Diaphragm (Birth Control)
Diaphragm (Birth Control)
Diaphragms are dome-shaped barrier methods of contraception that block sperm from entering the uterus. They are made of latex (rubber) and formed like a shallow cup. Since vaginas vary in size, each patient will need to be fitted by a doctor or nurse with a diaphragm that conforms to the shape and contour of the vagina as well as the strength of the muscles in the vaginal walls. Diaphragms must be used with spermicidal cream or jelly. The device should cause no discomfort, and neither the woman nor her partner should feel that it is there.
The purpose of a diaphragm is to prevent access to the womb (uterus) by the sperm and thus prevent conception. The level of effectiveness is about 95%.
Each client will undergo a physical examination and a Pap smear. If these are normal, the physician will fit the patient for the device and give instructions on how to insert, remove, and clean the object. She will also be taught the signs and symptoms of potential complications.
Prior to insertion, the inside of the dome and the rim are covered with a thick layer (perhaps a tablespoon) of a spermicide that is compatible with the diaphragm being used. The domed area covers the opening into the uterus (cervix) and keeps the spermicide in place. As a result, any sperm that might get under the diaphragm will be destroyed.
Diaphragms may be inserted two-three hours prior to intercourse, and must be left in place for six to eight hours following sexual relations. During this time the woman may not swim, bathe, or douche, but she may shower. If she desires to have intercourse again before the six to eight hours have passed, the diaphragm should not be removed. Instead, an applicator full of spermicide should be deposited into the vagina.
A diaphragm will last for a year or more. It should be examined weekly for holes. This can be done by holding it up to the light or filling it with water.
Before inserting the diaphragm, the woman should empty her bladder and wash her hands with soap and water. The device should be checked for leaks by filling it with water or holding it up to the light. A spermicidal jelly is then applied to the inside and outside, and especially around the rim. While standing with one foot elevated on a chair or step, lying down, or squatting, the woman folds the diaphragm inward toward the middle and inserts it into the vagina as far as it will go.
When removed, the diaphragm should be washed with a mild soap and water. After being dried, it can be dusted with corn starch before being returned to its container. The diaphragm should always be stored away from sunlight and heat in a cool, dry place. It should not be washed with harsh or perfumed soaps or used with perfumed powders because either of these substances can damage the diaphragm.
Although rare, wearing the diaphragm longer than the recommended time can result in toxic shock syndrome. The signs and symptoms of this serious illness include sudden onset of high fever, vomiting, diarrhea, dizziness, faintness, weakness, aching muscles and joints, and rash. The doctor must be notified immediately if any of these conditions appear. An allergic reaction to the spermicide or the material from which the device is made is also possible. Diaphragm use is also associated with an increased risk of bladder infections.
It should be noted that the diaphragm can become dislodged during intercourse, which could result in an unwanted pregnancy. To ensure a secure fit, a woman should be examined for a refitting if she gains or loses more than 10 lbs (4.5 kg), or after she gives birth.
Consumers can expect an efficiency rate of about 95% in preventing pregnancy. Using a male condom in conjunction with the diaphragm decreases the potential for pregnancy. Diaphragms provide no protection against AIDS or other sexually transmitted diseases.
"The Diaphragm." Cincinnati Women's Services. 〈http://gynpages.com/cws/8.html〉.
"Guide to Safer Sex." Sexual Health InfoCenter. 〈http://www.sexhealth.org/infocenter/GuideSS/diaphragm.htm〉.
Spermicide— A substance that kills sperm.
Toxic shock syndrome— An uncommon, but potentially fatal, disease that has been associated with the use of diaphragms and vaginal tampons. The symptoms include high fever, vomiting, and diarrhea.
The human anatomical diaphragm is a part muscle, part tendinous sheet, convex upwards, that separates the thorax from the abdomen. It is described as doubly ‘domed’, accommodating below it the liver on the right and the stomach and spleen on the left. It is attached to the inside of the lower margin of the ‘rib cage’: from the sternum (breast bone) in front, the cartilages interposed between this and the lower ribs around the sides, to reach the vertebral column behind. It is a complete partition except for openings to allow passage between thorax and abdomen: for the oesophagus to join the stomach, for the main artery (aorta) and for the main vein (inferior vena cava) that carry blood to and from the lower body, and for nerves and lymphatics vessels.
When the muscle of the diaphragm contracts, its convexity is flattened. This, together with other mechanical factors and muscular actions, causes an increase in the capacity of the thorax, which in turn draws air into the lungs. The motor nerve supply to the diaphragm comes to its upper surface in the phrenic nerves from each side of the neck. These carry the rhythmic bursts of impulses, relayed from the brain stem via the phrenic motor neurons in the spinal cord, which cause regular inspiration. Each time these stop, the diaphragm relaxes and rises, and air leaves the lungs. Although this cyclical control of the diaphragm and other breathing muscles occurs automatically, it is of course possible to control them voluntarily — to stop, start, or deepen breathing. The extent to which the diaphragm is used relative to the muscles of the thorax can also come under voluntary control, by selecting ‘abdominal’ breathing rather than chest expansion.
See respiratory system.See also breathing.
di·a·phragm / ˈdīəˌfram/ • n. 1. a dome-shaped, muscular partition separating the thorax from the abdomen in mammals. It plays a major role in breathing, as its contraction increases the volume of the thorax and so inflates the lungs. 2. a thin sheet of material forming a partition. ∎ a taut, flexible membrane in mechanical or acoustic systems. ∎ a thin contraceptive cap fitting over the cervix. 3. a device for varying the effective aperture of the lens in a camera or other optical system. DERIVATIVES: di·a·phrag·mat·ic / ˌdīəfragˈmatik/ adj. ORIGIN: late Middle English: from late Latin diaphragma, from Greek, from dia ‘through, apart’ + phragma ‘a fence.’
1. (in anatomy) a thin musculomembranous dome-shaped muscle that separates the thoracic and abdominal cavities. It plays an important role in breathing. There are openings in the diaphragm through which the oesophagus, blood vessels, and nerves pass.
2. a hemispherical rubber cap fitted inside the vagina over the neck (cervix) of the uterus as a contraceptive. When combined with the use of a chemical spermicide the diaphragm provides reasonably reliable contraception.