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Contraception - Management
What follow up and aftercare are required for the diaphragm and cervical cap?

  • Reassess after 1–2 weeks; review the device's fit and the woman's skills in using it.
    • She should be able to check the position of the diaphragm or cervical cap before and after intercourse and recognize if it is correctly positioned.
  • When inserted correctly, neither partner should be able to feel the diaphragm or cervical cap.
  • If it can be felt or is uncomfortable, the woman should return to reassess fit, or to consider an alternative diaphragm or cap, or another method of contraception:
    • Consider checking for the following:
      • If she is comfortable while using the method for the duration of its use, including during intercourse.
      • If she is able to tolerate keeping it in overnight if sex occurs in the evening.
      • If there is any intolerance or adverse effects to the use of spermicide.
    • For further information on the choice of diaphragms and cervical caps, see Availability.
  • The diaphragm or cervical cap should be replaced immediately if there are any holes or puckering.
    • Discolouration with use is normal; the latex is unaffected.
  • The fit of the diaphragm or cap should be rechecked by a trained healthcare professional after childbirth, abortion, or miscarriage, or if the woman gains or loses 3 kg or more in body weight, because the vagina and cervix can change shape or size.
    • Women are advised to wait 6 weeks after delivery before using the diaphragm or cervical cap. This allows the uterus to fully involute.
Basis for recommendation
  • These recommendations are based on the guidance issued by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2007d], and on expert opinion [Belfield, 1999; Guillebaud, 2007].

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