Caya is a soft, flexible, contoured diaphragm that covers the cervix. It is a hormone-free birth control alternative, with no side effects. It is woman-controlled and can be dispensed or prescribed by providers. It’s simple, effective birth control you provide.
Which Patients might benefit from Caya?
Caya can be used by most women. However, it may be particularly ideal for those who don’t want hormones for either a specific medical reason or personal preference.
- 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
You might also review our Why Caya page to discover more about why women are using Caya.
Steps for Coaching and Inserting Caya
Give the woman an opportunity to empty her bladder and bowel before the fit exam. Have her wash hands afterward since she 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 EduCare Kit or the woman’s own Caya® diaphragm if she has brought this. Wash the diaphragm with water and soap.
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).
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.
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.
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.
Now push the anterior edge (where the removal dome is located) up behind the pubic bone/pubic notch.
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.
If the Caya® diaphragm is too large, it will not be able to be inserted comfortably. The woman will feel the anterior edge of the diaphragm at the introitus. The fit will not be secure and it could slip out. Ask the woman to stand up and move around to get the Caya® situated. If the woman experiences uncomfortable pressure on the urethra or rectum, or feels the Caya is uncomfortable, the device may be too large for her. In this case, a traditional diaphragm sized 60 mm may fit her better.
Have the client check fit and placement of the Caya®. Once she has done this, have her remove the Caya® and practice inserting, confirming fit, and removing on her own. If she has difficulty using one position, counsel her to try a different position.
The woman should feel for the removal dome at the front end of the Caya® diaphragm. Using her finger she 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 she has her finger in the removal dome, she pulls down and out to remove the diaphragm. If she has difficulty removing the diaphragm, encourage her 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).
The woman should practice handling, inserting and checking correct placement of the Caya on her own. Then practice removal. The provider should encourage the woman to use what ever insertion position is most comfortable and easy for her. The woman should walk around for a few moments after inserting the Caya (the Caya will settle more firmly into position as the woman moves). The woman should use what ever position is most comfortable/easy for removal of the diaphragm. If she has difficulty, squatting and “bearing down” as if having a bowel movement will move the cervix closer to the introitus and may help. Before the woman leaves the clinic, you should be comfortable that the woman can insert, check position and remove the diaphragm.
After ensuring the woman 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 her 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 woman (patient) should be encouraged to contact her healthcare provider if she has any questions or concerns about using the Caya® diaphragm.
Final instructions
Counsel the woman to practice insertion, wearing, and removal several times before using it during intercourse. Providers also may recommend the woman come back about two weeks later wearing the diaphragm, so the provider can check and confirm fit again. This depends on the clinic protocol and also on the provider and client confidence about fit of the Caya diaphragm. Women should be encouraged to contact her healthcare provider at any time if she has questions or concerns. If she thinks the diaphragm may have been dislodged during sex or that she may not have been protected, she should contact her provider for Emergency Contraception (“the morning-after-pill”).Three ways to provide Caya to your patients
1
Dispense at Appointments
The quickest and most efficient way for them to obtain Caya is directly from you during their appointment.
2
Mail Order
Pharmacy
Issue a Caya prescription for fulfillment via mail-order pharmacy with delivery directly to your patient’s home.
3
Local
Pharmacy
Issue a Caya prescription for fulfillment and pick up at your patient’s local pharmacy.
EduCare Kit: Coaching in One Box
Our FREE Caya EduCare Kit simplifies the process of teaching your patients about Caya. Each purple box allow you to:
- Educate the patient about insertion and removal
- Show the patient how to clean and care for Caya
- Provide the patient with take-home information
*Dispose of the single-use diaphragm (with the hole) after appointment. Do not let the patient take it home.
Provider Resources & Brochures
All of our printed provider guidelines are also here as PDFs. You can open or download them anytime, and please contact us for printed copies.
Get More Information
For additional EduCare Kits, Provider brochures, or patient education and display materials for your office , please contact us directly, or use the form below.
