Can childbirth trauma cause vaginismus?
Sneha Annmary Chandy

Sneha Annmary Chandy

Apr 08Vaginismus

Can childbirth trauma cause vaginismus?

How is childbirth associated with secondary vaginismus?

Childbirth is a significant event that can be associated with secondary vaginismus for some women. While primary vaginismus refers to when a woman has always experienced a condition of involuntary tightening of the vaginal muscles, making penetration difficult or impossible and can even cause pain, secondary vaginismus develops after a period of painless intercourse/penetration and can be triggered by various factors, including childbirth. 


Here's how childbirth is linked to secondary vaginismus:

Physical Trauma

Childbirth, especially if it involves complications, can result in physical trauma to the vaginal and abdominal area. This can include perineal tears (natural tearing of the area below the vaginal opening up to the anus), an episiotomy (a surgical cut made at the opening of the vagina during childbirth), and a cesaeran (a cut through the abdomen). Such physical trauma can lead to pain and discomfort, which might trigger a protective or fear-based tightening of the pelvic floor muscles in response to anticipated pain, leading to secondary vaginismus. 


Psychological Factors

The experience of childbirth can be emotionally intense and, for some, a traumatic event. Anxiety, fear, or trauma related to childbirth can contribute to the development of secondary vaginismus. The anticipation of pain during sexual intercourse after childbirth, memories of the pain during delivery, or a general increase in anxiety levels can condition the body to respond by involuntarily tightening the vaginal muscles, leading to painful sex.


Hormonal Changes

After childbirth, hormonal changes can affect vaginal lubrication and elasticity. Decreased estrogen levels, especially during breastfeeding, can lead to vaginal dryness, thinning and weakening of the vaginal walls. This can make sexual activity painful. This pain can lead to the development of secondary vaginismus as the body's way of avoiding the anticipated discomfort.


Emotional trauma could lead to vaginismus

Childbirth can be an intense and physically demanding experience, often accompanied by emotional stress and trauma. The emotional trauma of childbirth can contribute to secondary vaginismus in several ways:

  • Fear and Anxiety- The experience of childbirth, especially if it was difficult or traumatic, can lead to a heightened fear and anxiety related to vaginal penetration. Women may subconsciously associate the pain and trauma of childbirth with penetration, triggering a fear response that leads to muscle tension and spasms.
  • PTSD (Post-Traumatic Stress Disorder) - Childbirth can be traumatic for some women, leading to symptoms of PTSD. Flashbacks, nightmares, and hypervigilance associated with PTSD can intensify anxiety and fear related to sexual activity, including vaginal penetration, which may contribute to the development of secondary vaginismus.
  • Changes in Body Image and Self-Esteem- The physical changes that occur during and after childbirth, such as weight gain, stretch marks, and changes in genital appearance, can impact a woman's body image and self-esteem. Feelings of insecurity or dissatisfaction with one's body may contribute to anxiety or avoidance of sexual activity, further intensifying vaginismus symptoms.



Consult a doctor to find the root cause

It's important for individuals experiencing symptoms of vaginismus to seek support from healthcare professionals, such as gynaecologists or therapists specialising in sexual health, to address both the physical and emotional aspects of the condition. Seeking professional help ensures an accurate diagnosis and assessment of underlying physical and psychological factors contributing to the condition. A gynecologist can provide medical management and reassurance in regards to any changes that have occurred. A pelvic health physiotherapist can address physical changes such as prolonged pain, strength deficits, decreased muscle coordination and sensation, and scar tissue management. A mental health therapist can offer invaluable support in processing emotions, managing anxiety, and developing coping strategies. Additionally, healthcare professionals can educate individuals about vaginismus, provide resources for support, and collaborate on a holistic treatment plan tailored to their specific needs. Timely intervention can prevent potential complications and improve long-term outcomes, ultimately enhancing sexual health, intimate relationships, and overall well-being.


Overall, the emotional trauma of childbirth does have a significant impact on a woman's psychological and physical well-being, potentially leading to the development or exacerbation of secondary vaginismus, highlighting the intricate link between psychological and physical well-being and sexual health. The fear, anxiety, and possible PTSD symptoms stemming from a traumatic childbirth experience can contribute to involuntary pelvic floor muscle spasms, making sexual intercourse painful or impossible. This condition not only affects physical health but also impacts intimate relationships and overall quality of life. Recognizing and addressing the emotional roots of secondary vaginismus through medical and psychological support is crucial. At Proactive for Her, we offer individualised, holistic  treatment, focusing on addressing both the physical components with our expert pelvic health physiotherapists, as well as the psychological aspects of postpartum with our expert mental health therapists.  By acknowledging the profound impact of childbirth trauma, one can seek the necessary care and support to heal both physically and emotionally, paving the way for a recovery which involves the entirety of a person's well-being.