diaphragm after childbirth

iVillage Member
Registered: 03-28-2003
diaphragm after childbirth
4
Fri, 10-22-2004 - 7:47pm

Hello! I am new to this board but not to ParentsPlace. I have three kids, 5, 3 and 1, and was just fitted for a diaphragm after having a near-perfect track record with condoms for 15 years (except for the 1-year-old but I think that was because we bought some w/o spermicide). Anyway, my question is ... is it possible that some women who have had children (especially very large babies like I have) simply cannot keep a diaphragm in, no matter what the size?

My midwife fitted me on Monday, said it was a good fit, showed me how to insert, left the room for about 10 minutes to let me practice and told me to move around, squat, etc. to see if it felt comfortable. Seemed fine. She checked it after she came back in and said that I had inserted it okay.

After I picked up my own at the drugstore, I tried it out at home, went to urinate with it in, and the front part slipped down under the pubic bone.

When in to see another midwife in the practice. (I trust them all completely. They have been with me through two of my pgs and births). I inserted the dia myself, and she said the fit seemed fine, and my technique was fine, but maybe we could try the next size up. Left again, inserted the bigger one, same routine, except I tried to be a little harder on it. Tried some kegels, deep squats, etc. It didn't move. Didn't try to go to the bathroom because I was half naked in the exam room with no attached bath, and with my baby in the stroller.

Again, she said I had inserted it fine. But I picked up the new one today, and the same thing happens, it slips under the public bone when I urinate.

I'm wondering if I'm just not a good candidate, if maybe the vaginal muscles are so loose from childbirth (3 babies: 8,11; 9,1; and 10 lbs) that no size would ever stay in. Is it possible some women just can't wear a diaphragm? I hope not, because of religious beliefs this is my last option except for surgery.

Thanks!

iVillage Member
Registered: 12-30-2003
Fri, 10-22-2004 - 9:59pm
Hi emmom1198, welcome!

Some women aren't good candidates for a diaphragm. However, before you get to that point you might want to ask to try a diaphragm with a different style rim. There are coil spring, flat spring and arching spring rims. It depends on your anatomy; the firmness of your vaginal walls and the shape of your pubic notch (into which the anterior rim of the diaphragm fits) as to which rim will be the best fit for you. If you have a very shallow notch a flat spring rim might be what you need. However, diaphragms that are too large and too small will both pop out of the notch. If your midwife doesn't have a different rim style to try she can probably write you an Rx for the style you want to try (the rim styles are usually interchangeable for any given diameter) if you are sure of the size you want. What is the size and rim style of the diaphragm that you were fitted with? Most diaphragms are made in 5mm increments between 65mm and 95mm but there are specialists that make custom diaphragms up to 120mm. I hope this helps,

Good luck,

      Jill

    

iVillage Member
Registered: 03-28-2003
Fri, 10-22-2004 - 11:28pm
Hi! Thanks for the info. They fitted me with an arching spring, 75 first, and now an 80. I've been doing more research tonight, and it looks like the arching spring is the best if your muscle tone is low, which I'm afraid may be part of the problem. This site was pretty informative: http://www.aafp.org/afp/20040101/97.html. I feel so naive about the whole thing. My husband pointed out tonight that I can't even work the leaf on our dining room table, but I'm pretty sure the problem isn't user error, since the midwives checked my insertion three times. I'll be making another appointment to go back next week, and will bring up what you said. And if I try on any different sizes, I'm going to see if I can't take them into the bathroom with me! :)

On another note, just in case this scenario doesn't work out, what are your thoughts on Essure? I had some complications during a surgery several years ago, and am afraid of being put under for a standard tubal. I'm a little nervous that Essure hasn't been out for long or tested enough, but I may have to head that direction.

Thanks again!

Jenny

iVillage Member
Registered: 12-30-2003
Sat, 10-23-2004 - 12:29am
Hi Jenny,

A 75mm or 80mm diaphragm is in the mid range of sizes. I wear an 80mm Milex Omniflex wide seal which has a coil spring rim. An arching spring rim is probably the most universally used of the rim styles as it is firm and the easiest to insert correctly.

Essure is still very new and there aren’t many doctors with a lot of experience inserting it as yet. The Essure site has a toll-free number to call to find an Essure trained doctor near you. We haven’t had many members post that have had Essure inserted. If you haven’t all ready take a look at the Essure website: http://www.essure.com/consumer/c_homepage.aspx Be sure to read the Essure Patient information booklet that is on the website. I was particularly interested to read the section about risks. Apparently Essure could interfere with some procedures and tests if they are required after insertion and I thought the insertion failure rate was still significant. Those aren’t necessarily reasons to avoid the procedure but you should be aware of them and discuss them with an Essure trained doctor. Let us know how you’re doing ok?

Good luck,

      Jill

    

iVillage Member
Registered: 03-28-2003
Sat, 10-23-2004 - 3:03pm
Thanks again! I'll have a lot more info when I go in this week.

Jenny