FSRH and UKMEC
In the early 1970s, the UK became the first country in the world to offer contraception free, under the NHS. A national guidance panel, the National Association of Family Planning Doctors (NAFPD), was set up to represent the doctors working in the field and share good practice. In 1993 NAFPD joined with JCC to form the Faculty of Family Planning and Reproductive Healthcare, as a faculty of (but independently governed from) the Royal College of Obstetricians and Gynaecologists. In 2007, recognising the importance of men’s health care and sexual health the Faculty was relaunched as the Faculty of Sexual Health and Reproductive Healthcare (FSRH), as it remains today.
As part of the FSRH’s work, it provides guidance on high quality of practice in sexual and reproductive health care, all freely available from their website.
The UK Medical Eligibility Criteria for Contraceptive use (UKMEC) offers evidence-based guidance on prescribing contraception safely. Originally adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive use (WHOMEC, first published in 1996), the criteria were first launched by the Clinical Effectiveness unit of the FSRH in 2006. The most recent edition, UKMEC 2016, is used by contraceptive providers across the UK to help guide contraceptive choice. It can be accessed through FSRH website. UKMEC is divided into four categories:
- UKMEC 1 unrestricted use
- UKMEC 2 benefits of use outweigh risks to woman’s health
- UKMEC 3 risks to health outweigh benefits of use
- UKMEC 4 unacceptable health risk
Generally, if a contraception is UKMEC 3 or 4 then it is best avoided.
While medical eligibility is an important factor in appropriate contraception prescribing there are many other factors to consider for the woman, including side effects, effectiveness and ease of use/access. The following pages will explore each available method to give the health care provider an overview of the pros and cons of each one.