All in my head?!?

[Heaz]

When my DH and I attended childbirth classes (offered through our local Midwife Center), the instructor was extremely vocal in her opinions of C-sections...that they are *always* unnecessary, and either an indicator of greed/laziness on the part of the OB/GYN, or of fear on the part of the mother. Pain of any sort during labor and delivery, in fact, was frowned upon as a manifestation of fear (and we are NOT supposed to be afraid, people!). I came out of that class (and my many readings on natural childbirthing) with this intense psychological pressure: certain that pain was all imagined, all about fear, and that basically it was my duty to just suck it up and get through it like a big girl.

Then I had a traumatic birth. I'm not sure I'm up to posting all of the gory details here right now, but the highlights were as follows:
* My water broke and was thick with meconium. So my midwife put me on an irrigation douche, which forced me into bed, on my back. That was the end of me changing position AT ALL during labor, except to sit halfway up during contractions. I was warned that any further movement would dislodge the douche and that the baby would aspirate and die.
* The baby was malpresented. Even though I was having off-the-chart, double-peaked contractions, his head was pressing against my spine and not my cervix. I was in indescribable pain.
* I was not dilating. In fact, several hours (okay, like 10) into the labor, my cervix started getting SMALLER. It was when this was reported that I broke down weeping and asked for the epidural. I am so fundamentally against medications that this was an enormous step for me.
* Naturally, the epidural stalled my labor. The docs at the hospital insisted on Pitocin and we spent several hours fighting that. My feeling was...if I had phenomenally strong natural contractions that didn't move things along, why put myself and the baby through more drugs that would do just as little? When I faced down a doctor and said, "WILL THIS DRUG OPEN MY CERVIX?" and he said no, then the midwife suddenly noticed "abnormal heart tones" and called the C-section. I am still honestly not sure if there was actually an issue, or if she realized that I was not going to play the hospital's game and just wanted to help me end it.

So. After this, I beat myself up. A lot. And hey, I didn't even need to internalize the blame! I overheard my MIL telling someone that I had a C-section because I was "scared". The instructor from our childbirth class never responded to my emails after I admitted to the C-section. And so on and so on and so on. I felt horribly broken and incompetent. And weak.

Flash forward 2 years and I was pregnant again. I read up on all of the VBAC information and tried to get myself psyched up for another try. I talked and talked and talked, and journaled my heart out, and tried to overcome my grief and anger about my first birth experience.

Labor time came and I was aggressively positive. My water did not break this time, and I spent the entire labor pacing and rocking and walking and on the birthing ball. Basically doing all of the things that I wished could have gone differently the first time around...including low, open-mouthed moaning, which I'd read encouraged openness globally (rather than tensing, holding breath, etc.). This baby was in perfect position. The labor was manageable...in fact, I remember laughing that it was almost EASY in comparison to the previous one (honest to God, back labor has to be the next worst thing to evisceration). So it was all good. It was going better.

And I still didn't freaking dilate!! I spent hours going back and forth with the midwife...let me try this, let me try that, let's just wait--sometimes it takes longer, right? Finally she got That Look. This woman has been catching babies for 20-some years, and so when she got That Look, I knew. She told me that the reason that I wasn't dilating was that the baby's head was not "in station". WTF, I was at 41 weeks and in full labor...why the hell wasn't he DROPPED yet? I asked her if we should call it. She wouldn't give me a straight answer. I said, "pretend I'm your DAUGHTER, not your PATIENT" and she said, "I don't think this is going anywhere, and I don't want to see you wear yourself out any more. You're going to end up with another C-section, it's just a matter of WHEN."

So I had another C-section. And she diagnosed me as having--oh hell, I forget the medical term now--a really small pelvic opening. She was with me in the OR and said that "there's no way a baby could have fit through there".

In a weird way, going through my second failed labor kind of helped me recover from my first. At least it looked like something beyond my control. And I got to confirm that even IF...even IF things had gone differently, it still probably wouldn't have made a difference.

Flash forward 2 more years to the present. I avoid intercourse to the point of being almost celibate. Part of it is the fear of conceiving (I don't think I can handle more children right now, nor do I want to face the reality of a scheduled C-section this time around). But it's more than that. I am so tight that sex is unpleasant, sometimes painful, and sometimes just impossible. I am even having trouble inserting my diaphragm. I have, over the past few visits, talked with several of the midwives about this feeling of tightness that I have. They blow it off as either not being fully aroused (tell your husband you need some foreplay and buy some Astroglide), or suggest that it's residual psychosomatic tension from my disappointing births.

Great. So THAT'S all in my head, too. But wait! I finally did some research, and OMG I think I have vaginismus. Which...most resources seem to insist (get ready for it!)...IS ALL IN MY HEAD. Yeah, I'm painfully tight and often impenetrable because I'm psyching myself out. Just like my babies didn't descend and my cervix didn't open because I was so afraid that I subconsciously stopped it. It's all my fault, all my fault, all my fault.

Fine. I'll buy it with the intercourse. Maybe. But what about the diaphragm and Menstrual cups? Maybe one out of 5 attempts goes well...the rest of the time, these items honest-to-goodness get squeezed out instantly.

And this tightness is a problem I have ALWAYS had. It took a number of failed attempts before I finally lost my virginity, because penetration was impossible. Many times since then, with more than one partner, I have been nearly or actually impossible to enter. I've even had more than one examiner praise me on my "excellent tone", and after my pregnancies a few gave me the ol' "hey at least you're not all loose and stretched out" consolation. When really, a part of me had been hoping that childbirth WOULD stretch me out to the point where I'd be more, uh, accepting.

I am tired of blaming myself for this!!

Of course, at the same time, now that I'm thinking "vaginismus", I flash back to my first labor. I was asking for the epidural during contractions, but would let up in between. The midwife asked about that. "Are you sure? You only ask during..." So I paid attention to it and after a few more contractions, told her, "It feels like I am doing Kegels to keep this kid in." At the time (and even now, mostly) I felt that this was because of the double-peaked contractions. I wanted SO BADLY to push and she kept telling me that I wasn't even close to dilated enough and MUST NOT push or I'd damage myself and stress out the baby. Now, I wonder...were these beyond-my-control Kegels? Was it just vaginismus acting up under stress?

And OMFG, could that mean that it really WAS all my fault? That I froze up and tensed up and just wouldn't let these kids out?

So great. Almost 5 years later and the cycle is complete. I'm back to blaming myself again.

And apparently I need to first convince my practitioners that I actually do have vaginismus and not just a lack of foreplay or interest...and then find a treatment plan that does not involve the assumption that it's caused by my self-hatred?

It's more the other way around. I have self-hatred because I can't get past this.

[nannymom]

What a lot for you to have to process and go through. I don't have any advice but I wanted to tell you form your post I don't think you have anything to blame yourself over.

[J's Mombee]

I don't know what to say, and after reading your post, I had to just you. I hope that you do find support in convincing your midwife or doctor about the vaginismus. Take in lots of information about it, and highlight the stuff that applies to you... or put an asterisk next to article titles if the whole thing applies to you.

[claras_mom]

Your post made me think of a book on my shelf...The V Boook: A Doctor's Guide to Complete Vulvovaginal Health, by Elizabeth Stewart, an MD who specializes in vulvovaginal disorders. It doesn't matter if the roots of your problem are physical or psychological; what does matter is that as near as I can tell from a quick skim of the section, it is treatable. I hope you can find a specialist who will take your experiences and your concerns seriously. It sounds as if you have been surrounded by people with no tact and less empathy--I can't even imagine a birth educator being so narrow in her/his thinking.

This isn't a conversation to have with a midwife, in my opinion.

[Heaz]

Originally Posted by claras_mom

Your post made me think of a book on my shelf...The V Boook: A Doctor's Guide to Complete Vulvovaginal Health, by Elizabeth Stewart, an MD who specializes in vulvovaginal disorders. It doesn't matter if the roots of your problem are physical or psychological; what does matter is that as near as I can tell from a quick skim of the section, it is treatable. I hope you can find a specialist who will take your experiences and your concerns seriously. It sounds as if you have been surrounded by people with no tact and less empathy--I can't even imagine a birth educator being so narrow in her/his thinking.

This isn't a conversation to have with a midwife, in my opinion.

Thank you. I just requested that book through interlibrary loan and await its arrival.

I'm curious; if not a midwife, then who? The midwife practice I use (there are 5 on staff) doesn't just do births, but also provides lifelong "well woman" care...GYN exams, etc...and I guess I (naively) figured that they'd be more likely to listen and understand than a traditional OB/GYN. My experiences, alas, have left me feeling very disappointed in them. At the same time, I'm apprehensive about going back to a traditional doc. I guess "might be open" is more appealing to me than "most likely goes by the book"...

Or should I be searching for a more specialized specialist? And what would that be?

I know, the answers are probably in the book.

[claras_mom]

My impression of the author of that book, just for example, is that she's specifically interested in the diagnosis and treatment of vulvovaginal disorders--she doesn't, as near as I can tell, deliver babies. So you're not necessarily looking for an OB/gyn, but a gyn with specific interests, up on the research, who knows that sexual dysfunction can't always be cured by more foreplay. It does sound as if a big part of the "cure" is therapy to get to the root of any psychological issues, but Stewart does talk about related physical causes.

Another possibility would be to have your point of entry be a family practitioner, if you have one you like/trust, who could then refer you to an appropriate specialist. Or....a major university med center would probably have people on staff with experience. A lot of times docs will have a "triage nurse" or help nurse--someone who will listen to the problem, ask questions, then get back to you with a recommendation from the doctors on staff for the next move. With my health insurance, I'd have to either go to my regular OB or to my family practitioner first, before any specialist, but you may be in a different position.

Whatever you do, don't give up!

[claddaghmom]

This might be far off the mark...but have you considered seeing a chiropractor...


After a back injury from gymnastics, I had terrible muscle spasms that started in my back, but then moved into my pelvic region. They actually affected my vaginal muscles. When you mentioned "they felt like kegels" it reminded me of exactly what I felt.

Perhaps some adjustments could help you?

[Mama_Leah]

But Kegels involve only your PC muscles, not your cervix. Vaginismus is caused by contractions of your PC muscles. I guess I'm not seeing how FTP is related since you do not and cannot control cervical dilation with muscles. However, the vaginismus could be secondary and related to your births and your feelings about them.

[Heaz]

I agree...I do think that my cervix not opening was because neither of my babies properly descended. I think I just freaked out because now that I have a name for the vaginismus, I remembered feeling that sensation during labor. After a few days of calming down, I do think that it's possible that it flared up during that nightmare first labor...but was only one of many symptoms and not a cause.

Thank you also to the poster who suggested chiropractic care. I may very well look into that.

[sapphire_chan]

Even if it were "all in your head" it wouldn't be your fault. Even if it's a psychological reason that you tense up at any contact with your vagina, that's just as valid as a physical reason.

You clearly had something going on before your births, and your births aggravated things. And I do think the aggravation is psychosomatic the whole fear-tension-pain loop thing. To address the psychological aspects that are probably present now even if that's not what started them, my suggestion is to look up information on things that sexual abuse survivors have found help them be able to have intercourse when they're finally ready to even consider it.

[RiverMamma]

First of all No it is not just in you head, it did however start there.
Second of all, No it is not your fault!

Our unconscoius thought patterns do lay the stage for what happens in our lives. But... they are unconscious, they were created by our childood, our culture, our ancestors, & maby even past lives. (If you belive in such things.) Discovering what these ingrained emotions are is dificult enough, let allone addressing them and trying to transmute them into something positive. You can try affirmations like "I am open." Even if it sounds like a lie, just keep saying it, wright it 1,000 times, make a painting of it to hang on the wall... whatever it takes. Eventually it will start to feel real, & then become real.

I don't know if I'm one to talk though, I have some deep subconscious emotional garbage that interfered with my birth & now my marage too. I don't even know what it is or where it came from, I can just feel that it's there, weighing on my heart. I have been trying though. I made a collage actually, not a painting, but close, I painted on it.

And BTW, yes there are darn good medical reasons for c/s and they do save lives damnit! I think that my subconscious issues may have had something to do with the cause for my c/s, but nonetheless had this been a few hundred years ago, DD & I would both be dead. In fact, allot of women and baby's died. And if saving lives isn't reason for a c/s then nothing is! So what if fear passed through generations has anything or even everything to do with it! I am alive!!! My Daughter is alive!!! That's what matters!

Of course, I know what you mean about the issue just causing emotional issues. I'm not really OK with the whole thing still. I think I have a worse relationship with my vagina now than I did before the birth, & certainly with my DH.

Anyways, I reciently posted my birth story, if your interested the link is in my sig.

[Heaz]

You can try affirmations like "I am open."

Yup. Did that in the second labor...and did not have the Kegel-y feeling that I had in my first. I do think that I was just so stressed during that first labor that *everything* tensed up. Which is exactly what they warned against in childbirth classes, alas.

It may bear mentioning that I also battle TMJ. In fact, going in to the first labor, I told my DH that he needed to remind me to keep my jaw relaxed. My body has always been a barometer of my emotional state.

The problem is when I have physical tension and NO idea what caused it. Horrible back labor, check. But, trying to insert menstrual cup which went in just FINE the day before...WTH is up with that?

You'd think being conscious of the physical tension would allow me to "manually override" it, but it doesn't always work that way. I end up in this vicious cycle, where I'm all emotionally stressed out ABOUT the physical tension, and of course that makes the physical tension worse. Believe me, I know every relaxation technique in the book. Sometimes it just doesn't work.

The book arrived today, I'm going to go pick it up. Thank you, all of you, for your responses and advice. It's an embarrassing and upsetting problem...

[RiverMamma]

Try the affermations all the time, like 24/7, to help with the ongoing problem. Also, try different affermations like "I am loose" "I am healthy" "I am Free" Just some ideas, come up w/ your own.

Yeah, the manual override has never worked for me. I guess my emotions are just more powerfull than my will. The subconscious is an interesting array of issues that arn't even always ours! But they are there & affect our lives.

I'v never tried it, but have you ever conciderd hypnosis? I'v herd it can produce amazing results.

BTW how do you feel about reincarnation? My mom did some past life regression work, & it certainly pinpointed where two of her major health issues stemed from. Having that info helped her let go of the unnecicary emotions tied to it, and helped her begin the healing process. Again though, this is a personal thing that is only pertinant to belief systems.

[Doula Dani]

I can't believe the unsupportive and negative people you've been surrounded by. My god. Hugs for you mama.

I am a doula, and I have had both of my children by c section. It was a struggle to heal emotionally both times (especially the last time), but I came to the realization that some babies do indeed need to be born by cesarean. Some babies don't and are anyway. Cesareans can be beautiful birth experiences as well, and that's what I learned with my last. Just because you have a cesarean, does not mean you're not worthwhile, or that you're not as good as someone that had an easy vaginal birth.

The fact of the matter is, anyone else in a position like yours could've easily had the same outcome. You did nothing wrong.

I'm just so sorry you dealt with such insensitivity. I would be writing a not friendly letter to your child birth educator.

[frontierpsych]

I am certainly not qualified to tell you whether or not it's all in your head BUT I think even if that is the case, it is NOT "all your fault". We can't always control our thoughts, our fears, etc. If we could, we'd always be happy and never be afraid of anything. Unless you were *consciously* doing something to stall your labour (can you even do that??) I don't see how it could be considered your fault.

[heidirk]

First of all, to you. And second, I agree with the PP who said, even if it was a 'head problem' that does NOT make it your fault!!

FWIW- It IS possible for fear or tension to prevent dialation of the cervix. If soemthing as simple (?) as fear can raise my blood pressure by 20 points, than anything is possible.

Also, if your pelvic muscles are that contracted, habitually, they could very well prevent your pelvis from loosening as it usually does during pregnancy. There also has to be some room down there for the baby's head to apply itself to the cervix, and acheive dialation. Maybe you don't secrete enough relaxin during PG?

Even if it is your tension, and your body, it is NOT YOUR FAULT! Don't blame yourself, it's obvious that you used all the information you had available, and made the best choice you could.

[dylan]

Aw...geez. What a journey! I hope this thread is helping you feel more supported and less alone...I'd like to add my $.02....

I don't think what you've experienced can be distilled down to any one cause, physical or psychological. There really is so much going on that it creates a constellation of factors that results in what's happening for you.

First of all, I feel angry that in your birthing class you got messages that you shouldn't be afraid, that there was a right way and a wrong way, that things were "frowned" upon that often are out of our control - conscious or unconscious.

If you'd already had physical issues with being tight, those may be related to very early patterns that originate very early - at your own birth, inherited ancestrally, or what your mother was going through...or something completely different that in your body manifested as tightening your vaginal area.

Birth may have triggered those unconscious patterns - I wouldn't call it a "fear" because that implies it was conscious and something you could have "managed". I don't believe that you could have done anything differently.

And then the spiral began...and here you are. There are obviously physical issues to care for - and it sounds like that's where you've been focused.

There may also be somatic - body based, but of a psychological nature - and emotional issues that haven't been dealt with....and layers of whatever feelings you've had about each birth, what was expected, your sexual life, etc...it's all very built up it seems.

I think it would help to begin teasing apart the threads, start with the thoughts and feelings that are most alive - say, for instance, anger at being made to feel "guilt" about your births and blaming yourself, or regret that your births didn't go as you'd hoped/planned....get support for those pieces and perhaps it will be easier to think about the deeper levels and become more aware of what's needed next both physically and emotionally.

Good luck...and remember you have so much support here!

[holyhelianthus]

I had to deal with a midwife that believed it was all in my head and that I willed myself to slowly progress and have pubic pain. I still blame myself.

I'm so sorry, mama.

[mamabearing]

Wow a hard story

I feel like you were surrounded from the get go and set up that unless you had the perfect unmedicated vaginal birth you were going to feel failure.

I don't blame you at all. I would blame the intolerace and closemindedness of those who are supposed to be your support people.

I was a Bradley teacher in 1982 and I had similar values, though I remember moms having C/S and I never "blamed" them. That must be a deeper level of indoctrination. A few years ago I went to a Lamaze conference and I have a deep feeling of being "indoctrinated" not "educated". As a then 15+ OB nurse I saw so much more tolerance to questioning of assumptions and real debate at medical and nursing conference and the Lamaze conference had a total different feel. It was like " we who have the TRUTH about birth" and must "spread it to the masses." It felt religous to me. If I asked a question they answered "everything we do is evidence based" but didn't provide the evidence.

I guess what I am saying is I see in your story that the trauma you feel is possibly from a closemindedness of the very people who are supposed to support you.

I am sorry you have suffered so much.

[laohaire]

I have read a little about vaginismus before - I don't have it but looked into it a bit when I realized I had low desire. I really don't remember too much of what I learned, but I fully believe that sometimes it's completely physical and not pyschosomatic. And yes, sometimes could be psychosomatic and even then, like PP have reaffirmed, it's not your fault. But I think it's important either way to recognize that it might not even be psychosomatic. Not everything is. I'm going blind, do these same people think I'm just overanxious and therefore not seeing as well??

I did also want to say that I think and hope you are on the path to healing now. It must be such a relief to have a name for what you're going through, and not just some vague "failure on your part" as you seem to have felt. You're not alone, and it seems the book you have might have some real, practical options to explore - I hope?