Peer Reviewed
Practical procedures

Fitting a diaphragm

Terri Foran
The diaphragm, the preferred method of contraception for some women, must be fitted correctly and the user educated on its insertion and maintenance.
Key Points

    Female barrier contraception has been used since ancient times. Greek and Roman physicians advised women that half a lemon inserted high in the vagina before sexual activity acted as both a physical barrier and a natural spermicide. Women in China were instructed to use moulded opium resin as a means of covering the cervix. This practice may have had some unexpected side effects since opium appears to be well absorbed through the vaginal epithelium.

    The first modern diaphragm was developed by German gynaecologist Dr C. Haase in the 1880s. This simple, shallow, dome-shaped barrier with a flexible spring rim effectively reduced the number of sperm deposited at the cervix. (Sperm do not survive long in the acidic vaginal environment and become incapable of achieving fertilisation within a few hours.) The diaphragm was widely used in the first half of the twentieth century; for instance, 21% of all married couples in America during the 1940s relied on this device for contraception.

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