Sex during pregnancy

Couples often worry about having sex during pregnancy. They may be afraid that having sex could cause a miscarriage or harm the baby. With a normal pregnancy, sex is safe into the last weeks of pregnancy. In fact, some studies suggest that having sex during pregnancy is associated with a lower risk of delivering too early!

The baby is well-cushioned by amniotic fluid and the strong muscles of the uterus. There is also a thick mucus plug that seals the cervix and helps to protect against infection.

It is best to talk to your doctor or nurse midwife about your specific situation to make sure you are considered at low risk for complications such a pre-term labor or miscarriage. Your doctor may advise you to limit your sex if there are signs or complications during your pregnancy. Women whose cervix seems to be opening early, and those with bleeding or an abnormally located placenta (placenta previa) should not have sex while they are pregnant.

Changes In Sexual Drive

You and your partner may experience fluctuations in sexual drive during the pregnancy. This is common during the different phases of pregnancy and will be different for everyone.

During the FIRST trimester many women experience extreme breast tenderness, fatigue, nausea, vomiting, and an increased need to urinate that might decrease their sexual drive. Some couples have a feeling of increased closeness that may influence their sexual desires.

Many women find that during the SECOND trimester the initial symptoms have gone away and they have an increased desire for sex. One theory for the increased desire is the increased blood supply in the pelvic region. Some women find freedom from birth control appealing and this adds to the continued sense of special closeness with their partner.

The desire for sex may change again in the THIRD trimester. Your abdomen is very large, which may make it awkward for you to have sex. Some women feel physically unattractive, while others may feel an increased sense of desirability.

The key to dealing with changes in sexual desire is to communicate your feelings and thoughts with your partner. Even with the changing desires for sex during pregnancy, some women have an increased desire for physical affection, gentle touching, and cuddling.

Positions

Having sex as your pregnancy progresses may be difficult or uncomfortable. There are a variety of positions that seem to work with greater comfort. These include:

• Both partners lying sideways, either face-to-face or spoon position.
• Woman on top.
• Rear entry.
• The woman lying on her back, knees bent, near the end of the bed.

Unsafe Sex

If you have oral sex, air should not be blown into your vagina. This can cause an air embolism or an air bubble to get in your bloodstream and block a blood vessel. This is extremely uncommon, but can be fatal to you and your baby.

When Limitations May Be Needed

There are some conditions or complications with pregnancy that may impact having sexual intercourse. Your health care provider may advise you to limit or avoid sex if you have one of the following conditions:

• A history of miscarriage
• A history of pre-term labor
• Vaginal bleeding or cramps
• Leakage of amniotic fluid or breaking of water
• Incompetent cervix (the cervix or opening of the uterus is weak and opens prematurely, which increases the risk for miscarriage or premature delivery)
• Placenta previa (the structure that provides nourishment to the baby is in front of the cervix or in the lower part of the uterus, instead of the usual location at the top of the uterus)
• Pain with intercourse
• Infection

You should call your health care provider if you are unsure whether sex is safe for you. If you have any symptoms that you are unsure about, such as pain, bleeding, discharge, or contractions after sex, contact your doctor.

Some women are advised to stop having sex in the last weeks of pregnancy. It is best to check with your health care provider for specific recommendations.

Remember, talking to your partner about your sexual feelings and desires during the pregnancy are important. These conversations will help lay the groundwork for the big changes about to take place for both of you -- parenthood!

Review Date: 2/19/2007
Reviewed By: Douglas A. Levine, MD, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

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