IMPORTANT: Whenever possible, show the woman the location of the pubic bone and cervix with a model or a picture. Explain that the diaphragm is inserted behind the pubic bone and covers the cervix.

Basic Steps Important Details
1. Squeeze a spoonful of spermicidal cream, jelly, or foam into the diaphragm and around the rim
  • Wash hands with mild soap and clean water, if possible.
  • Check the diaphragm for holes, cracks, or tears by holding it up to the light.
  • Check the expiration date of the spermicide and avoid using any beyond its expiration date.
2. Press the rim together; push into the vagina as far as it goes
  • Insert the diaphragm less than 6 hours before having sex.
  • Choose a position that is comfortable for insertion—squatting, raising one leg, sitting, or lying down.
3. Feel diaphragm to make sure it covers the cervix
  • Through the dome of the diaphragm, the cervix feels like the tip of the nose.
  • If the diaphragm feels uncomfortable, take it out and insert it again.


4. Keep in place for at least 6 hours after sex
  • Keep the diaphragm in place at least 6 hours after having sex but no longer than 24 hours.
  • Leaving the diaphragm in place for more than one day may increase the risk of toxic shock syndrome. It can also cause a bad odor and vaginal discharge. (Odor and discharge go away on their own after the diaphragm is removed.)
  • For multiple acts of sex, make sure that the diaphragm is in the correct position and also insert additional spermicide in front of the diaphragm before each act of sex.
5. To remove, slide a finger under the rim of the diaphragm to pull it down and out
  • Wash hands with mild soap and clean water, if possible.
  • Insert a finger into the vagina until the rim of the diaphragm is felt.
  • Gently slide a finger under the rim and pull the diaphragm down and out. Use care not to tear the diaphragm with a fingernail.
  • Wash the diaphragm with mild soap and clean water and dry it after each use.