Estimated reading time: 8 minutes
Many women have questions about sex during pregnancy. Is it safe? Can it hurt the baby? Is it normal to have no interest in sex, or to suddenly have an increased desire? Are there situations in which you might need to avoid sex? We’ll explore all of these things as we look at sex during pregnancy.
Table of contents
Your Normal is Normal
Before we dive deeper into this topic, let’s just start by acknowledging that there is no normal when it comes to libido or sexual desire. Just as women vary widely in sexual interest when not pregnant, women don’t all fit one mold during pregnancy either. Your normal isn’t the same as someone else’s normal… and both are completely normal! Things like the safety of sex during pregnancy apply to all low-risk women. But as we discuss things like desire for sex, enjoyment of sex, or fears surrounding sexual intimacy, know that what we’re discussing may or may not apply to you. Follow your body’s lead!
Can Sex During Pregnancy Hurt My Baby?
Most pregnancies are considered low risk, so this advice will be directed toward women who are having normal, low-risk pregnancies. Later, we’ll address circumstances in which avoiding sex may be advised.
For a low-risk pregnancy, be assured that sex will not hurt your baby, who is well cushioned and protected by the amniotic fluid and the strong muscles of your uterus (1). Your uterus is also protected from any outside contamination by a thick mucus plug that seals your cervix after you become pregnant (2). There is no medical evidence that sexual intercourse increases the risk or miscarriage or premature birth or harms the baby in any way (2, 4). If you’re having a normal pregnancy, you can have sex as often as you desire and keep doing so until you go into labor (3). You’ll need to stop only when your water breaks or if your provider advises you to abstain for any other reason.
How Pregnancy Affects Desire for Sex
Most women find that their desire for sex changes during pregnancy, perhaps even multiple times throughout those nine months. While everyone is different, many women seem to find a similar pattern that changes (approximately) with each trimester.
First Trimester
In early pregnancy, many women find that they have a decreased (perhaps drastically decreased) desire for sex (4). As we’ve explored in our early pregnancy posts, the first trimester often brings symptoms such as nausea/morning sickness and extreme fatigue. It isn’t surprising that a person who is exhausted and nauseated would not feel like she wants to have sex.
In addition to not feeling great, there may be fears or emotional considerations that especially affect the first trimester. Because miscarriages are most common in the first trimester, some women find themselves extra fearful that any extra activity could cause a miscarriage. These fears may be heightened for women who have previously experienced a miscarriage, or who had difficulty conceiving. On top of all of this, a woman may be stressed by the still-new news of pregnancy, or may still be struggling with how to see herself as a pregnant person and feel uncomfortable in her body.
Second Trimester
You may experience an increase in your sex drive in the second trimester. (3). For most women, the nausea and fatigue subside as the first trimester passes. As you feel healthier and get your energy back, you may feel more like engaging in sex again. You also likely feel more comfortable about baby’s safety as you’ve gotten past the miscarriage danger zone.
You may find yourself more able to enjoy sex for another reason. By this time, your blood volume has increased dramatically. To accommodate the increase, your blood vessels become more flexible and dilate, sending more blood to the skin. The increased blood flow to your pelvic area may heighten sensations and make sex even more enjoyable.
Third Trimester
Your sex drive may decrease again in the third trimester. You’ve gained weight, your shape has changed, you may have tender breasts, and it may be hard to find a position that’s comfortable. Fatigue has likely returned, and you may have aches and pains from carrying your growing baby. However, with the increased blood volume still present, you may find sex enjoyable if you can just find a comfortable way to engage.
How to Have Sex or Share Intimacy During Pregnancy
Sex in the first trimester, and even into the second, isn’t much different from before pregnancy. But by the end, you may need to get creative to figure out ways that work for you with your new shape. You will likely need to temporarily retire positions where you’re on your back or where your partner’s weight is on top of your belly. You may find that the most comfortable positions are lying side by side, man-behind positions, or woman-on-top positions. All of these take the pressure off of your abdomen.
Remember that intimacy doesn’t have to mean sexual intercourse. If you don’t feel like you want to have sex, or if you find that it is uncomfortable or painful, you can still find ways to be close to your partner. You can be intimate through cuddling, kissing, massages, other forms of sexual contact, or just working on deepening your emotional connection with each other. Pregnancy can be a time when you and your partner grow closer and feel more bonded to each other than before, and sex is not required to feel this closeness.
How Your Pregnant Body Reacts to Sex
Sex drive and positioning aside, you may find that you notice some sensations when you have sex during pregnancy that you don’t notice when not pregnant. You may experience some cramping after having an orgasm. Uterine contractions are a normal part of having an orgasm, so cramps and possibly some light spotting are normal. Additionally, semen contains prostaglandins which stimulate uterine contractions (3). These mild contractions are not intense like labor contractions and will not harm your baby or cause labor. In the third trimester, you may notice Braxton Hick’s contractions after an orgasm, and they may last from a few minutes to half an hour afterward (2). You also may feel your baby become more active after sex. This is just due to your adrenaline release, and not a sign that baby is distressed or anything is wrong.
These reactions are typically not problematic. Cramping and spotting are not a problem unless you have severe, persistent cramping, or heavy bleeding (like the bleeding from a normal period). While Braxton Hick’s contractions are harmless, if they continue for more than half an hour after sex and you’re concerned, give your doctor or midwife a call.
When Is Sex Not Advised?
There are some situations in which your healthcare provider may tell you to refrain from sex. While intercourse is not a problem in a low-risk pregnancy, your caregiver may ask you to err on the side of caution if you’re high risk for any reason. Some of the reasons you may need to abstain include:
- You’re at risk for preterm labor
- Your partner has a sexually transmitted infection
- You have placenta previa (a low-lying placenta)
- You have an incompetent cervix (one that opens early)
- You have vaginal bleeding during pregnancy
- You have continuing or painful cramps after intercourse
- Your membranes have ruptured (Even in a low risk pregnancy, you should never have sex after your membranes have ruptured, which means that your water has broken.) (5)
If your doctor tells you not to have sex, make sure you communicate well and get a clear understanding of what’s okay and what’s not. Your doctor may tell you not to have intercourse (in which case other sexual activity is okay) or may advise that you don’t have orgasms at all.
Communication is Key
Some women may feel bashful when talking about sex. But let’s face it. It’s just a normal part of pregnancy and childbirth. It may not be a topic of conversation at the Thanksgiving dinner table, but hopefully is something you can communicate openly about with your partner and your healthcare provider. Clear communication with your doctor or midwife can help you know what’s safe for you and your baby. And communicating openly with your partner as your sexual desires and physical abilities change is key to a positive intimate relationship.
Further Reading: To read more about sex during pregnancy and after delivery, head over to the March of Dimes website where they have a great resource packed with information about the topic.
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References:
1. Sex during pregnancy: What’s OK, what’s not. (2018, July 10). Retrieved July 24, 2020, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318
2. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.
3. American College of Obstetricians and Gynecologists. (2021). YOUR PREGNANCY AND CHILDBIRTH: Month to month, 5th edition.
4. Curtis, G. B., & Schuler, J. (2016). Your pregnancy week by week. Cambridge, MA, MA: Da Capo Life Long.
5. Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2018). Pregnancy, childbirth, and the newborn: The complete guide. New York, NY, NY: Da Capo Lifelong.
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