Editing Diaphragm (birth control) (section)

==History==
[[File:Die Frau als Hausärztin (1911) 155 Occlusiv-Pessar.png|thumb|Mensinga “occlusive pessary” (1911)]]
[[File:Photo_of_Contraceptive_Diaphragm.jpg|thumb|Photo of Caya diaphragm]]
The idea of blocking the cervix to prevent pregnancy is thousands of years old.  Various cultures have used cervix-shaped devices such as oiled paper cones or [[lemon]] halves, or have made sticky mixtures that include [[honey]] or [[cedar (plant)|cedar]] [[resin]] to be applied to the [[External orifice of the uterus|cervical opening]].<ref name="pp2">{{cite web|title=A History of Birth Control Methods|work=Planned Parenthood|date=June 2002|url=http://www.plannedparenthood.org/files/PPFA/history_bc_methods.pdf|access-date=2010-12-16|url-status=live|archive-url=https://web.archive.org/web/20101214142126/http://www.plannedparenthood.org/files/PPFA/history_bc_methods.pdf|archive-date=2010-12-14}}</ref> However, the diaphragm—which stays in place because of the spring in its rim, rather than hooking over the cervix or being sticky—is of more recent origin.

An important precursor to the invention of the diaphragm was the rubber [[vulcanization]] process, patented by [[Charles Goodyear]] in 1844. In the 1880s, a [[Germany|German]] gynecologist, Wilhelm P. J. Mensinga, published the first description of a rubber contraceptive device with a spring molded into the rim. Mensinga wrote first under the pseudonym C. Hasse, and the Mensinga diaphragm was the only brand available for many decades.<ref>Über die facultative Sterilität vom prophylaktischen und hygienischen Standpunkt (Pseudonym C. Hasse), Verlag Louis Heuser, Neuwied/Berlin 1882</ref><ref>Aus dem ärztlichen Leben. Ratgeber für angehende und junge Ärzte (Pseudonym C.Hasse), Verlag Otto Borghold, 1886</ref><ref name="evolution">{{cite journal|date=February 2000|title=Evolution and Revolution: The Past, Present, and Future of Contraception|journal=Contraception Online (Baylor College of Medicine)|volume=10|issue=6|url=http://ssai-starss.com|url-status=dead|archive-url=https://web.archive.org/web/20140222195427/http://ssai-starss.com/|archive-date=2014-02-22|access-date=2017-09-24}}</ref> In the United States, the physician Edward Bliss Foote designed and sold an early form of occlusive pessary under the name "[[womb veil]]" starting in the 1860s.<ref>Robert Jütte, ''Contraception: A History'' (Polity Press, 2008, originally published in German 2003), p. 154; Andrea Tone, ''Devices and Desires: A History of Contraceptives in America'' (MacMillan, 2001), p. 57 [https://books.google.com/books?id=ClHpjlw8zQEC&dq=%22womb+veil%22+%22edward+bliss+foote%22+inauthor%3Atone&pg=PA57 online] {{webarchive|url=https://web.archive.org/web/20160613155750/https://books.google.com/books?id=ClHpjlw8zQEC&pg=PA57&dq=%22womb+veil%22+%22edward+bliss+foote%22+inauthor%3Atone&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=3&cd=1 |date=2016-06-13 }};</ref>

American birth control activist [[Margaret Sanger]] fled to Europe in 1914 to escape prosecution under the [[Comstock Act of 1873|Comstock laws]], which prohibited sending contraceptive devices, or information about contraception, through the mail. Sanger learned about the diaphragm in the [[Netherlands]] and introduced the product to the [[United States]] when she returned in 1916. Sanger and her second husband, Noah Slee, illegally imported large quantities of the devices from Germany and the Netherlands. In 1925, Slee provided funding to Sanger's friend Herbert Simonds, who used the funds to found the first diaphragm manufacturing company in the U.S., the Holland-Rantos Company.<ref name="pp2" /><ref name="note">{{cite web|title=Biographical Note|work=The Margaret Sanger Papers|publisher=Sophia Smith Collection, Smith College|location=Northampton, Mass|year=1995|url=http://asteria.fivecolleges.edu/findaids/sophiasmith/mnsss43_bioghist.html|access-date=2006-10-21|url-status=live|archive-url=https://web.archive.org/web/20060912180741/http://asteria.fivecolleges.edu/findaids/sophiasmith/mnsss43_bioghist.html|archive-date=2006-09-12}}</ref>

Diaphragms played a role in overturning the federal [[Comstock Act of 1873]]. In 1932, Sanger arranged for a Japanese manufacturer to mail a package of diaphragms to a New York physician who supported Sanger's activism. U.S. Customs confiscated the package and Sanger helped file a lawsuit. In 1936, in the court case ''[[United States v. One Package of Japanese Pessaries]]'', a federal appellate court ruled that the package could be delivered.<ref name="pp2" />

Although in Europe, the [[cervical cap]] was more popular than the diaphragm, the diaphragm became one of the most widely used contraceptives in the United States. In 1940, one-third of all U.S. married couples used a diaphragm for contraception. The number of women using diaphragms dropped dramatically after the 1960s introduction of the [[intrauterine device]] and the [[combined oral contraceptive pill]]. In 1965, only 10% of U.S. married couples used a diaphragm for contraception.<ref name="evolution" /> That number has continued to fall, and in 2002 only 0.2% of American women were using a diaphragm as their primary method of contraception.<ref>{{cite journal|last=Chandra|first=A|author2=Martinez GM|author3=Mosher WD|author4=Abma JC|author5=Jones J.|title=Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth|journal=Vital and Health Statistics|volume=23|issue=25|year=2005|url=https://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf|access-date=2007-05-20|url-status=live|archive-url=https://web.archive.org/web/20070630135904/http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf|archive-date=2007-06-30}} See Table 56.</ref>

In 2014 [[Janssen Pharmaceuticals]] announced the discontinuation of the Ortho-All Flex Diaphragm, making it very difficult for women in the U.S. to have that option as a birth-control method.<ref>{{cite web |url=http://www.cervicalbarriers.org/products/diaphragms.cfm |title=Diaphragms |access-date=2016-05-26 |url-status=live |archive-url=https://web.archive.org/web/20160309212223/http://www.cervicalbarriers.org/products/diaphragms.cfm |archive-date=2016-03-09 }}</ref><ref>[http://www.tbtam.com/2014/04/ortho-diaphragm-discontinued.html#.U9vFe61dXTw Ortho Diaphragm Discontinued | The Blog That Ate Manhattan<!-- Bot generated title -->] {{webarchive|url=https://web.archive.org/web/20140810222243/http://www.tbtam.com/2014/04/ortho-diaphragm-discontinued.html |date=2014-08-10 }}</ref>{{Unreliable source?|date=August 2014}}

The single-sized, silicone diaphragm was developed by [[PATH (global health organization)|PATH]] during the late 2000s. It was licensed to Kessel Marketing & Vertriebs GmbH of Frankfurt, Germany, which began to market it as the Caya Diaphragm. The diaphragm was approved for contraception in Europe in 2013 and in the United States the following year.<ref>{{cite web |url=http://www.path.org/projects/silcs.php |title=A new kind of diaphragm |access-date=2015-11-08 |url-status=dead |archive-url=https://web.archive.org/web/20151026065737/http://www.path.org/projects/silcs.php |archive-date=2015-10-26 }}</ref>  Since then, Kessel has also developed a traditionally circular, multi-sized diaphragm made from the same materials that they released in Germany in 2020 under the name Singa.<ref>{{Cite web|date=2019-12-03|title=Singa®: distribution of the new diaphragm|url=https://www.medintim.de/singa-distribution-of-the-new-diaphragm/?lang=en/|access-date=2020-08-14|website=Medintim|language=en-US}}</ref><ref>{{Cite web|title=NEU! das Singa diaphragm|url=https://www.medintim.de/neu-singa-diaphragm/|access-date=August 13, 2020|website=Medintim}}</ref>