I am a Licensed Midwife in CA. This summer I had a patient with vulvadynia. She had pain with every vaginal exam unless we used topical cetacaine gel. She had a difficult time relaxing her pelvic muscles enough to push her baby out. We transported after 2 hours of pushing with only slight descent. The baby was fine-- there was no reason to go except that she complained of a spasming in her cervix area in between contractions (she kept touching right above her pubic hair saying that the spasming was far worse than the contraction) and little descent. At the hospital the ob/gyn gave her a pudendal block. With that she was able to relax her pelvic floor enough to push her baby down far enough to apply the vaccuum. She had a vaginal birth, all was well.
I would love to be able to send her information on how to treat this. There is little information available right now. Do you know any thing about vulvadynia and what I can tell my clients in the future?