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Cervical cap
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==Process== ===Fitting=== [[Image:Contraception_cape_cervicale_svg_hariadhi.svg|350px|thumb|Position of a cavity rim cap. The actual size of the cap and cervix is significantly larger than shown.<ref>Searching the Internet for anatomical images shows significantly larger cervices than shown here (in all 20+ cases). Since the cerival cap goes around the cervix, it must be larger also.</ref>]] Individuals who wish to use a cervical cap are screened by a [[health care provider]] to determine if a cervical cap, or one brand of cap, is appropriate for them. If a cap is determined to be appropriate, the provider will determine the proper size. The user must be refitted after any duration of pregnancy, whether the pregnancy is [[abortion|aborted]], [[miscarriage|miscarried]], or carried to term through vaginal [[childbirth]] or [[caesarean section]].<ref name="pp" /> Several factors may make a cap inappropriate for a particular woman. Women who have given birth may have scar tissue or irregularly shaped [[cervix]]es that interfere with the cap forming a good seal.<ref name="fwhc2">{{cite web |title=Cervical Cap - Q&A |publisher=Feminist Women's Health Center |date=January 2006 |url=http://www.fwhc.org/birth-control/capinfo2.htm |access-date=2008-04-19 |url-status=dead |archive-url=https://web.archive.org/web/20071019002015/http://fwhc.org/birth-control/capinfo2.htm |archive-date=2007-10-19 }}</ref> For some women, available sizes of cervical caps do not provide a correct fit. Also, cavity rim caps are not recommended for women with an anteflexed uterus.<!-- --><ref>{{cite journal |title=Uncertainty exists on availability of cervical cap, distributor says | journal = Contracept Technol Update | volume = 10 | issue = 4 |pages=57β8 |year=1989 | pmid = 12342202 |author1=<Please add first missing authors to populate metadata.>}}</ref> In infrequent cases a woman may have a long vagina but short fingers and thus may not be able to place the cap correctly.{{sfn|Stopes|1924|pp=142-3}} Overall, 80% to 85% of women who want caps can be fitted without issues.<ref name="Chalker1 p.. 262">Chalker1 p.. 262</ref> The rim cap should be such that the rim tucks into the [[Vaginal fornix|fornix]] snugly and evenly so as to maintain good suction to hold it in place.<ref name="Chalker1 p.. 262"/> In some countries, some devices (such as the Lea's Shield) are available [[Over-the-counter drug|without a prescription]].<ref name=summary>[https://www.fda.gov/cdrh/pdf/P010043b.pdf Summary of Safety and Effectiveness Data] {{webarchive |url=https://web.archive.org/web/20080912045050/https://www.fda.gov/cdrh/pdf/P010043b.pdf |date=September 12, 2008 }}</ref> ===Method of use=== The first step in inserting or removing a cervical cap is [[hand washing]], to avoid introducing harmful [[bacteria]] into the vaginal canal.<ref name="pp">{{cite web |last=Johnson |first=Jennifer |title=Diaphragm, Cervical Cap and Shield |publisher=Planned Parenthood |date= December 1, 2005 |url=http://www.plannedparenthood.org/health-topics/birth-control/diaphragm-cervical-cap-shield-4244.htm |access-date=2008-04-19 |archive-url = https://web.archive.org/web/20080325011659/http://www.plannedparenthood.org/health-topics/birth-control/diaphragm-cervical-cap-shield-4244.htm |archive-date = March 25, 2008}}</ref> The cap is inserted prior to [[sexual intercourse]];<ref name="CBAS" /> some sources state that insertion prior to [[sexual arousal]] decreases the risk of incorrect placement.<ref name="femcapdirections">{{cite web |title=Directions for use |publisher=FemCap |year=2007 |url=http://www.femcap.com/directions.htm |access-date=2008-04-19 |archive-url = https://web.archive.org/web/20080310075905/http://www.femcap.com/directions.htm |archive-date = March 10, 2008}}</ref> Most sources recommend the use of [[spermicide]] with the cap,<ref name="CBAS" /><ref name="pp" /><ref name="femcapdirections" /><ref name="ovesinstructions">{{cite web |title=Instructions for Use |publisher=Veos PLC |year=2003 |url=http://www.oves.com/english/html/consumer/consumer_usage.htm |access-date=2008-04-19 |archive-url=https://web.archive.org/web/20090210040935/http://www.oves.com/english/html/consumer/consumer_usage.htm |archive-date=2009-02-10 |url-status=dead }}</ref> but some sources say spermicide use is optional.<!-- --><ref name="fwhc2" /><ref name="fpn">{{cite web |title=Cervical Cap |work=Family Practice Notebook |year=2000 |url=http://www.fpnotebook.com/GYN11.htm |access-date=2008-04-19 |archive-url = https://web.archive.org/web/20070930023601/http://www.fpnotebook.com/GYN11.htm |archive-date = September 30, 2007}}</ref> The cap remains in the vagina for a minimum of 6<ref name="femcapdirections" /><ref name="ovesinstructions" /> to 8<ref name="CBAS" /><ref name="fpn" /> hours after the last intravaginal [[ejaculation]]. It is recommended the cap be removed within 72 hours (within 48 hours is recommended in the U.S.).<ref name="CBAS" /> Other than the disposable Oves cap, cervical caps can be washed and stored for reuse.<ref name="fwhc"/> Silicone devices may be boiled to sterilize them.<ref name=video>{{Cite web |url=http://www.leasshield.com/images/leasvideo.mpg |title=Instructional video |access-date=2008-05-24 |archive-date=2015-10-18 |archive-url=https://web.archive.org/web/20151018194543/http://www.leasshield.com/images/leasvideo.mpg |url-status=live }}</ref> Reusable caps may last for one<ref name="femcapfaq">{{cite web |title=Frequently Asked Questions |publisher=FemCap |year=2007 |url=http://www.femcap.com/faq.htm |access-date=2008-04-19 |url-status=dead |archive-url=https://web.archive.org/web/20080511223914/http://femcap.com/faq.htm |archive-date=2008-05-11 }}</ref> or two<ref name="pp" /> years. Some caps have a pull tab for removal, but it is claimed that pulling on it should not be done, since it the cap tends to adhere very tightly to the cervix. Instead, putting a finger under the rim and pulling with a jerk should easily detach it.{{sfn|Stopes|1924|pp= 141-2}}
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