Name of the Procedure:

Diaphragm for Contraceptive Use Technical Term: Contraceptive Diaphragm Insertion

Summary

A diaphragm is a barrier method of contraception that is inserted into the vagina to cover the cervix, preventing sperm from entering the uterus. It is usually used in conjunction with spermicide to increase its effectiveness.

Purpose

The diaphragm is primarily used for birth control to prevent pregnancy. It provides a hormone-free contraceptive option that women can control.

Indications

The diaphragm insertion is indicated for sexually active women who desire a non-hormonal, user-controlled method of contraception. It’s particularly suitable for women who cannot use hormonal contraceptives due to medical conditions or personal preference.

Preparation

Patients may be asked to:

• Have a pelvic exam to determine the correct diaphragm size.
• Practice inserting and removing the diaphragm to ensure proper usage.
• Obtain a prescription for spermicide, which is used with the diaphragm.
• Review any current medications with their healthcare provider to rule out any possible interactions with the spermicide.

Procedure Description

1. The patient receives instructions on how to insert the diaphragm.
2. Initially, a healthcare provider may fit and insert the diaphragm to ensure proper placement.
3. It involves folding the diaphragm in half and inserting it into the vagina, ensuring it covers the cervix completely.
4. Spermicide is applied inside the diaphragm before insertion.
5. The patient may be monitored to ensure they can correctly insert and remove the diaphragm on their own.

Tools and Equipment: Diaphragm, spermicide, lubricant Anesthesia or Sedation: Not typically required

Duration

The initial fitting and instruction session typically lasts about 30 minutes. Daily use involves the diaphragm being inserted before intercourse and left in place for at least 6 hours afterward but not more than 24 hours.

Setting

• Outpatient Clinic
• Family Planning Office
• Gynecological Office

Personnel

• Gynecologist
• Nurse Practitioner
• Family Planning Specialist
• Healthcare Provider trained in diaphragm fitting

Risks and Complications

• Allergic reactions to the diaphragm material or spermicide
• Vaginal irritation or discomfort
• Urinary tract infections
• Rarely, toxic shock syndrome if left in too long

Benefits

• Hormone-free contraception
• Can be used only when needed
• Allows for spontaneous sexual activity (once inserted)
• Provides women with control over their contraception

Recovery

• No significant recovery time is needed.
• Follow-up appointments may be scheduled to reassess fit or address any issues.
• Patients are advised to inspect the diaphragm regularly for wear and tear and replace it as recommended (usually every 1-2 years).

Alternatives

• Oral contraceptives (pills)
• Intrauterine devices (IUDs)
• Condoms
• Hormonal implants or injections

Pros and Cons: Alternatives may offer different advantages such as continuous protection or reduced need for user intervention but might come with hormonal side effects or the need for procedural insertion.

Patient Experience

During the initial fitting, the patient may feel some discomfort similar to a pelvic exam. Afterward, inserting and using the diaphragm may involve a learning curve, but generally becomes more comfortable with practice. Over-the-counter pain relief can be used for any mild, initial discomfort, and proper lubrication should minimize any irritation.