The diaphragm is a dome shaped latex or silicone cup that fits securely in the vagina and covers the cervix. It should always be used with a spermicidal gel formulated for diaphragm use. It works by 1) blocking the opening to the uterus and 2) holding spermicide that may destroy sperms' cell membranes.
The diaphragm can be inserted into the vagina at the time of intercourse or up to 2 hours before intercourse. After intercourse, the diaphragm must be left in place for at least 6 hours. Using it longer than 24 hours is not recommended because of the very rare but possible risk of toxic shock syndrome.
The diaphragm is fitted by a healthcare provider. Insertion and removal instructions are given at the time of fitting. With proper care, diaphragms can ideally last up to two years.
Failure rate for typical use is 16%, while failure rate for perfect use is 6%.
The cervical cap is placed over the cervix and should be used in conjunction with spermicides. There are two types of cervical caps available in the United States. Lea's Shield is oval shaped and comes in one size. The FemCap comes in three sizes and is shaped like a bowl. They can be inserted any time prior to intercourse, but must be left in place for at least 8 hours after sex and no more than 48 hours. It is not to be used during menstruation.
Push the cap into the vagina and make sure that the cap directly covers the cervix.
If a woman has never given birth, the typical failure rate is 14%. In women who have given birth, the typical failure rate is 29%.
Both of these cervical caps are available by prescription only and costs between $60-$75 (plus fees for exam and fitting)
Vaginal spermicides are creams, foams, gels, or suppositories containing chemicals that prevent sperm motility. They can be used alone, but for highest protection against pregnancy spermicide should always be used alongside the cervical cap and diaphragm.
Failure rate: 15% - 29%