Women's Sexual Health
INTERCOURSE PAIN Many times women will have pain in their vaginal area or in the pelvic region of their lower abdomen when they are having intercourse. After an examination from their OB-GYN, there is no cause or solution to your pain. This is because there is no pathological reason for the pain, which this is a good thing! 
Intercourse pain often comes from the pelvic floor muscles being strained due to poor pelvic alignment. As a specialist in treating pregnant women and balancing the pelvic floor to help turn breech babies or help with easier deliveries, I often use the same technique to help women have less pelvic pain with intercourse.
The technique is non-invasive, and is gentle. You can read about the technique below, just realize, we are not dealing with a pregnancy but the concept is the same.
Please call me if you have questions.
PELVIC PAIN/PUBIC SYMPHYSIS PAIN
Dr. Jennifer is WEBSTER TECHNIQUE CERTIFIED
There is little scientific data to show that pelvic misalignment is associated with malpositions because traditional medicine does not recognize misalignment as a problem or research it, nor do they take the idea of “pelvic misalignment” seriously. Really, they barely take the idea of non-breech malpositions seriously! Therefore, it cannot be stated from an evidence-based point of view that pelvic alignment is associated with fetal malpositions or difficult labors, or that re-aligning the pelvis would prevent malpositions, prevent cesareans, or lessen the incidence of difficult labors.
Obviously, research into this issue is very important, but quite unlikely to occur anytime soon. The funding and interest is simply not there in the traditional medical community. This lack of data does not prove or disprove the misalignment theory; it simply has not been researched in the traditional scientific manner. Chiropractors, on the other hand, have seen in their own practices for years that women with misaligned backs and pelvises tended to have more malpositioned babies. There are some limited case series studies on this available in chiropractic research journals, but even this is not very well-documented.
The first really significant work was done by Dr. Larry Webster, founder of the International Chiropractic Pediatric Association. He found that simply by realigning the pelvis and releasing the soft tissues, most breech babies turned head-down within a few treatments. It is important to emphasize that he did NOT manually turn the baby in any way, but simply realigned the mother’s pelvis and ‘released’ the ligaments supporting the uterus. The baby then was not “constrained” anymore from assuming the best possible position, and so usually quickly turned vertex.
Dr. Webster taught this “Webster In-Utero Constraint Technique” to many other chiropractors. Success rates depend on the skill of the practitioner, but usually are documented at about 80% or more in turning the breech baby. This is much higher than the success rates for manually turning the baby with the often-rough procedure known as a “External Cephalic Version”. ECV success rates generally run anywhere from 40-65% or so, whereas the Webster Technique successfully turns 80% or so, at least in the data available so far.
Thus, it seems likely that many cases of breech babies are quite probably associated with pelvic misalignment, and that treatment to re-align the pelvis may help many breech babies turn head-down. However, proof of this is limited to anecdotal evidence, lectures and articles from Dr. Webster, a few small case series, and surveys about chiropractors’ experience with the Webster Technique. Not overwhelming evidence by any means, but all we have at this point. Yet it may be women’s best bet in preventing malpositions and relieving pelvic pain.
The Webster Technique also has a variant that can be used with babies that are head-down but facing the wrong way (posterior). Although little formal data exists on this, anecdotally many women and midwives have reported this to be helpful for non-breech malpositions as well. Thus, it is quite likely that in many cases, pelvic misalignment is often accompanied by baby malposition of varying types, not just breech presentations, and treatment may help resolve such malpositions.
Anecdotal evidence also suggests that many women who have had past cesareans for non-progressive labor or “Cephalo-Pelvic Disproportion” (supposedly, baby too big or pelvis too small) actually may have had malpositioned babies. It’s not that the baby was too big or the mom’s pelvis too small, it’s that the baby’s position did not permit it to go through easily, causing it to get “stuck.” These women (one of whom is Kmom!) often report that if they get regular chiropractic care in subsequent pregnancies, they frequently go on to have a Vaginal Birth After Cesarean because the baby malposition is prevented or is more easily resolved. They also regularly report that their pubic symphysis pain decreases significantly with treatment.
So although little concrete scientific data exists from mainstream studies (largely because it has not been studied), and although anecdotal evidence has to be treated with caution, women with misaligned pelvises often seem to experience pelvic pain/SPD, and possibly a higher rate of malpositioned babies. It seems logical (though unproven) that treatment to help re-align the pelvis may help lessen pelvic pain, and may also prevent or correct a fetal malposition.
Although not every women with SPD experiences a malpositioned baby, it does seem to be very common in this group. Since baby malpositions commonly lead to lots of interventions like epidurals and forceps that tend to worsen pubic pain and may even damage the pubic symphysis permanently, checking for misalignments and working carefully to avoid/treat baby malpositions may be important to avoiding long-term pain or permanent pubic symphysis damage. This is a fascinating area that is just beginning to be researched but has potentially far-reaching implications.
Although the best idea may be to resolve chronic SPD pain through realigning the pelvis girdle and soft tissues, most women have at least some residual pubic and low back pain stick around for pregnancy and the early postpartum weeks because of hormones. Therefore, tips for coping with pubic pain tend to be a focus of many SPD websites.
Many of the suggestions include:
Use a pillow between your legs when sleeping;
body pillows are a great investment!
Use a pillow under your ‘bump’ (pregnancy tummy) when sleeping
Keep your legs and hips as parallel/symmetrical as possible when moving or turning in bed
Some women also find it helpful to have their partners stabilize their hips and hold them ‘together’ when rolling over in bed or otherwise adjusting position
Some women report a waterbed mattress to be helpful
Silk/satin sheets and nighties may make it easier to turn over in bed
Swimming may help relieve pressure on the joint (many sites recommend avoiding breaststroke but Kmom did not find it to be a problem at all for her; see what works for you)
Deep water aerobics or deep water running may be helpful as well (there are flotation devices to help you stay afloat easily during this; you do not need to know how to swim in order to do this)
Keep your legs close together and move symmetrically (other sources recommend a very small gap between the legs with symmetrical movement)
When standing, stand symmetrically, with your weight evenly distributed through both legs Sit down to get dressed, especially when putting on underwear or pants
Avoid ‘straddle’ movements
Swing your legs together as a unit when getting in and out of cars; use plastics or something smooth and slippery (like a garbage bag) on the car seat to help you enter car backwards and then turn your legs as a unit
An ice pack may feel soothing and help reduce inflammation in the pubic area; painkillers may also help
Move slowly and without sudden movements
If sex is uncomfortable for you, use lots of pillows under your knees, or try other positions
If bending over to pick up objects is difficult, there are devices available that can help with this
Really severe cases may need crutches, although these should probably only be used as a last resort
Sciatica may be helped by stretching the hamstring muscles with a stirrup around your foot (long piece of rope, two neck ties tied together, etc.) See the Elizabeth Noble book for directions (resources)
Back pain can often be helped by resting backwards over a large gymnastic or ‘birth’ ball (see resources)
Some women report that pelvic binders/maternity support belts are helpful for pelvic pain; brands in the U.S. include Prenatal Cradle or BabyHugger or the Reenie Belt. However, if the pelvic bones are really misaligned, some women report more pain with these. Listen to your body on whether to use these
Please refer to www.plus-size-pregnancy.org/pubicpain.htm to read the whole article.
