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The Birth Mag

The Diaphragm Comeback

February 6, 2020

by Michele James-Parham

Despite being invented in the latter part of the 1800s, the diaphragm did not really get popular in America until around the 1940s. Then its popularity took a major dip in the late 1960s after the IUD was introduced. In the last five years, my midwifery practice has seen the comeback of the diaphragm. More people are looking for a birth control method that is reversible, easy to manage, non-hormonal, economical, and that does not always require an office visit.

There are two types of diaphragms on the market that are accessible in America with a prescription. The first is made of latex and requires a fitting from a healthcare provider. It is also recommended that diaphragm users be refitted after an increase in weight of more than 10 pounds, after any pregnancy that lasts more than thirteen weeks, and after vaginal or cesarean birth. Latex diaphragms are typically replaced every one to three years. The second type of diaphragm is made of silicone and is a one size fits most design, which does not require a fitting from a healthcare provider. However, it is still recommended that a person try one out with the aid of a healthcare provider to determine if the fit is correct for them. Silicone diaphragms are typically replaced every ten years. Regardless of which type a person uses, it is recommended that they use a water based spermicidal gel to aid in insertion and efficacy.

With a properly fitting diaphragm that is used with spermicidal gel, during every instance of sexual intercourse, and left in position six to eight hours after intercourse there is a perfect use efficacy rate of 94%. In contrast to that, the efficacy rate of the typical use of diaphragms is only 88% – this means that there is a 12% fail rate for typical use or that 12 in 100 diaphragm users will become pregnant. Diaphragm users who have experience using menstrual cups seems to have an easier time using diaphragms, especially regarding figuring out insertion and removal techniques.

In my midwifery practice, I like to recommend diaphragms as back up or additional pregnancy protection for clients who are using the Fertility Awareness Method and or exclusive chestfeeding as their birth control of choice. Diaphragms offer a better efficacy rate for clients who want to still be able to have sexual intercourse during the fertile period of their menstrual cycle. Diaphragms also provide back up protection for nursing parents who have not had their menstrual cycles return, are unable to adequately track their cycles, or who have irregular cycles.

If you have clients who have used a diaphragm in the past, clients who are intrigued now and wanting to try one, or clients who are looking for a form of contraception that does not utilise hormones, consider carrying and offering diaphragms as part of your practice.

Sources Consulted:

Planned Parenthood. (2020). Plannedparenthood.org. https://www.plannedparenthood.org/learn/birth-control/diaphragm/how-effective-are-diaphragms

History of Contraception-Cervical Caps and Diaphragms. (2012). Case.edu. https://case.edu/affil/skuyhistcontraception/online-2012/Cervical-Caps-Diaphragms.html

Smith, L. (2015, June 24). Diaphragm birth control: Use, advantages, and risks. Medical News Today; Medical News Today. https://www.medicalnewstoday.com/articles/295727.php

Michele James-Parham is a midwife, herbalist, speaker, & educator of over two decades. They have a queer & trans centered midwifery practice in Pittsburgh, PA where they live with their spouse & two children. Their practice information & social media contacts can be found at their website: midwitchery.net

Filed Under: Reproductive Health

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Happy new year! 2020 was rough on the Birth Mag cr Happy new year! 2020 was rough on the Birth Mag crew, and we know it was for many of you as well. This turned out to be a terrible year to launch a new magazine project, but it's over, and we're moving forward.

What's next then? First and foremost, the next print issue is coming! Look for a sneak peek of the upcoming cover next week. We are also settling in to a more consistent release of digital content going forward. 

We are so thankful for everyone who has hung in there with us through the tumultuous ride that was 2020, and look forward to bringing you so much more in 2021!

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Even if you don’t know which ones they are.
Even if you practice in a small rural town.
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The lactation issue is out! We had an abundance of The lactation issue is out! We had an abundance of delays, but they have now all been mailed. If you've been waiting on this issue, keep an eye on your mailbox, because it is on the way!
Community led, community based. The Birth Mag is l Community led, community based. The Birth Mag is looking for new submissions! Are you a birth worker? Are you interested in helping your fellow birth workers learn and grow to be more inclusive and educated on the issues birthing people are facing today? We want to hear from you! Compensation starts at $35 for any article that is used. Please e-mail us at thebirthmag@gmail.com for more information or to submit an article.
#Repost @thevaginachronicles
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There is so much to learn from this week. So much to give and receive. .
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This list is not an extensive and in no particular order but it is some of the HARD and persistent work that we must do. .
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Black people breastfeed. Even when we tell you no after you’ve asked 15 times if we want formula. Even when we are afraid of what it looks like and how we can continue It. Even when we see how you look at our breasts not understanding how different they can be. Even when we must figure out breastfeeding complexities by ourself. Even when we had to do it for you, before we could do it for our own children. .
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WE BREASTFEED!
#Repost @blkbfingweek • • • • • • HAPP #Repost @blkbfingweek
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HAPPY BLACK BREASTFEEDING WEEK! 🤩

By our histories and by the truths we know from living, our possibilities are greater than any imagination. 

For all the days that have felt hopeless, we invite you to enter a period of nourishment to revive.

Where there has been loss, grief and uncertainty, our restoration is key to being present and imagining healthy futures. 

And all through #BBW20, we reclaim our time, lives and families. 

Let’s gooooooo! 

#ReviveRestoreReclaim #blackbreastfeedingweek

Artist: Andrea Pippins @andreapippins
#Repost @storkandcradleclasses • • • • • #Repost @storkandcradleclasses
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New York, New York

Today starts Native Breastfeeding Week. Here are some native breastfeeding facts you should know.

-“The mission of the Native Breastfeeding Week community is to reflect the diversity of native breast-feeding experiences and to encourage and uplift visibility of native breast-feeding experiences”
-“this community also helps to address the inequality and injustice of indigenous mothers and their abilities to practice their roles in accordance to the tribal communities they dissent from”
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-many native mother’s insurance doesn’t cover donor milk which could greatly benefit infants.
-many native women lack breastfeeding support because of social and cultural norms.

Facts are from @ja_lyonhawk article posted at illusa.org 2019

Please visit Native Breastfeeding Week’s Facebook Page for info about the virtual events you can support this week. ❤️

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#Repost @taprootdoula • • • • • • Blac #Repost @taprootdoula
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Black Maternal Health Week is EVERY week •
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Art @designedbydg •
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The best way I’ve improved my ability to care for black parents is to listen to them. But before I could learn to listen, I had to commit to the LIFELONG task of confronting my biases against them. I must also commit over and over to the a promise that I would confront bias and racism I witness in my colleagues, providers, leadership and institution. This involves being brave, frank and unapologetic, and well-versed in the mechanisms for reporting abusive and problematic  behavior, even in situations with an imbalance of power (nurse v. physician, etc.) Anti-blackness is the default in our culture. As healthcare workers if we don’t intentionally, diligently, and sustainably work to confront and destroy our biases, these biases WILL lead to black birthing people and babies’ harm and death.
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Every birth worker - doctor, nurse, doula, midwife - needs to invest in an anti-racism training - @rebirthequity ~ @theblackdoula ~ @shishi.rose ~ @abide_women are some leaders who receive compensation to help you confront your biases against black birthing people. Anti-racism training is not CULTURAL COMPETENCY TRAINING. Cultural competency training is required by most employers, it’s been around for a while, and it doesn’t change s#%^.
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Follow 
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