A cervical cap is a reusable, dome-shaped barrier method of contraception that prevents pregnancy by physically covering the cervix and blocking sperm from entering the uterus. This small, flexible silicone cup, often used with spermicide, offers a hormone-free birth control option. Acquiring a cervical cap involves a multi-step process that begins with a medical appointment, as it is a prescription-only device requiring an individualized fitting.
Prescription and Fitting Requirements
Obtaining a cervical cap begins with a mandatory visit to a healthcare provider for a prescription and a fitting. The device is not available over the counter because a proper fit is essential for effectiveness and safety. A provider, such as an OB/GYN, a nurse practitioner, or a clinician at a family planning center, must determine the correct size.
During the appointment, the clinician performs a pelvic exam to assess the size, shape, and position of the cervix, which dictates the size of the cap needed. The provider will then try a sample cap to ensure it fits snugly over the cervix and creates an adequate seal. This personalized fitting process is required to ensure the cap remains correctly in place during sexual activity.
The fitting appointment also includes instruction on how to correctly insert, remove, and care for the cap, which is part of its effective use. Patients may need a follow-up visit to confirm they are comfortable with the technique before relying on the cap for contraception. Since the size of the cervix can change following events like a vaginal birth, a refitting may be necessary if the patient’s obstetric history changes.
Specific Acquisition Channels
Once the healthcare provider has determined the correct size and issued a prescription, the cervical cap can be acquired from several vendors. Retail pharmacies are a primary source, including major drugstore chains, though it is advisable to call ahead. Many pharmacies do not regularly stock the cervical cap and may need to order it, which can take several business days.
Specialized family planning clinics, such as Planned Parenthood health centers, can often provide the cervical cap directly to the patient after the fitting appointment. These centers frequently have the device on hand or can dispense it through their in-house pharmacy, streamlining the process. Some online mail-order pharmacies also fulfill prescriptions for the device, which is a convenient option for those who prefer delivery.
When purchasing, the prescription will specify the exact brand and size determined during the fitting, ensuring the correct product is dispensed. The necessary spermicide, which must be used with the cap, is sold separately and can be purchased over the counter at any drugstore without a prescription.
Cost, Insurance, and Accessibility
The financial investment for a cervical cap includes the cost of the device itself and the separate charges for the required medical exam and fitting. Without insurance, the total cost for the exam, fitting, and the cap typically ranges from $0 to about $275, though the cap alone may cost up to $90. The ongoing cost of the required spermicide is an additional expense, costing approximately $5 to $15 per kit.
Under the Affordable Care Act (ACA), most private health insurance plans must cover all FDA-approved methods of contraception, including the cervical cap, without out-of-pocket costs like copayments or deductibles. This coverage extends to the device itself, the initial exam, and the fitting services required to obtain it. However, plans that are “grandfathered” or associated with certain religiously-affiliated employers may be exempt from this requirement.
Patients should contact their insurance provider directly before the appointment to confirm coverage details, including whether a specific brand is covered and if the provider is in-network. If a patient does not have insurance, or if their plan does not cover the cap, state programs or health centers like Planned Parenthood may offer the device and associated services at a lower cost or for free, based on income.
Available Brands and Sizing
In the United States, the only brand of cervical cap currently approved by the Food and Drug Administration (FDA) and widely available is the FemCap. This device is made of silicone and is designed with a wide brim and a removal strap. It is reusable and intended to be replaced every one to two years, or as needed.
The FemCap is manufactured in three specific sizes, with the size selection based on the patient’s obstetric history. The smallest size, 22 millimeters (mm), is used for individuals who have never been pregnant. The medium size, 26 mm, is prescribed for those who have been pregnant but have not had a full-term vaginal delivery, such as those who have had a miscarriage or cesarean section.
The largest size, 30 mm, is reserved for individuals who have had a full-term baby delivered vaginally. The determination of the correct size is the responsibility of the healthcare provider during the fitting, which is why a prescription is necessary for acquisition. The prescription ensures the patient receives the specific size required for the cap to function as an effective barrier method of contraception.