Who Can and Cannot Use Diaphragms

Medical Eligibility Criteria for
Diaphragms

Ask the client the questions below about known medical conditions. Examinations and tests are not necessary. If she answers "no" to all of the questions, then she can start using the diaphragm if she wants. If she answers "yes" to a question, follow the instructions. In some cases she can still start using the diaphragm. These questions also apply to the cervical cap.

1.    Have you recently had a baby or second-trimester spontaneous or induced abortion? If so, when?

NO    YES The diaphragm should not be fitted until 6 weeks after childbirth or second-trimester abortion, when the uterus and cervix have returned to normal size. Give her a backup method^* to use until then.

2.    Are you allergic to latex rubber?

NO    YES She should not use a latex diaphragm. She can use a diaphragm made of plastic.

3.    Do you have HIV infection or AIDS? Do you think you are at high risk of HIV infection? (Discuss what places a woman at high risk for HIV [see Sexually Transmitted Infections, Including HIV, Who Is At Risk?]. For example, her partner has HIV.)

NO    YES Do not provide a diaphragm. For HIV protection, recommend using condoms alone or with another method.

* Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Tell her that spermicides and withdrawal are the least effective contraceptive methods. If possible, give her condoms.

For complete classifications, see Medical Eligibility Criteria for Contraceptive Use, p. 333. Be sure to explain the health benefits and risks and the side effects of the method that the client will use. Also, point out any conditions that would make the method inadvisable, when relevant to the client.