Sexual intimacy during pregnancy

Sexual intimacy is a normal and healthy part of a committed relationship. Before pregnancy, you likely felt comfortable being intimate with your partner. Now that you’re pregnant, you may have questions or feel unsure about having sex with your partner.

There are lots of myths about sex and pregnancy, such as:

• Sex can be harmful or painful during pregnancy.
• Intercourse could hurt the baby.
• The baby somehow “knows” that sex is taking place.
  

Truth:

• Unless your health care provider advises you otherwise, sex during pregnancy is safe for you and your baby.
• As for the baby, he or she has no idea what Mom and Dad are doing. The baby is well protected by a cushion of fluid in the womb and by the mom's abdomen.
  

When Is Sex Unsafe During Pregnancy?
There are some circumstances that can make sex during pregnancy unsafe. Women who have the following health complications should talk to their health provider before engaging in sex:

• A history or risk of miscarriage
• A previous preterm birth or other risk factors for preterm birth
• Unexplained vaginal bleeding, discharge or cramping
• Leaking amniotic fluid
• Placenta previa (when the placenta is low and covers the cervix)
• Incompetent cervix (when the cervix is weakened and opens too soon)
  

If your pregnancy is considered to be high risk, you may need to be more cautious than other women. Your health care provider may advise you to avoid intercourse for all or part of your pregnancy.

How Does Pregnancy Affect My Sex Life?
Many women find that pregnancy makes them want sex more than they did before they became pregnant. This sex drive is caused by hormonal changes. For some women, newfound voluptuousness can play a role in making them feel sexier than ever.

Other women may find that their sex drive comes in waves while pregnant. Here are some common changes you may find throughout your stages of pregnancy.

First Trimester

• The first 3 months of pregnancy are often accompanied by physical symptoms that can lower your interest in sex.
• Symptoms such as feeling tired, nauseated, soreness in the breasts and the frequent need to go to the bathroom can make sex seem bothersome.

Second Trimester

• By the time you reach your second trimester, the nausea, fatigue and breast tenderness have usually gone away or are much more manageable.
• Your belly is growing but it’s still small enough to comfortably engage in sexual activity.  
• You may even have more desire for sex! Women gain about 3 pounds of blood during pregnancy, and most of that blood flow is directed below the waist line.
• Some women find the increased blood flow increases their ability to have an orgasm—even more than once.

Third Trimester

• Toward the end of pregnancy, your growing belly and the anticipation of childbirth and raising your new baby may reduce your interest in sex.
• Your concerns are perfectly normal. There are other ways you can be intimate with your partner without having sex.
  

Which Sex Positions Are Best During Pregnancy?
Positions that work before pregnancy and early in pregnancy can be uncomfortable or even unsafe at later stages of the baby's development. For example, a woman should avoid lying flat on her back (traditional missionary position) after the fourth month of pregnancy because the weight of the growing uterus puts pressure on major blood vessels. Fortunately, there are alternatives to the traditional missionary position. Try these:

• Woman on top: This position puts you in control of how fast, slow and comfortable you want to be.
• Spooning: Imagine the way that spoons fit together in the silverware drawer. Lay sideways with your partner lying behind you during sex. This position lowers the amount of pressure placed on your belly.
• Hands and knees: This position works best during the first and second trimesters as it also lowers the pressure placed on your belly. But as your belly gets bigger during the very end of pregnancy, you may find this uncomfortable.

You don’t have to engage in intercourse to be intimate with your partner. Other ways to share your sexual desire include:

• Kissing
• Cuddling
• Sensual massages
• Oral sex
  Note: If you choose oral sex, be sure your partner does NOT blow air into your vagina. This can cause an embolism (a blood vessel blocked by an air bubble), which can lead to serious harm for you and your baby.

Usually, if a woman enjoyed certain sexual activities before pregnancy, she can continue them during pregnancy as long as she feels comfortable. Talk to your health provider about any specific questions.

More Suggestions for You and Your Partner

• Talk to your partner about your needs in an open and loving way. Be aware of his concerns as well as your own. If you work together, you can figure out how to put a smile on each other's face.
• Let mutual pleasure and comfort be your guide. If something doesn't feel right for either one of you, change what you're doing.
• Keep your sense of humor.
• To avoid sexually transmitted infections, use a condom when having sex or have sex with only one person who doesn't have any other sexual partners. Discuss HIV testing for you and your partner with your health care provider.
• If the pregnancy is high risk or if you have any questions at all, ask for help from your health care provider.

Once the baby is born, it’s best that you wait until after your postpartum checkup before resuming intercourse. Typically, it takes at least 4 weeks after delivery before a woman feels comfortable and ready for sex. Take heart in the fact that most couples resume an active sex life sometime during the first year of their baby's life.

Courtesy of the March of Dimes