Lesson 2: Continuing the Choice

In this second lesson the following methods will be discussed; the Diaphragm and Cervical Cap, Spermicides, Natural Family Planning and the Fertility Awareness Methods, male and female surgical sterilization methods.

Diaphragms and Cervical Caps

Diaphragms, and cervical caps to a lesser extent, of some sort or another have been used throughout history. From vaginal plugs made of crocodile dung to today's latex and silicone, women have relied on blocking the cervix to prevent pregnancy.

The diaphragm and cervical cap work in similar ways, they both block sperm from entering the uterus, but they fit in different ways. The diaphragm fits around the cervix, like a shallow bowl, and spermicide is placed on the inside and outside of it and especially around the rim. Additional spermicide must be placed in the vagina before each additional sexual act, and the diaphragm should not be left in place for less than 6 hours after the last sexual act, but should not be left in place longer than 24 hours. The cervical cap is similar to the diaphragm. It is shaped like a thimble and it fits directly on the cervix, and spermicide needs to be placed inside of it only. No additional spermicide is needed for additional sexual acts, and the cap can remain in place up to 48 hours, but should not be removed less than 8 hours after the last sexual act.

After each use both should be washed with mild soap and warm, not hot, water. Allow the device to dry thoroughly, and then it can be dusted with cornstarch, no other powders of any kind, and placed back in its case. Both should be examined before each use for holes or tears in the latex. You can check for holes by holding the device up to the light or by filling it with water.

The possible side effects of diaphragm usage include; allergic reaction to the spermicide or latex, bladder infections, and toxic shock syndrome. Cervical caps may cause the following side effects; allergic reaction to the spermicide or latex, and abnormal cell growth of the cervix.

Diaphragms and cervical caps with typical use are about 80% effective. Diaphragms, with perfect use are 94% effective, and cervical caps with perfect use are about 91 percent. These figures of perfect use are only for women that have not given birth before. For those women that have given birth before, the effectiveness is lower.

Diaphragm use pros; can provide some protection against some STDs, can be inserted before sexual act begins, can be used during a woman's period, fully reversible, and may reduce the risk of cervical cancer. Cons of using the diaphragm include, the possible side effects, can be hard to reach for some women, can be dislodged, can be messy, requires a prescription, a new one may be needed if there is a weight gain or loss of 10 pounds or more, after childbirth, or a miscarriage. The cervical cap has similar pros and cons.