also lists conditions that fall under categories 3 and 4 for Progestin-only-pills (POPs), including breast cancer, SLE, cirrhosis and liver tumor, acute Deep Vein Thrombosis (DVT), and anticonvulsants and Rifampicin. In contrast, the MEC for Emergency Contraceptive Pills (ECPs) does not list any category 3 and 4 conditions. The MEC for Centchroman (Ormeloxifene) lists contraindications, including polycystic ovarian disease, cervical hyperplasia, recent history of jaundice or liver disease, severe allergic state, and chronic illness such as tuberculosis or renal disease. Client-assessment tools, including checklists, are provided to facilitate the assessment process. These tools include the Pregnancy Checklist, Client Assessment for COCs, Client Assessment for POPs, Client Assessment for Centchroman, and Client Assessment for ECP.