The cervical cap is a thimble-shaped latex rubber barrier device intented for female internal use. For best use, spermicide (a gel which kills sperm) should fill approximately 1/3 of the cap. The cap should then be carefully positioned in the vagina covering the cervix (the opening to the womb). The cap works by suction, maintaining the position of the cap as a barrier to prevent sperm from entering the uterus (womb)and prevents fertilization. Caps come in four sizes. The recommended cervical cap size is determined by your physician, at a custom clinic fitting. The cap is considered between 84-91% effective as a contraception device for use with couples who have not yet conceived a child. Among typical couples who use a cervical cap as a birth control method, approximately 16% will experience an accidental pregnancy in the first year. If the cervical cap is used consistently and correctly, about 9% will become pregnant. The cervical cap is 68-74% effective when used for women who have already given birth. More pregnancies occur if the cervical cap is started after a woman has already delivered a child, as often the cervix changes shape after delivery.