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Sex during Pregnancy
Answers to common questions about sex during pregnancy

Throughout the course of your pregnancy, you will experience a wide range of emotions and physical changes. One change you or your partner may encounter is an increased or decreased sex drive. Hormones, body image, relationship issues, and prenatal health can all affect your sex drive or your capability to engage in sexual activity.

Sexual Desire
A woman’s desire for sex during pregnancy can fluctuate month-to-month or trimester-to-trimester. During the first trimester, fatigue, vomiting, and nausea may put a damper on sexual activity. By the second trimester, many women regain their energy levels and feel more aroused due to physical changes such as full breasts, increased vaginal lubrication, and increased blood flow to the pelvic region. Once the third trimester arrives, fatigue and body aches and pains may contribute to a decrease in your sexual desire.

Your partner may also be experiencing an increased or decreased sex drive. In one respect he may be aroused by your full breasts and round belly, trying new sex positions (to account for your growing abdomen), and a newfound freedom from contraception concerns. On the other hand, your partner may feel anxious due to a fear of harming the fetus, physical awkwardness, or nervousness about becoming a father.


Communicating with Your Partner

It is important for you and your partner to communicate about your sex life and discuss what feels right for both of you throughout your pregnancy. What feels pleasurable one week may feel painful or awkward the next.

Talk to your partner about your comfort level regarding the amount of sex you would like to have, the different positions you would like to try, and where you would like to be touched. Ask him about his preferences as well. If you are unable to have sex due to discomfort or medical reasons, look for other ways to keep your love life alive such as giving a massage, kissing, holding hands, or bathing together.

Participating in sexual activity while pregnant can be enjoyable, and as long as you are experiencing a healthy or “normal” pregnancy, prenatal sex does not harm your baby. The penis does not come into contact with the fetus during sex due to the mucus plug in your cervix and the muscles of the uterus. In addition, it is safe for a pregnant woman to reach orgasm.


When Prenatal Sex Is Not Safe
Sex may not be a safe activity if your pregnancy is considered high-risk or if other significant complications exist. Your doctor may advise against prenatal sex if you are diagnosed as having any of the following conditions:

  • Unexplained vaginal bleeding
  • The presence of symptoms (cramping or contractions) or risk factors (multiple gestations) that may indicate or predispose a woman to preterm labor
  • Leakage of amniotic fluid (the fluid that surrounds the baby)
  • Placenta previa, a condition in which the placenta is situated in an area that covers the cervix (opening of the uterus)
  • Incompetent cervix, a condition in which the cervix is weakened and opens (dilates) prematurely, raising the risk for miscarriage or premature delivery

If you are unsure whether prenatal sex is safe for you, contact your obstetrician. In addition, if you notice any unusual symptoms after intercourse, contact your pregnancy health care provider immediately.

Mild cramping may follow sexual intercourse and orgasm. This cramping is due to the prostaglandins in semen and the contraction of pelvic muscles during orgasm. The cramping, however, should be mild and short-lived. If cramping persists or intensifies to regular contractions, you should contact your obstetrician.

There are some sexual behaviors that should be avoided when pregnant. When participating in oral sex, make certain that your partner does not blow air into your vagina. This can cause an air embolism, which is the blockage of a blood vessel by an air bubble. An embolism can be fatal to the fetus or the mother.

It is also important to abstain from sexual activity with a partner that has a sexually transmitted disease (STD) such as genital warts, Chlamydia, herpes, or human immunodeficiency virus (HIV). If you become infected with an STD during pregnancy, it can be transmitted to your baby. In addition, you should always avoid having sexual intercourse with a partner whose sexual history is unknown to you.


Sexual Activity during the Latter Stages of Pregnancy
During the latter half of the pregnancy, sexual intercourse in the missionary position (woman flat on her back) should be avoided. By being flat on your back, the gravid uterus may compress the blood vessels returning blood to your heart, and subsequently oxygenation to the fetus. Experiment with different positions which are comfortable for you and your partner, but you should not lie flat on your back.

Talk to your doctor about sexual activity during the final weeks of your pregnancy. Depending upon your physical condition and medical history, your doctor may advise you to abstain from sexual intercourse. The hormone prostaglandin (used to induce labor), is present in semen but not in the amount required to induce labor. In general, sexual activity will not trigger labor unless your body is ready.


How soon can I have sex after the baby is born?
Medical opinions vary as to when you should resume sexual activity after delivery. In general, it is recommended that you wait until after your postpartum checkup before you resume intercourse.

Since every woman’s situation is different, it is best to talk to your doctor, nurse, or midwife regarding any concerns you may have about your sexual activity and prenatal health.