Having vaginismus need not be a barrier to having a baby.
Not everyone wants children. Not everyone wants penetrative sex. Not every vagninismic person identifies as a woman and not everyone with vaginismus who wants children is in a monogamous and/or heterosexual relationship - or intending to be in a relationship at all.
Over the ten years I’ve specialised as a vaginismus therapist, my clients tend to be in their teens or 20s with penetrative sex as an all consuming goal and an avoidance of thinking about children, or in their late 30s and 40s with penetrative sex also as a goal but with the added fear that they are too late, or running out of time to have children. With all vaginismus clients who want children now or in the future, this seems horribly, devastatingly out of reach. I have been in both of these camps.
Most of what you will read about vaginismus is about is penetrative sex with a penis. Indeed all my training to date has been about this. I tired to write about vaginismus and conception, birth and pregnancy before I went through it and it was near impossible to find info. I believe this is because there isn’t one standard way and the care and initiative and knowledge you get varies from private clinic to private clinic and NHS hospital to NHS hospital.
Some of the info here is what I have learnt from personal experience, some is what have gleaned from clients and some from medical professionals. I’m writing this to get the ball rolling. This is by no means the last word on the subject, it is mainly a blog of ideas that I hope will inspire anyone who needs it to do their own reading, ask their own questions and find their own way. I would be incredibly happy for anyone to message me with a contradiction, change or add any info to this piece - my email is at the bottom.
Conception without penetration
First things first: you do not have to have penetrative sex to get pregnant. Let me repeat: YOU DO NOT HAVE PENETRATIVE SEX TO GET PREGNANT!
Pausing the quest for penetration before conception can feel like a huge wrench. Further, if you do recover from vaginismus and feel time is running out to conceive, it can put extra pressure on your bits. The NHS website recommends sex every two to three days when trying to conceive. So a mix of penetration and artificial insemination can be a great thing for many couples. I would even recommend it to people who are in full control of their genitals but are finding all the sex needed to hopefully strike it lucky is too much.
Other issues include a partner not being wanting to fully commit to a relationship with children before they know that they could have sex. Often when I am in couples therapy with such couples, the tension can be consuming. The lack of sex can be to blame for every issue that comes up or it can cause enough resentment to drive a couple apart. If this is your partnership, I strongly recommend couples therapy with a therapist who you each feel listened to and respected by. Once you have a plan - for this and your sex life - you may both feel more in control.
Artificial insemination
Usually people who find penises hard or impossible to take can put smaller things up themselves, and I’ve helped people in therapy to be able to do this, sometimes, more manageable goal. With artificial insemination, you use a blunt syringe that is much much smaller than a penis - more like the smaller dildo in the Sh! Vaginismus kit. What’s more, you don’t need to worry about pleasuring a syringe.
If you are doing this when the sperm person is present, they ejaculate into a sanitised beaker. Keep it warm under the cover while the liquid has settles, then suck it up into the sanitised syringe and you squirt it up into yourself. If needed you can use special, conception-safe lube (regular lube or spit can harm the sperm).
There is a lot written about how much time you can wait between ejaculation and insertion of the sperm, positions on inserting and other minutiae involved in this procedure. Please read up on it and find a guide from a reputable source that you feel suits you. Also there is some unhelpful things about whether you should orgasm at this time. Some have written that orgasms help pull the sperm in and some say, well it makes it nicer. If you do, great but it’s a hell of a lot of pressure to put on the situation. Remember, tragically, people who have been raped can get pregnant. So it definitely isn’t necessary.
While a lot that has been written about artificial insemination can seem very clinical, it can actually be an incredibly romantic thing to do. If your partner is ejaculating, you could give them a hand job and say loving or saucy things. To insert the sperm, you could lay back with your head in your partner’s lap and a pillow under your bum to raise your pelvis (raised pelvis can assist with any internal).
Clinical conception
If you are unable to get the sperm up yourself, or if you’re after a more sure fire way of doing it, this can be done in a clinical setting. Intrauterine insemination (IUI) involves a clinician injecting the sperm straight into the womb. It’s great if the sperm has less mobility. While in-vitro fertilisation (IVF) involves removing the eggs and fertilising the sperm outside the body to create an embryo and then injecting this back into the womb. IUI is cheaper and less invasive with less drugs. IVF has a higher success rate and is better for people over 40 and/or who may have issues regarding egg quality. With IVF, the embryologist can pick the best eggs and sperm to give you the best chance.
With these treatments there needs to be some internal scans. Some clinics and even some NHS hospitals may agree to do this under sedation. For IVF, the removal of eggs is usually done under sedation or general anaesthetic. Depending on where it’s being done, inserting of sperm or embryo this can also be done under sedation. Bear in mind that in a private clinic sedation costs more. Once pregnant, with IVF, at seven weeks there is usually an internal scan that can’t be done with sedation. Later scans, from 12 weeks are usually, happily done over the belly.
Other options
Not everyone can access or afford clinical conception. The NHS has months-long waiting list and is only available up to age 42. Some private clinics will help people get pregnant with their own eggs into the mid 40s.
If you have issues with your eggs or fear that you would, there are other options. Though these options are not for everyone and have their own challenges. You could try donor eggs - some clinics will treat patients into their mid 50s. You may use eggs from someone in your family, from a friend or from an egg bank. In the UK, this would be an open donation meaning that a child who is donor conceived via sperm, eggs or both, could find out the donor’s details when they are 18. It can be cheaper to have donor conception abroad and this can mean it is anonymous. There is a lot written about this on the donor conception network - an amazing resource for anyone considering this option.
Surrogacy can also be a wonderful option. It can involve using your eggs, a third parties, eggs or the eggs of the surrogate. A surrogate could be someone you know or found through an organisation. It’s important all parties involved understand a clear contract and boundaries for the pregnancy and beyond. The Human Fertilisation and Embryology Authority (HEFA) is good source of info.
Then there is fostering and adoption. If I had a penny for every person, usually having parented their children, who says triumphantly, “why don’t you just adopt” I would be pretty bloody minted. This can be a hugely amazing thing to do though taking on a vulnerable little one is a challenge. If you have wanted to have biological children or to be pregnant, or to have your child from birth, it can take a lot of grieving and processing to decide to take, and ready yourself to embrace this process and it certainly isn’t for everyone. For those who do this, there are some amazing agencies and adoption communities that can offer lifelong support as you form your family.
Remaining childfree
Choosing these routes is the first step. It could be you don’t fall pregnant, you experience pregnancy loss, you are unable to find a surrogate or you are unsuccessful in your applications. It could also be that you aren’t in the right situation financially, logistically or emotionally to have a child. It’s often a very painful roller coaster with an uncertain outcome. Stepping off it can feel like a relief as well as a huge loss. It can be hard to talk about because it can be a more abstract grief than a living relative dying. There are places to go to talk about this, both free and to be paid for. And in time people can find other ways to use those parenting feelings.
Support:
At each stage, therapy can help though, if your local authority doesn’t offer this for free, this can be an added expense. Support groups, helplines and forums are aplenty. I wish you huge luck in getting to where you want to be.
- The Human Fertilisation and Embryology Authority
- Fertility Network UK
- Fertility Friends
- Tommy’s
- The Donor Conception Network
- Adoption UK
Guest post by: Sarah Berry
Sarah Berry is an accredited, integrative therapist who works with individuals, couples & open relationship groups. She draws on CBT, existential, psychodynamic and Gestalt theories, as well as the tools and exercises specific to psychosexual & relationship therapy.
