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Diaphragms come in sixth place when it comes to contraceptive effectiveness with typical use. Check out the lineup of current pregnancy prevention methods recognized by the American College of Obstetricians and Gynecologists (ACOG) and see how they rank up below.
| Effectiveness Ranking | Contraceptive Method | Pregnancies per 100
Users in 1st Year |
Effectiveness |
| 1 | Implant | .05 | 99.95% |
| 2 | Sterilization (Permanent) | .2 to .5 | 99.5 to 99.8% |
| 3 | IUD | .2 to .8 | 99.2 to 99.8% |
| 4 | Injection (Hormonal) | 6 | 94% |
| 5 (tied with patch & ring) | Pill | 9 | 91% |
| 5 (tied with pill & ring) | Patch | 9 | 91% |
| 5 (tied with pill & patch) | Vaginal Ring | 9 | 91% |
| 6 | Diaphragm | 12 | 88% |
| 7 | Male Condom | 18 | 82% |
| 8 | Female Condom | 21 | 79% |
| 9 | Cervical Cap | 17 to 23 | 77-83% |
| 10 | Sponge | 12 to 24 | 76-88% |
| 11 | Natural Fertility Awareness | 24 | 76% |
| 12 | Spermicide (alone) | 28 | 72% |
You’ll see that the contraceptive diaphragm is around the middle of the pack when it comes to preventing pregnancy. But it doesn’t necessarily have to get stuck in the middle—there are several ways to supercharge your diaphragm’s efficacy to move it further up the list, creating a closer-to-perfect method of birth control. Let’s see how it’s done.
Even if you’re not any good at math, it’s easy to see how combining different contraceptive methods can make your chances of pregnancy plummet. So if a diaphragm has an effectiveness of 88% and male condoms have an effectiveness of 82%, using a diaphragm with a condom will drastically improve your protection against pregnancy, with the added bonus of shielding you from certain STDs.
You can get even better results from using the diaphragm together with a hormonal contraceptive. Talk to your doctor about your options and never combine multiple hormonal contraceptives (see chart: all of the methods above the diaphragm are hormonal, except sterilization).
Diaphragms are versatile and can be used with many other contraceptive methods, including natural family planning methods like the FAM or FAB methods. Even the withdrawal method (also known as “coitus interruptus” or “pulling out”) will significantly increase your diaphragm’s success rate. Combining other contraceptive methods with your diaphragm is a surefire way to amp up your pregnancy prevention effectiveness.
Related: Natural Birth Control: Fertility Awareness Pregnancy Prevention
Using spermicide with a diaphragm is a MUST. That’s because sperm can survive inside a woman’s body for up to two days. That means that simply barricading the cervix with a diaphragm alone for six hours after ejaculation may not block or remove all sperm. Spermicide kills sperm and it takes around six hours to get the job done. That brings us to tip #3.
Never remove your diaphragm less than six hours after sex. Doing so puts you at risk for pregnancy since the spermicide may not have killed all the sperm, meaning some live sperm may still be left inside your body. Carefully read your diaphragm’s instructions for timing when to insert and when to remove it.
For insertion, you need to know that spermicide is most effective if applied less than two hours before sex. If you insert the diaphragm earlier than this, you can add more spermicide.
As with all birth control methods, consistency is key. Since we’re all human, it’s possible that sometimes we aren’t perfect. That’s why many studies show two rates for effectiveness: typical vs. perfect use. Typical allows for human error, while perfect is reserved for those who have immense self-control. For example, the Caya Contoured Diaphragm has an effectiveness of 86% for those who use it perfectly every time and 82% for typical use. Using your diaphragm every time you have sex, and following the instructions perfectly, can increase the effectiveness by up to 4% for this particular type of diaphragm.
Our final tip for maximizing your diaphragm’s pregnancy-preventing powers is to make sure it’s in place properly. Inserting a diaphragm can definitely take some getting used to and practice makes perfect. There are some things you can do to verify that you’ve got it in right.
Once you’ve inserted your diaphragm based on the instructions provided, you can feel with a finger to verify that your cervix is covered by the diaphragm’s barrier material. Another way to check that your diaphragm is correctly placed is to move around—squat, jump, twist, and turn! You shouldn’t be able to feel the diaphragm and it shouldn’t get dislodged with movement. If you can check these boxes off, you’ve got it inserted correctly.
Related: Diaphragms as a Contraceptive: What’s It Like to Use One?
Pregnancy prevention is an important part of women’s health. Birth control should be effective and manageable without causing you any additional health problems. My Virtual physician is here to help you find the method that works best with your body. If you’re considering the diaphragm or any other methods, reach out to our team today to discuss your options and get your prescription.
