Diaphragm (contraceptive) - History

History

The idea of blocking the cervix to prevent pregnancy is thousands of years old. Various cultures have used cervix-shaped devices such as oiled paper cones or lemon halves, or have made sticky mixtures that include honey or cedar rosin to be applied to the cervical opening. However, the diaphragm—which stays in place because of the spring in its rim, rather than hooking over the cervix or being sticky—is of much more recent origin.

An important precursor to the invention of the diaphragm was the rubber vulcanization process, patented by Charles Goodyear in 1844. In the 1880s, a German gynecologist, C. Haase, published the first description of a rubber contraceptive device with a spring molded into the rim. Haase wrote under the pseudonym Wilhelm P. J. Mensinga, and the Mensinga diaphragm was the only brand available for many decades. In the United States, the physician Edward Bliss Foote designed and sold an early form of occlusive pessary under the name "womb veil" starting in the 1860s.

American birth control activist Margaret Sanger fled to Europe in 1914 to escape prosecution under the Comstock laws, which prohibited sending contraceptive devices, or information about contraception, through the mail. Sanger learned about the diaphragm in the Netherlands and introduced the product to the United States when she returned in 1916. Sanger and her second husband, Noah Slee, illegally imported large quantities of the devices from Germany and the Netherlands. In 1925, Slee provided funding to Sanger's friend Herbert Simonds, who used the funds to found the first diaphragm manufacturing company in the U.S., the Holland-Rantos Company.

Diaphragms played a role in overturning the federal Comstock Act. In 1932, Sanger arranged for a Japanese manufacturer to mail a package of diaphragms to a New York physician who supported Sanger's activism. U.S. customs confiscated the package, and Sanger helped file a lawsuit. In 1936, in the court case United States v. One Package of Japanese Pessaries, a federal appellate court ruled that the package could be delivered.

Although in Europe, the cervical cap was more popular than the diaphragm, the diaphragm became one of the most widely used contraceptives in the United States. In 1940, one-third of all U.S. married couples used a diaphragm for contraception. The number of women using diaphragms dropped dramatically after the 1960s introduction of the IUD and the combined oral contraceptive pill. In 1965, only 10% of U.S. married couples used a diaphragm for contraception. That number has continued to fall, and in 2002 only 0.2% of American women were using a diaphragm as their primary method of contraception. Diaphragms, both the Ortho brand and Reflexions, and the spermicidal gel used with them, can be purchased online. There is an e-mail community of users, where resources may be found, as well as tips on making one's own homemade spermicide, to be used with a barrier method.