Vaginismus and Pregnancy
Vaginismus, pregnancy, and childbirth open the door to many questions and concerns, all of which are typical and common to women around the globe regardless of race, culture, religion, educational level, financial status, etc.:
Getting pregnant is a healthy process, a natural evolvement aimed at procreation, or we would become extinct. Having vaginismus does not prevent nor preclude getting pregnant. But there are other considerations, so read on.
YES, you can!
Many believe that pregnancy can only happen with a ‘penis in vagina’ (vaginal intercourse), and that non-penetrative sexual activities – oral sex, manual sex, etc. – are safe.
Even women without vaginismus, who prefer to refrain from intercourse, will often forgo the use of contraception because they feel that pregnancy is not possible through non-penetrative sexual activities.
Fact: a woman can get pregnant if the male ejaculates by her genital lips during the week leading to ovulation, when the hormonal chemistry in her reproductive system is conducive to sperm survival! We have had many patients who were still virgins yet already parents, several times over. Be smart and responsible!
Yes, it can happen
By having the man ejaculate into a small cup and the woman self-inseminating (if she can insert the small syringe), or
By undergoing assisted reproduction (infertility treatment).
Firstly, the underlying anxiety that is associated with vaginismus may prevent getting pregnant in the first place, as it would even without the presence of vaginismus.
Secondly, what happens to a woman with vaginismus during pregnancy?
Medically, unless she can tolerate pelvic (gynecologic) exams and vaginal ultrasounds, she will have to be managed “from the outside,’ and often by a high-risk obstetrician;
Emotionally, she will struggle with fears and worries, including pregnancy, childbirth, and other stressors, all of which may negatively affect the development of the baby.
However, getting pregnant with vaginismus is not necessarily a bad thing. Many women/couples that we met embraced this gift while admitting that they tried all they could in their desperation, even at the cost of feeling “fake” about getting pregnant that way.
That will depend on the clinician who is treating you.
Our position has been that although the vagina is typically safe for penetration during pregnancy, there could be unforeseen circumstances or developments that may disrupt the pregnancy and we prefer not to have our treatment be considered as a potential cause for them.
In other words, we will not provide the physical aspect of our intervention if you are pregnant, not even if your healthcare provider promises you are safe to be treated. But we are happy to address your emotional needs, anytime!
Absolutely yes, unless given medical instructions to the contrary!
And why not remain sexually active for as long as you feel well and physically comfortable? Pregnancy is not an illness, and sexual intimacy is an important aspect of the relationship.
Won’t the pelvic floor (vaginismus) muscle clenching block the baby’s exit, making a c-section a must??? Not at all. The physiologic process of childbirth makes the pelvic floor muscles a non-player.
Women with vaginismus who can tolerate an internal exam (albeit under duress), may very well deliver vaginally and without special accommodations.
Women who were never able to be internally examined during pregnancy may be delivered via a c-section as a precaution against encountering a surprise anatomical or structural abnormality.
Will vaginal birth cure my vaginismus?
“Okay, so I had my baby vaginally, and now the vaginismus should be cured. Yet, it is still here… What is going on?”
The answer is simple: childbirth (‘coming out of the vagina’) does not address nor cures the fear and apprehension associated with vaginal penetration (‘coming into the vagina’). These are two different bodily activities.
In other words: do not count on giving birth as a cure for your vaginismus but rather seek professional help for the condition so you won’t be disappointed after giving birth.
Secondary vaginismus may develop because of different causes superimposed on an underlying anxiety condition. Without that anxiety, the woman will address the cause as a matter of fact and then will move forward to re-using her vagina without hesitation.
Examples of causes for secondary vaginismus after childbirth, all associated with an underlying anxiety condition:
The episiotomy healed too tightly, intercourse became painful or impossible;
The episiotomy did not heal and necessitated further intervention;
Fear of ‘breaking’ the vagina having given birth;
First intercourse after giving birth was painful, with the woman assuming that she is ‘broken’ or that ‘something is wrong;’
Childbirth was more complicated than expected, perceived by the woman as a traumatic experience;
“I look different down there. I am not the same.”
Self-esteem issues, such as excess weight, being flabby, not attractive any longer;
Pressure by the partner to resume sexual intimacy.
Use proper contraceptive measures if you do not want to get pregnant, remembering that vaginismus is not a contraception method!
Discuss the pregnancy/childbirth process with your OBGYN so that your vaginismus need will be addressed.
Examine the pros and cons of becoming a parent with vaginismus.
Seek treatment for vaginismus – there is no reason to live with it!