The cervical cap
Secor, R.M.
Naacog's Clinical Issues in Perinatal and Women's Health Nursing 3(2): 236-245
1992
ISSN/ISBN: 1046-7475 PMID: 1596432 Document Number: 314724
Over the centuries cervical caps have been made of gold, silver, opium, beeswax, and rubber. US women have been able to use the Prentif cavity rim (PCR) cervical cap since 1988. Women in England have been using it since the early 1900s. It comes in 4 sizes (22, 25, 28, and 31 mm). Before insertion, women must add spermicides inside the cap. The US food and Drug Administration (FDA) does not recommend it be worn for 48 hours, however. During this time period, they can have intercourse more than once without reapplying spermicide. The PCR cervical cap acts as a barrier and the gel or cream destroys any sperms which slip through a gap between the cap and the cervix. Among near perfect users, its effectiveness rate is 94%. Women at highest risk of pregnancy include younger, less educated, and more sexually active women and those who want a family someday. The most frequent complaints are cap dislodgement, cap odor, and partner discomfort but they do not always cause women to stop using it. Some advantages and benefits include high effectiveness, less urinary problems, convenience, inexpensive, and easy to use. Various disadvantages are that there are few trained clinicians, there is limited awareness among women and clinicians, they do not fit 20-40% of women, and fittings are time consuming. An abnormal Pap smear, cervical dysplasia, history of pelvic cancer, history of toxic shock syndrome, and severe cervical laceration constitute absolute contraindications. Temporary contraindications include current history of pelvic, cervical, vaginal, or urinary traction infection; intermenstrual bleeding; medical procedures to the cervix; breast feeding; and oral contraceptive use. As part of the initial cervical cap fitting, clinicians should perform a complete physical examination. They should also take the needed time to counsel and educate the women about the cap and its insertion.