The Diaphragm

Reprinted from Off Our Backs (February 27, 1970), a Woman’s News Journal.

This article is the second in a series on birth control, compiled and presented with the aid of the Women’s News Co-op. The first article, which dealt with “the pill” and the recent unsettling facts brought to light surrounding its use, clearly indicates the necessity for information on other birth control means. Because of the capitalist media’s big push for the pill over the last few years, little information has been readily available on other birth control methods. We will endeavor, in this series, to rectify this situation.

The diaphragm, also called a pessary, is a birth control device which is the safest in terms of the woman’s health of all the devices known. It is designed to cover the opening to the uterus (cervix), and with experience will be as easy to insert as a tampon. It is made of soft rubber and looks like half a lemon peel with the rim rolled back upon itself. Inside the rim there is either a coil spring or a flat spring which may be compressed on opposite sides into the shape of a slipper for insertion.

Vaginal creams or jellies are available and should be used with the diaphragm. They come in tubes like toothpaste and are spread around the rim and inside the cup. These preparations help destroy male sperm, are impenetrable by semen and act as suction to keep the diaphragm in position.

You can insert the diaphragm standing, squatting, or lying down. Hold and compress the diaphragm between the thumb, index and third fingers. The index finger is placed inside the compressed diaphragm. Insert the diaphragm as far back as it will go behind the cervix. Then push the near part of the rim up behind the pubic bone in front. The diaphragm will have sprung into position to cover the cervix. Check this by running your forefinger around the rim and over the dome to be sure.

Mechanical ‘inserters are sometimes prescribed as an alternate to the coil spring diaphragm. The diaphragm is placed on the introducer, which looks like a curved plastic stick, fitting the rim into the end groove, then hooking the opposite rim over the appropriate notch. Ease the introducer along the floor of the vagina, as you would a tampon, until it can no longer be pushed in. To remove the introducer after the diaphragm is in place, give it a quarter turn left or right—which disengages it from the diaphragm. Then, gently withdraw the introducer. The near rim of the diaphragm is then pushed up behind the pubic bone. Check as before to make sure the dome is covering the cervix.

When inserted properly, neither you nor your mate will be aware of the diaphragm in the vagina, and there will be no dulling of sensation. The contraceptive preparation is not harmful to the vaginal canal nor harmful if ingested orally.

It should remain in place for from six to eight hours after intercourse. Intercourse may be repeated without removing the diaphragm; however, an applicator filled with the contraceptive cream or jelly must be inserted outside the diaphragm each time.

A douche may be taken at the time of removal, half before and half after. To remove the diaphragm, a finger is hooked under its edge and it is drawn out. The douche will wash away any remaining semen and eliminate the odor which is offensive to some women. Opinions differ on the use of a douche, especially concerning whether or not to add medication to the water. Some doctors feel that douching is not necessary at all.

Diaphragms must be fitted to your cervix. This is very important; many women have just gone to a drug store, bought the wrong size and become pregnant. If the diaphragm is too small or too large, it is more likely to become dislodged. The size of your cervix will change after giving birth to a child and may change again after a few months. It must be refitted both times. The doctor will fit your diaphragm and either write a prescription for you to obtain one from a drugstore or sell you one from his office. The approximate cost is $3 to $5, and with good care lasts several years.

Rubber deteriorates with age. Prior to use, the diaphragm should be filled with water or held up to a light to detect any holes or cracks. After use, wash it with mild soap and water and dry it to prevent early deterioration. A light dusting of talc will help keep the rubber from sticking together.

When the diaphragm is properly fitted and used as directed, it is almost impossible for a woman to become pregnant.