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  • Title: Fitting the cervical cap.
    Author: Brokaw AK, Baker NN, Haney SL.
    Journal: Nurse Pract; 1988 Jul; 13(7):49-50, 52, 55. PubMed ID: 3405494.
    Abstract:
    The cervical cap is now available for general use by American women. Several steps are necessary to select women who are good candidates for cap usage and to successfully fit the cap. Many women are not good candidates for the cap. The cap is generally not suitable for women who have recently become sexually active or who are first-time contraceptors. Many users are women who cannot use more widely available contraceptives. Successful cap use requires a highly motivated, persistent woman who will correctly insert and remove her cap. The size, shape, length, position and location of the cervix must be assessed by the clinician prior to fitting the cap. The cervix should be visually inspected for lesions or cervicitis and a Pap smear should be taken. After an initial cap is selected, the stability of the cap, gaps between the cap and cervix, areas of uncovered cervix and the adequacy of the suction seal should be assessed. The woman should be taught how to insert and remove the cap. Additionally, she should be instructed to use a backup method of contraception until she is sure that the cap will remain in place during sexual intercourse. Successful cap fitting requires a careful, methodical approach by the clinician and a carefully selected, highly motivated client. This article presents the steps of cervical cap fitting. As the cervical cap is now available as a contraceptive option for American women and few American clinicians have experience in fitting cervical caps, the steps of cervical cap fitting are outlined. Prior to fitting the cap, it is essential to obtain a brief medical and contraceptive history and to screen for contraindications to the cap. Because the cap is a barrier contraceptive that tightly covers the cervix, cervical changes, infections, or blockage of the menstrual flow theoretically are possible, and women with abnormal Pap smears, current infections, or endometriosis probably should not use the cap. The client's motivational level also should be assessed as cap insertion and removal can be difficult. The clinician must assess the size, shape, length, position, and location of the cervix prior to fitting the cap. The cervix should be inspected visually for lesions or cervicitis and a Pap smear should be taken. Following the selection of an initial cap, gaps between the cap and cervix, areas of uncovered cervix, and the adequacy of the suction seal should be assessed. The user also should be instructed to use a backup contraceptive method until she is certain that the cap will remain in place during sexual intercourse. To correctly fit the cervical cap requires considerable time, effort, and skill on the part of both the client and the clinician.
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