Is the diaphragm a viable option?

[rockerrock]

I have two children, both conceived first cycle of trying, and I'm trying to decide on what contraception to use.

I don't want any hormones (it took 6m to regain my cycles after coming off the pill, and it was horrible: painful cramps, mood swings etc). I also don't want the coil (I believe that life begins at conception and so don't like how it may prevent implantation).

We want a third child, but not yet sure of the timing. If I were to fall pg it wouldn't be the end of the world, other than over a few cycles (since then I'd be heavily pregnant/with a newborn when we are planning on a move halfway across the world...).

Sooo I've been thinking of the diaphragm. But I'm put off because:

1. Isn't it a faff (remembering to put in and take out)?
   
   
2. Doesn't have to use spermicide ruin spontaneity (I hate condoms for this reason)?
   
   
3. It just seems, well, a bit old-fashioned...
   
   I'm currently BF and my cycles haven't come back yet, but I know better than to rely on that as a method of contraception...
   
   Any ideas/answers? Is there any good contraceptive for me??

[NorthernLurker]

Well I think you're right and this is about the only option atm. I think you may have a bit of trouble finding somebody to fit one as they aren't so much used now. The other option would be to use your body temp and cycle plotting and combine with condoms but that won't work without a regular cycle I don't think and is in any case a faff. Just be prepared for the hard sell on Mirena coil - that seems the default option these days!

[rockerrock]

I'd never trust myself with the charting (plus I doubt it'd be reliable, since I rarely never get a solid three hours sleep at the moment)!

Was hoping there'd be some elusive other form of contraception not mentioned on any of the websites or in any of the leaflets... ;)

Thanks: will try to scout one out.

[NorthernLurker]

When you've had baby number 3 and if you think that's it with baby bearing then a vasectomy for your other half will work well

[rockerrock]

Haha! Yes - he knows that's coming. After I've gone through the pill, fiddling around looking at mucus, pregnancy, childbirth and BF times (hopefully) three, that's the least he can do :)

[NorthernLurker]

Absolutely! Just realised it's 5 years since I've had to think about contraception. That's a nice feeling

[Facepalmninja]

Hi there Rock, we use the diaphragm, chart my fertile days and we use condoms as well when in fertile phase. Having one fitted is very easy, most family planning and GP units offer this service.

[Startail]

I used it when DH and I first got together. Yes it's a bit of a faff.

You either have to put it in yourself any evening you think your going to have sex, or just before you definitely want to and it's a touch messy as you have to smear it with spermicide first.

In fact we ended up with DH slipping it in and us both checking it was in the right place. You do have to be very happy fumbling about down there as they don't have release strings and are a bit of a fiddle to get out.

However, we got on with them much better than condoms. I eventually swapped to the combined pill sometime after we were married and together full time. Having had a perpetually BFing DD2 I've ended up on the mini pill and intend to remain on it until the end of AF.

[Startail]

Oh and I was an experiment in the safe period method of contraception

[kalidasa]

Hi, I am in a similar situation. I have conceived each of the only three months that we weren't using contraception (two early losses, one baby son). My pregnancy was unbelievably awful (very severe hyperemesis and then severe SPD - was in a wheelchair - neither of which have fully resolved six months after giving birth). I have been advised to avoid all hormonal methods as I am apparently oversensitive.

I don't have a moral objection to preventing implantation BUT I am keen to avoid a method that works this way because in all three pregnancies I started to feel very unwell 48 hours after conception (i.e., certainly before implantation). Obviously I don't want to feel unwell for a week or so every or most months, and I would also find it upsetting and unsettling to be 'aware' of failed conceptions like that.

But my understanding is that the copper coil (NOT the Mirena) is thought to work primarily by preventing the sperm meeting the egg, rather than by preventing implantation (though it may do this as well). For this reason I am going to give the copper coil a go. (What I've read said that the Mirena is the other way round, and primarily prevents implantation.) I'm having it fitted in a few weeks so if you still haven't decided in a few months' time PM me and I'll let you know how I'm getting on with it and whether I suspect that I am still conceiving with it.

I went for a consultation at the Margaret Pyke clinic (specialist family planning place in London) and they did have some options I hadn't heard of - e.g. the 'vaginal ring' (hormonal but v. low dose). They also actively teach the fertility awareness method.

If you are not keen on the coil in your position I would learn FAM and combine it with a barrier method (condom/diaphragm/cap) for added security. In fact this is what I did for years (with condoms) and despite being - it has turned out - obviously v. fertile it didn't fail for me.

If you don't get much sleep that might rule out FAM but it might not - some people find that their temps are clear enough even with not a lot of sleep or a fairly disturbed night. Though you would have to learn the method and try for a few months to find out. Personally the only thing that mucks up my charts is if I am not only awake but actively up/walking around for hours in the night. Some disturbance is fine.

That was really long but I would recommend going to a specialist family planning place if you can. I was really impressed with the Margaret Pyke.

[MonstersDontCry]

I'm having the same problems op. I don't want any hormonal contraceptives. I found the copper coil and thought 'great!' until I read that it can stop implantation which I wouldn't be happy about.

I'm pregnant with accidental DC2 which proves condoms are not for us!

[AuntieStella]

I haven't had a diaphragm, but have had a number of TMI conversations with a friend who had one.

A few things which stuck in my mind:

a) you need to be comfortable and confident with the insertion procedure, and very familiar with your internal contours so you are sure it's in the right place
b) you need to put it in in advance, so no fiddling round during the act (can't remember what she said about spermicide)
c) if you put it in then don't have sex, it can be surprisingly depressing when you take it out.

[rockerrock]

This is all fascinating: thank you!

kalidasa you raise a really interesting point about 'knowing' you're pregnant before implantation. With both pregnancies I've known within a few days (I just feel utterly awful and it stays that way for the next 10 weeks...) so this is a consideration for me also which I hadn't even thought about...

From what's been said, the diaphragm is a bit of a faff... Maybe I should reconsider charting and then using condoms when I'm fertile. I charted before TTC both my children so I know my 'normal' temps pre- and post-O, so I wouldn't need to do it every day, just sporadically to make sure they matched up with everything else. As I say, getting pg would only be A Bad Thing for a few months at the end of the year, so it's only then we'd really need to be careful.

It's been said before, but it'd much easier if fertility was 'off' until you turned in 'on', rather than the other way around...

[kalidasa]

Yes in your circs I think FAM is a good idea. Do review the rules though as it is a bit different if you're charting to avoid rather than to conceive - in particular I have never trusted the rules for the 'safe period' before ovulation. The other weakness is that I think most descriptions of the method (e.g. 'Taking Charge of Your Fertility', which is otherwise excellent) downplay the extent to which your natural drive to conceive can overrule your rational self in the run-up to ovulation in surprising ways. For instance, the only times in years of charting that I forgot or misremembered exactly where I was in my cycle turned out to be (in retrospect) around ovulation. Also I think if women are used to artificial cycles they can be taken aback at the strength of their surge in libido in the run-up to ovulation in a natural cycle.

Anyway, if you do want another child just not yet I would go for FAM + condoms. The great thing about FAM is that it just gives you the info and what you do with it is up to you - for instance, you could do FAM and just use condoms at the fertile time in general, but then in those months where you really mustn't conceive you could abstain completely in the fertile period and use condoms the rest of the month. It is very flexible and you can respond to circumstances in a natural way. Good luck with it!

[bigkidsdidit]

I'm in almost exactly the same situation as you. I WILL NOT use hormonal contraception of any form, I've tried Depo and 2 pills and they all get rid of my sex drive absolutely. I was thinking about the copper coil but heard they can make your periods last for weeks

I'm going to use the diaphragm and also condoms in my most fertile phase. SPontaneity doesn't matter much, it's not like DH and I do it on the sofa any more

[kalidasa]

bigkids just saw your post. At my appointment last week (at specialist family planning place) I was told that you can expect your period to be slightly longer on the copper coil - for instance if it is usually 4-5 days you should expect 6-7; if it's usually one day of heavy bleeding and cramps, you should expect two. You do bleed after insertion as well, but you shouldn't bleed for weeks. Actually I think hormonal methods like Mirena are more likely to give you light bleeding that drags on and on. I'm a bit nervous about the heavy/painful periods thing but still reckon it's worth a go.

Fortunately I had always had an odd feeling that hormonal methods weren't a good idea, so have never tried them. Just as well as it turns out.

[FreckledLeopard]

The diaphragm wasn't a faff so much, but I did get recurrent cystitis with it, which might be something to think about if you're prone to getting UTIs.

I finally ended up on the contraceptive patch, which had none of the problems that I'd had when on the pill - no spotting, bloating, weight gain, mood swings and no problems when stopping it either.