Name of the Procedure:

Diaphragm or Cervical Cap Fitting

Summary

A diaphragm or cervical cap fitting is a procedure where a healthcare provider helps a patient correctly size and position these barrier methods of contraception. The diaphragm and cervical cap are rubber or silicone domes that cover the cervix to prevent sperm from entering the uterus.

Purpose

The fitting addresses the need for a reliable, non-hormonal birth control method. The goal is to ensure the patient has a properly fitting device to optimize effectiveness and comfort while minimizing potential side effects.

Indications

• Patients seeking a non-hormonal contraception method.
• Individuals who cannot use hormonal birth control due to medical reasons.
• Those who prefer a reversible and controlled birth control option. Suitable for sexually active women who can remember to use it consistently and properly.

Preparation

• No specific fasting or medication adjustments are required.
• Patients may need to schedule an appointment when they are not menstruating.
• It is helpful to have a recent gynecological exam report.

Procedure Description

1. Initial Consultation: Discuss contraceptive history and preference.
2. Pelvic Examination: Perform a pelvic exam to assess the vaginal and cervical health.
3. Sizing: Use a fitting kit with different sizes of diaphragms or cervical caps to determine the correct size. The healthcare provider will insert each size until the most appropriate fit is found.
4. Education: Provide instructions on how to insert, remove, and care for the device.
5. Practice: The patient practices inserting and removing the device under guidance.
6. Follow-Up: Schedule a follow-up appointment to ensure a continued proper fit and answer any questions.

No anesthesia or sedation is required for this procedure. The primary tools used are the diaphragm or cervical cap sizing kit and lubricant.

Duration

The fitting typically takes between 20 to 60 minutes.

Setting

The procedure is usually performed in an outpatient clinic or family planning center.

Personnel

• Healthcare provider (e.g., gynecologist, nurse practitioner, or family planning specialist)
• Medical assistant (sometimes)

Risks and Complications

• Minor discomfort during fitting.
• Allergic reaction to the material.
• Increased risk of urinary tract infections.
• Rarely, toxic shock syndrome if the device is left in too long.

Benefits

• Non-hormonal, reversible birth control method.
• Immediate effectiveness when used correctly.
• Control over contraception by the patient. Benefits are usually realized immediately upon correct use.

Recovery

• No significant recovery time is needed.
• Patients may experience minor discomfort initially.
• Follow care guidelines for insertion, removal, and cleaning.
• Schedule a follow-up appointment as advised.

Alternatives

• Hormonal contraceptives (e.g., pills, patches, injections).
• Intrauterine devices (IUDs), hormonal and non-hormonal.
• Condoms (male and female).
• Permanent solutions like tubal ligation.
• Natural family planning methods. Each alternative has its own pros and cons regarding effectiveness, side effects, and user control.

Patient Experience

• Minor discomfort is common during initial insertion and sizing.
• May feel awkward at first, but confidence typically grows with practice.
• Anxiety about correct usage can be mitigated with thorough instruction and practice.
• Minor concerns can be addressed in the follow-up visit.

Pain management and comfort measures include using adequate lubricant and taking a relaxed approach during insertion and removal practicum.