Can childbirth cause vaginismus? Can it be prevented?

The temporary pains of childbirth can trigger ongoing vaginismus sexual pain.

When women experience ongoing sexual pain, burning, tightness, discomfort, or penetration difficulties following childbirth, it is typically vaginismus. Vaginismus may be triggered by physical or emotional trauma from birth, vaginal health complications, delivery surgeries such as episiotomies (a surgical incision through the perineum made to enlarge the vagina and assist childbirth), temporary vaginal bruising from delivery, tearing, attempting to have intercourse before healing is complete (see below), or any other temporary cause of pain including the normal delivery process. Women are often left with the perception that they are not fully healed from the childbirth, when, in fact, it is vaginismus causing ongoing difficulties.

Vaginismus will typically continue to cause ongoing sexual pain and penetration difficulties, even months or years after childbirth was experienced, until it has been treated. Once triggered, vaginismus causes the body to tighten the pelvic floor when penetration is attempted, making attempts at reinitiating intercourse unavoidably difficult. When attempts at intercourse result in pain and failure, the body reacts even more strongly, further entrenching the vaginismus effect. This is sometimes referred to as the vaginismus 'cycle of pain', as it evolves into an ongoing, worsening experience.

The longer the vaginismus pain response persists, the more intense the tightness tends to become. Eventually, simple penetration may become impossible (note also that penetration difficulties can develop immediately). For this reason, the sooner the vaginismus symptoms are diagnosed and treated, the easier they may be to resolve.

Reducing the likelihood of developing post-natal vaginismus following delivery

There are a number of things that can be done to help reduce the chances of experiencing vaginismus following delivery, and to help make the resumption of intercourse as positive an experience as possible:

1. To reduce potential emotional trauma from delivery, combat any fears regarding the birthing process with facts. Discuss fears or concerns with midwives, nurses, or physicians. Become educated and knowledgeable about the birthing process.
2. To help reduce any unbalanced anxieties or 'anticipation of pain' fears, avoid listening to or focusing on 'horror' birth stories. Most women have positive birth experiences. If fears of delivery pain loom large, remember that epidurals and other medical intervention is usually available if chosen. Consult with a physician to be prepared for pain management strategies should they become necessary.
3. Keep a positive mind-set and attitude. Thoughts like "Women give birth everyday" and "If they can do it, I can do it!" help allay negative thinking.
4. Unless a physician has advised otherwise, continue having sex throughout the pregnancy.
5. Post-partum, wait 6 weeks as recommended by most physicians to resume intercourse - this is important as it allows the vaginal canal to heal so that no physical pain is initially experienced in the transition back to intercourse following delivery.
6. Take things slowly - first time sex after delivery should be relaxed with slow movements.
7. Lubricate heavily as there are often hormonal changes post-pregnancy especially when nursing, which can cause vaginal dryness.
8. Do not be surprised if sex initially seems different than before. Emotional stress and fatigue brought on by demands of parenting along with hormone flucuations can make a woman feel less than senuous. Also, making the transition from being a 'mommy' to being a 'lover' may take some adjustment.
9. See a physician immediately if there is any post-delivery pelvic pain to avoid triggering vaginismus. There may be the possibility of infection, or some other problem that could be easily resolved without long-term effect.

For women who overcame vaginismus at an earlier time before pregnancy, there is often a concern that they might develop vaginismus again following delivery. Fortunately, with the skills learned through successfully treating vaginismus, any pelvic trauma experienced during labor that potentially could trigger secondary vaginismus should have a relatively quick resolution. Although every person and experience is different, in general, the process of overcoming vaginismus will become a life-long skill, providing long-term, pain-free resolution of the problem.

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