Page:Contraception; 1st ed. (IA in.ernet.dli.2015.94163).pdf/214

therefore the method of contraception which should be advised is the cervical occlusive pessary, may yet be peculiar in having an under-developed or suppressed cervix, and for that reason will be unable satisfactorily to fit and use the cap. Similarly women who have had the cervix amputated will be unable to use that method.

Ill-considered advice has sometimes been given to such women to wear the "Dutch Cap" (see p. 160), but if they are small or normally shaped, potent, and capable of the properly completed act of coitus, I do not advise this for the reasons detailed on p. 162. For such women the sponge (see p. 132) is probably the best method, or the quinine suppository (see p. 105) by itself may be sufficient.

If, on the other hand, cervical deformation is coupled with a general obesity and stretching of all the parts, the "Dutch Cap" (properly made) will then probably be the best method to use, and it will be justified because the firm gripping movements of the vagina will have been lost already, and the "Dutch Cap," therefore will not be interfering with processes which the woman without it might complete.