Vaginismus, vaginal examinations and birth choices

[MusicloverKate]

Just been to my first booking appointment for our first baby. Mentioned I have vaginismus and the midwife didn’t know what it was. I explained it to her and said I don’t have the most severe case. I can still use tampons for example. But I don’t think she followed. She suggested I might want to consider an elective c section because if they can’t do vaginal exams they can’t check how dilated I am in labour. If they don’t know that I’m in active labour or not then that’s a big problem for them. It came across like she was genuinely very worried for me if I had a natural birth because of that. Has anyone any experience birthing without vaginal examinations? Or better yet giving birth with vaginismus? As an aside, I’ve also got a slightly tilted cervix. I’ve been referred to a consultant for a phone call. Would oddly feel better seeing someone face to face so they can examine me because I don’t think it’s that bad. It would maybe let us all see what my body can and can’t do in terms of VEs. A bit worried about it all now.

No advice but I would definitely ask for a consultant appointment to talk through your options. They will know best course of action.

I don’t have any advice, I’m just really shocked at a midwife not knowing what vaginismus is!

Hope you get some support with this

Vaginismus aside, vaginal examinations during labour, birth and the aftermath (checking for tearing etc) are entirely optional. It’s not a medically necessary part of childbirth - it’s just preferred by medical professionals.
After a traumatic experience first time around, I gave birth to dcs 2 & 3 without a single vaginal examination and without a medical professional touching me or my baby at all.
It is your choice.

I was quite far on in labour before my first VE and used gas and Air for them until I had a spinal for a forceps delivery. I have much milder vaginismus (issues having smear tests primarily).

I think it will likely depend on how straightforwardly your delivery is progressing? If you do want the option of a vaginal delivery, you may find exams tolerable with gas and air and would likely be fine with an epidural too?

It might mean a sweep isn't possible and induction might be harder, but that's probably again something worth discussing with a consultant in advance do you could have a plan for if you are post dates?

I was going to say what Ringmaster said.
Vaginal examinations are optional and not really even necessary tbh.
See www.aims.org.uk/information/item/vaginal-examinations-in-labour

You might find that you cope fine with a vaginal birth and it might even help your vaginismus. But if you prefer to have an ELCS that's fine too. I would advise requesting an appointment with the consultant midwife to discuss your options and they can answer any questions you might have.

Also, there must be a charity or support group for vaginismus that has information and advice about birth options.

I won't be having routine vaginal exams, just my choice - they're totally optional!

If I want one on the day then ok, but will be at my request.

Also see vulvalpainsociety.org/news-events/vps-webinars/past-vps-webinars/consent-and-vaginal-examinations-in-labour-6-july-2021/

I had really bad vaginismus (no tampons, haven't even had a smear etc)

With my first I actually raised my issues and I was booked for a c section no questions asked. I ended up going into labour the day before and they tried to get me into theatre still but it was so busy that night and my labour happened very quickly so ended up giving birth naturally!

I refused examinations and they still allowed me into hospital and gave me gas and air (during Covid times) they didn't seem bothered with me refusing. I accepted one internal at the very end but with the gas and air and contractions I was too distracted to really worry about it. Same with the stitching, I was so in love with my new baby and still allowed gas and air that at that time of exhaustion I really didn't mind!
I've gone from being so petrified and needing anxiety counselling during pregnancy due to vaginismus, to realising that I preferred the way things worked out in the end and I wouldn't have changed it for the world.

Currently pregnant with baby number two, I've needed no anxiety management at all (22 weeks) and I will refuse internal examinations again so no concerns as I know I can do the rest ☺️ I'm not saying my vaginismus is 'cured' but giving birth has made me far more confident. You're allowed to say no!

You're stronger than you think! Good luck ❤️

I developed vaginismus after DC1 and before DC2. I had a natural delivery with internal exams (these were painful but hard to say whether they were more painful due to vaginismus). In any case the overall pain of contractions/delivery/pushing were quite bad and I think any vaginismus discomforts were probably too small in comparison so I didn't notice. If anything my condition has improved 90% post DC2 birth (and counselling) and I have very little problem now - my main one only being tampons.
A natural birth could help you - but don't bank on it.

I don't have any experience with vaginismus but my waters broke and baby didn't get moving so had to be induced. They only did one vaginal exam about an hour before he was born because they needed to check if things were progressing or if I needed a c section because it had been so long. To be fair I don't think that was strictly necessary as I was feeling the need to push, they just didn't believe me! They didn't do exams because of fear of infection with my waters breaking. Its very common when waters break before labour to avoid vaginal exams so its certainly not impossible to give birth without them. I think it makes things a lot easier for medical professionals to see how you are progressing. I'd definately ask to see a consultant and if you want a vaginal birth push for it.

@ChickenRoseNugget thanks for sharing your story. I was in the same situation as you. We are now thinking of baby number 2. We conceived baby number 1 with a Home Insemination Kit. May I ask which method did you use to conceive? I'm dreading the whole process again! Thanks

I had a degree of vaginismus (plus I think just being naturally quite small); I couldn't use tampons at all for years. I remember that before DS1 was born, and despite a very difficult pregnancy, I was more worried about vaginal exams in labour than anything else about giving birth! But in the end it was really OK. The first midwife (actually a male midwife) early in labour was ultra-gentle and once you are in established /advanced labour in my experience you are quite distracted anyway! Gas and air also helps. Would also corroborate point made above -- giving birth vaginally definitely helped my vaginismus quite a lot, even though I had a tear, once that healed sex was quite a lot easier afterwards and I just felt much less anxious about the whole issue. I still find smears / having coils inserted etc painful and unpleasant but I can manage it much better.

I had one traumatic VE during my first labour (no vaginismus, just found it horrible and painful) so declined them for labour #2. I put it in my birth plan and said very clearly that they would not be happening, so please don't even bring it up. It was fine (but it was a homebirth, so the attending midwives were very competent and accepting of my choices). They have other ways, non-intrusive of telling how labour is progressing, which are far more conducive to a non-stressful labour.

To be honest, if you've been assigned a midwife who hasn't heard of vaginismus, and doesn't know that vaginal exams are optional and not the be all of monitoring progress, I'd be asking for a different one as she sounds a bit shit.

I declined internal examinations during labour and basically just told them they had to use other skills to check. I was offered an ambulatory trace which measured the strength of contractions for a while and I just told them when I could feel it was time to push and the head was coming. If she doesn't know what vaginismus is I'd ask for someone else to be honest. She clearly knows nothing about vaginas!

I have Tokophobia and went into labour 3 weeks early with my son, when I got to pregnancy assessment they knew not to do any examinations and just monitored my contractions with the machines - within an hour they knew how established labour was and I was rushed in for a section. It’s possible not to be examined.

I also had a tilted uterus - never caused any issues and actually had a very small bump due to this.

Hope all goes well for you x