It is perfectly normal and safe!
If you’re having a normal pregnancy, sex is considered safe during all stages of the pregnancy. A normal pregnancy is one that’s considered low-risk for complications such as miscarriage or pre-term labor. Expectant parents often worry that sex can be harmful during their pregnancy. They fear that intercourse could hurt the baby, or even cause miscarriage. Some are afraid that the baby somehow “knows” that sex is taking place. The baby is well protected by a cushion of fluid in the womb and by the mom’s abdomen and is completely safe.
The partner sometimes worries that intercourse might cause discomfort or pain for the pregnant woman. Worries like this are common and completely normal, but most of them are unfounded. In actuality, sexual desire may increase in some due to the changes of pregnancy that leave the vulva engorged and sensitive and the breasts extra sensitive. If your pregnancy is considered to be high risk, you may need to be more cautious than other women. In this case, your health care provider may advise you to avoid intercourse for all or part of your pregnancy.
Pregnancy and sex
Many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy. Also, many women find that sex becomes uncomfortable, as their bodies get larger. You and your partner need to keep the lines of communication open regarding your sexual relationship. Talk about other ways to satisfy your need for intimacy, such as kissing, caressing, and holding each other. You also may need to experiment with other positions for sex to find those that are most comfortable. Many women find that they lose their desire and motivation for sex late in the pregnancy - not only because of their size but also because they’re preoccupied with the impending delivery and the excitement of becoming a new parent.
There are many reasons why sex during pregnancy can be more enjoyable, even if you are doing it less. There is an increase in vaginal lubrication, engorgement of the genital area helps some people become orgasmic for the first time or multi-orgasmic, the lack of birth control, or if you have been trying for awhile, a return to sex as pleasure as opposed to procreation, and other reasons. On the other hand there are reasons why sex might not be as pleasurable: fear of hurting the baby, nausea, fatigue, awkwardness, etc.
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 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, such as lying sideways or having the woman on top. There are many positions that are more comfortable as you expand. These include:
- Woman on top
- Spooning (Man behind woman, rear entry)
- Hands and Knees
- Side lying, knee pulled up
Tips for sex during pregnancy
- If you’re concerned, ask your health care provider if it’s okay to have sex
- Talk to each other about your needs and concerns in an open and loving way. If you work together, you can probably figure out how to put a smile on each other’s face. Open communication will be the key to a satisfying and safe sexual relationship during pregnancy. Explain to your partner what is going on and what they can do to help you be sexual. For example: more cuddling, relaxing baths, romantic dinners, massages, mutual masturbation, whatever you and your partner agree upon is exactly what you need
- Let mutual pleasure and comfort be your guide. If something doesn’t feel physically or emotionally right to one of you, change what you’re doing
- Keep your sense of humor
- Don’t allow how infrequently you may be having sex interfere with your relationship. It is the quality of lovemaking that should be important, not the quantity.
- To avoid sexually transmitted infections, have sex with only one person who doesn’t have any other sexual partners and/or use a condom when having sex. 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 guidance from your health care provider
- After the baby is born, wait until after your postpartum checkup before you resume intercourse
- If your partner is performing oral sex (cunnilingus) on you, be careful that he does not blow any air into your vagina. Doing this could force air into your bloodstream and cause an embolism, which could obstruct a blood vessel and can lead to deadly consequences for both mother and child.
- Performing oral sex on your partner (fellatio) is always safe during pregnancy and for some couples is a very satisfactory substitute when intercourse isn’t permitted.
- Mild cramping - both during and after orgasm - is very common and harmless during most low-risk pregnancies. This may be due to a combination of the increased blood flow to the pelvic area during pregnancy, the normal congestion of the sexual organs that occurs during arousal and orgasm, and the normal contractions of the uterus following orgasm. Remember, sex and orgasm during a normal, low-risk pregnancy is perfectly safe and not a cause of miscarriage.
When not to have sex during pregnancy
All that being said, there are still times when sex should be avoided during a pregnancy. These include:
- Your practitioner has advised against it
- You have a history of premature birth or labor
- If placenta previa is known to exist. (Where part of the placenta is covering the cervix)
- Your water has broken
- Your are currently experiencing bleeding
- You or your partner has an active sexually transmitted disease
- During the first trimester if a woman has a history of miscarriages or threatened miscarriage, or shows signs of a threatened miscarriage.
- During the last 8 to 12 weeks if a woman has a history of premature or threatened premature labor, or is experiencing signs of early labor.
- In the last trimester, if twins are being carried.
Revision date: July 3, 2011
Last revised: by Jorge P. Ribeiro, MD