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The diaphragm and the cervical cap should not be used until six weeks after delivery (vaginal or cesarean) or second trimester abortion and healing is complete. Re-fitting may be necessary at that time (re-fitting is not necessary after a first trimester abortion).
If intercourse occurs prior to six weeks, the use of another appropriate method (i.e., condom) should be recommended.
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The shape of the cervix, the size of the vaginal vault, and vaginal muscle tone may change after pregnancy and delivery or after second trimester abortion. It takes four to six weeks for the uterine involution to be complete, and bleeding/spotting can continue for up to eight weeks as well (cap use is contraindicated during bleeding).
Additionally, there is marked weight loss after delivery, and many providers recommend re-fitting after a weight loss of more than seven kilograms.
- Hatcher RA, Trussell J, Stewart F, Stewart GK, Kowal D, Guest F, et al. The diaphragm, contraceptive sponge, cervical cap and female condom. In: Contraceptive Technology. New York: Irvington Publishers, 1994:191-222.
- World Health Organization. Improving access to quality care in family planning: medical eligibility criteria for contraceptive use. Geneva: WHO, 1996.
- Wiley A. The diaphragm. In: Corson S, Derman R, Tyrer L, editors. Fertility Control. Boston: Little, Brown & Company, 1985:223-32.
- Secor RMC. The cervical cap. NAACOG's Clinical Issues 1992;3(2):236-45.
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