Healthcare Professionals
Caya is a reusable barrier contraceptive which facilitates hormone-free contraception. Suitable for about 80% of women a fitting is required to confirm suitability. Caya is an interesting option for women who are:
- Breast feeding
- Under risk of thrombosis
- Allergic to latex
- Prefer natural planning
- Prefer no side effects
- Six-weeks post-pregnancy
- Undergoing Cancer Treatment
- Want a back-up contraception
- Doesn’t need to regulate periods
- Want a birth control they control
If you are a healthcare worker in the UK and are thinking of prescribing the Caya diaphragm, get in touch with us.
We periodically have product samples and hard copies of materials to share, which will help you train your team and educate your patients. Send an email to "info @ ethicalfamilyliving.co.uk" for more details.
Quick Start Guide For Patients
This handy A5 size handout is an invaluable resource for patients to take away with them after their fitting appointment and when the basics of the diaphragm have been explained. Obviously not a substitute for fully reading the MIFU or a practice/coaching session on correct use, this handout serves as a good reminder of the basics for when the patient is ready to start using their diaphragm.
From time to time we may have printed stocks of these available for healthcare professionals. Contact us to discuss supply.
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Guidelines For Healthcare Professionals
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Steps for Coaching and Inserting Caya
The animated guide below shows the simplified steps for fitting a patient for the Caya diaphragm. Basically confirming that the diaphragm will indeed fit correctly and cover what is needed in order to offer effective barrier contraception.
Demonstration or ‘test’ diaphragms are available for purchase. They have a small hole cut into the membrane to prevent them becoming confused with the patients own Caya and to prevent their use as a contraceptive.
They can be purchased alone, but they are also included in our Singa diaphragm fitting sets. Additionally, two are included in our Caya Educational Pack. All of these options are available by clicking into the Caya product below.
Step 1.
Give the patient an opportunity to empty their bladder and bowel before the fit exam. Have them wash hands afterward since they will also insert, check fit, and remove the Caya during this fitting. You can use either the single-use diaphragm (with the hole) provided in the Educational Kit or the patient’s own Caya® diaphragm if they have brought this. Wash the diaphragm with water and soap.
Step 2.
Carry out a preliminary gynecological examination on your patient. Palpate the patient’s cervix and retropubic recess. Check for any anatomical changes, e.g., pronounced uterine prolapse, cystocele (see above: absolute contraindications).
Step 3.
Hold the Caya® diaphragm between your thumb and index finger on the grip dimples on the side of the diaphragm. The arrow on top of the removal dome must be pointing in the direction of the cervix. Show your patient how to hold the diaphragm correctly.
Step 4.
Squeeze the sides of the Caya® diaphragm together as shown in the illustration. Now apply some contraceptive gel into the two resulting membrane indentations. Approx. 4 ml of gel is sufficient (equivalent to approx. one teaspoon). Extra gel may be applied to the leading edge of the diaphragm to help with insertion. Show your patient the correct way to apply the gel.
Step 5.
With one hand holding the Caya® in the folded position, open the labia with the other hand. While keeping the Caya® folded, insert the diaphragm as deeply as possible. Push down so the diaphragm slides along the posterior vaginal wall toward the tail bone. You will need to shift your hand position as the diaphragm is inserted, so eventually your finger will push on the anterior edge of the Caya® as you push it into place. The cervical cup should be covering the cervix.
Step 6.
Now push the anterior edge (where the removal dome is located) up behind the pubic bone/pubic notch.
Step 7.
The Caya® diaphragm should lie diagonally between the posterior fornix and the pubic notch (or recess). The cervix should be covered by the cervical cup. If the diaphragm is too small, the membrane of the diaphragm may not cover the cervix even after the Caya is fully inserted. If the pubic notch is too flat or shallow, the anterior edge of the diaphragm may not stay secure along the anterior vaginal wall. If the Caya is too small, suggest trying a traditional diaphragm sized 85 mm or larger.
Step 8.
If the Caya® diaphragm is too large, it will not be able to be inserted comfortably. The patient will feel the anterior edge of the diaphragm at the introitus. The fit will not be secure and it could slip out. Ask the patient to stand up and move around to get the Caya® situated. If they experience uncomfortable pressure on the urethra or rectum, or feels the Caya is uncomfortable, the device may be too large for them. In this case, a traditional diaphragm sized 60 mm may fit her better.
Step 9.
Have the patient check fit and placement of the Caya®. Once they have done this, have them remove the Caya® and practice inserting, confirming fit, and removing on their own. If they have difficulty using one position, counsel them to try a different position.
Step 10.
The patient should feel for the removal dome at the front end of the Caya® diaphragm. Using their finger they will hook the diaphragm rim through the removal dome. The dome can be used either by the underside or by slipping the finger over the spring and pushing down on the removal dome. Once they have their finger in the removal dome, they pull down and out to remove the diaphragm. If the patient has difficulty removing the diaphragm, encourage them to try a different position (e.g., squatting or one foot on a stool positions open the pelvis and bring the cervix closer to the introitus).
Step 11.
The patient should practice handling, inserting and checking correct placement of the Caya on their own. Then practice removal. You should encourage the patient to use what ever insertion position is most comfortable and easy for them. The patient should walk around for a few moments after inserting the Caya (the Caya will settle more firmly into position as they move). The patient should use what ever position is most comfortable/easy for removal of the diaphragm. If they have difficulty, squatting and “bearing down” as if having a bowel movement will move the cervix closer to the introitus and may help. Before the patient leaves the clinic, you should be comfortable that they can insert, check position and remove the diaphragm.
Step 12.
After ensuring the patient understands how to insert, check fit and remove the Caya®, dispose of the Caya® sample diaphragm (with a hole). This sample diaphragm is intended for single-person use and must not be given to the patient. If using the patient’s Caya® diaphragm, have them clean it under running water with a mild soap, dry and put back in its case. Finally, ask your patient to again wash her hands thoroughly. Depending on protocol at your clinic you can encourage the woman to return a week later – wearing the diaphragm – to have the fit and correct placement checked after she has practiced at home. The patient should be encouraged to contact their GP if they have any questions or concerns about using the Caya® diaphragm.
Step 13.
Counsel the patient to practice insertion, wearing, and removal several times before using it during intercourse. You also may recommend they come back about two weeks later wearing the diaphragm, so you can check and confirm fit again. This depends on your clinic's protocol and also on your and patient's confidence about fit of the Caya diaphragm. Patients should be encouraged to contact their GP at any time if they have questions or concerns. If the patient thinks the diaphragm may have been dislodged during sex or that they may not have been protected, they should contact their GP for counselling and consider Emergency Contraception (“the morning-after-pill”).
Filter
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Singa Diaphragm Fitting Kit
From £49.85For professionals use only.
Contains: Instructions for Singa & Caya.
2x Caya diaphragms (with holes).
2x 60, 65, 70, 75, 80, 85, 90mm Singa diaphragms (with holes).
NOT for contraceptive use.
