Vaginismus and Pregnancy: TTC Options, Birth Planning, and What Happens to Your Pelvic Floor

What happens to your body - and your pelvic floor - when you want to get pregnant, and you have a history of vaginismus or pelvic pain?In this episode, I speak with Dr. Saige Evans, an occupational therapist with a clinical doctorate in occupational therapy and the clinical director at Bloom Pelvic Therapy in Tampa Bay, Florida. She leads a team of pelvic health OTs and PTs across three clinics and also sees clients herself, specializing in sexual health and pelvic pain. She also has her own history of vaginismus - which she brings openly to this conversation, including her experience of trying to conceive and giving birth.We start before the logistics - with the feeling. The specific weight that lands when you want to have a baby and you're not sure your body will cooperate. From there we get into the full picture: conception options when PIV isn't possible (including at-home insemination kits and what the fertility clinic pathway actually looks like with pelvic pain), how to think about ovulation tracking when anxiety makes everything harder, and what's really happening to your pelvic floor across pregnancy - including what relaxin actually does and doesn't do. We talk about birth planning in detail: positions that help a hypertonic pelvic floor let go, the difference between pushing and getting out of the way, and how to think about C-section versus vaginal birth. Saige also shares things she wasn't prepared for - including catheters, cervical checks, and what she wishes she'd had support around in the hospital. And she ends with something I think a lot of people need to hear: why you shouldn't wait.Whether you're in the early stages of thinking about this or you're already navigating pregnancy with a pelvic pain history - this one covers a lot of ground that's hard to find anywhere else.In this episode:The emotional weight of wanting a baby when you have pelvic pain - and where those questions startConception options when PIV isn't the path: at-home insemination kits, IUI, and moreOvulation tracking - when it helps and when it makes things harderWhat actually happens to your pelvic floor across pregnancy, including what relaxin does and doesn't doBirth positions and breathing strategies for a hypertonic pelvic floorC-section vs. vaginal birth - how to think through it when you have pelvic painCervical checks, catheters, and what nobody tells you beforehandHow to advocate for yourself with your care team - and what to brief your partner onWhy you shouldn't wait to seek support, even if everything's about to changeConnect with Saige Evans:Saige's InstagramBloom Pelvic TherapyBased in Tampa Bay, Florida (three locations: Tampa, St. Petersburg, and Lutz)Connect with Mathilde:InstagramWebsite