A diaphragm is a strong, thin, soft rubber dome with a flexible rim. It must be used with spermicidal jelly or cream. Spermicidal jelly appears to be more effective than the cream. The diaphragm fits around the cervix (opening to the uterus) and acts as a barrier by preventing sperm from entering the uterus. The spermicidal jelly kills any sperm that may get past the diaphragm rim.
Women differ not only from the size of their vagina, but to some degree the shape of their vagina, cervix, and the amount of tissue and muscularity of the vaginal walls. Therefore every woman must be fitted individually for her diaphragm by a gynecologist, or family planning specialist. The fit should be checked every year when a woman has her annual pap and exam. It should also be checked after the end of each pregnancy, or after a substantial weight gain or loss.
You can learn to insert the diaphragm yourself. A tablespoon of spermicidal jelly/cream is squeezed into the dome of the diaphragm and smeared on the inside rim, and on the outside surfaces of the diaphragm. The diaphragm is then gently squeezed into an elongated shape and inserted into the vagina by hand. This can be done in a standing or squatting position. Your health care provider will provide instruction on how to insert the diaphragm when you are in the office. You will be taught to check for proper positioning by running your finger over the rim of the diaphragm to determine that it is properly positioned behind the pubic bone and over the cervix.
You can walk around, shower, urinate, and move normally with the diaphragm in place. However, after a bowel movement you should recheck it’s position.
With proper use and good fit, the Diaphragm is approximately 95-98% effective in preventing pregnancy. The diaphragm should not be inserted more than 2 hours before ejaculation, as the spermicide will no longer be working effectively. If two hours or more has passed since the application of the spermicidal and insertion of the diaphragm, an additional applicator of spermicide should be used. Vaseline should never be used as a lubricant If you are using a diaphragm as it will deteriorate the rubber.
If fitted properly, the diaphragm will not be felt by either partner during intercourse.
Proper Care of the Diaphragm
Upon removal of the diaphragm, it should be washed with unscented soap and rinsed thoroughly with warm water. Allow it to fully dry. You may want to apply a light dusting of cornstarch before you return the diaphragm to it’s case. Store your diaphragm away from light and extreme heat. Periodically check to be sure there are no holes or tears in your diaphragm.