A study of the acceptability of the diaphragm among low-income women in São Paulo, Brazil, found that about 11% of 1,723 women who sought a method in one of five public health clinics opted for the diaphragm following a contraceptive educational session on all methods. The main reason they gave for doing so was because it was physically harmless. Women who chose the diaphragm were older and better educated than those who chose the pill, and were more likely than IUD users to want to space births rather than limit them. However, 46% of the women who selected the method were no longer using it three months later, compared with 29% of women who chose the condom and 16% who chose the pill. Although low-income women appear willing to use the diaphragm, providers may need further training to assist women in resolving difficulties that appear in the first few months of diaphragm use.
(International Family Planning Perspectives, 21:114-118, 1995)