Barrier Method: Cervical Cap

Cervical Cap

Cervical Cap

Description

• A barrier-type method of contraception, similar to the diaphragm but smaller;
• A thimble-shape, soft rubber cup that the patient places over the cervix;
• Held in place by suction;
• The addition of a spermicide creates and additional chemical barrier;
• Persons who are not suited for diaphragms may use a cervical cap; failure of the cervical cap is commonly due to failure to use the device or inappropriate use of the device.

Advantages

• The cap requires less spermicide;
• It has an efficacy rate of 85% for nulliparous women and 70% for parous women when used correctly and consistently;
• It does not alter hormone levels;
• It can be inserted up to 8 hourse before intercourse;
• It does not require reapplication of spermicide before before repeated intecourse;
• It can remain in place longer than diaphragms because it does not exert pressure on the vaginal walls or urethra.

Disadvantages

• It requires possible reffiting after weight gain or loss of 15 lb *6.8 kg) or more, recent pregnancy, recent pelvic surgery, or cap slippage.
• It is more likely to become dislodged during intercourse;
• It may be difficult to insert or remove;
• It may cause an allergic reaction or vaginal lacerations and thickening of the vaginal mucosa;
• It may cause a foul odor of left in place for more than 36 hours;
• It can't be used during mesntruation or during the first 6 post-partum weeks;
• It should not be left in place longer than 24 hours;
• It is contraindicated in people with a history of toxic shock syndrome (TSS), a previously abnormal Pap test, allergy to latex or spermicide, an abnormally short or long cervix, history of pelvic inflammatory diseases (PID), cervicitis, papillomavirus infection, cervical cancer, or undiagnosed vaginal bleeding.

Implications

• Make sure that the person is properly fitted with the cap;
• The gap os space between the base of the cervix and the inside of the cervicl cap ring should be 1 to 2 mm (to reduce the possibility of dislodgement);
• The rim should fill the cervicovaginal fornix;
• If the cap is too small, the rim leaves a gap where the cervix remained exposed; if the cap is too large, it is not snug against the cervic and is more easily dislodged;
• Instruct the person on how to insert the cap properly;
• Re mind the person that the cap needs refitting after weight gain or loss of 15 lb or more, recent pregnancy, recent pelvic surgery or cap slippage.