Sex during pregnancy is the absolute last thing on some women’s minds, especially when they are dealing with nausea, vomiting, and overwhelming fatigue. Other women, however, may crave sex in pregnancy. And men, too, are split into different camps regarding sex during pregnancy. Some men may find nothing sexier than a pregnant woman, but other men may be too afraid of hurting the baby or their pregnant partner to enjoy sex.
But desire aside, is sex during pregnancy even safe?
The good news -- or bad news, depending on how you look at it -- is that “sex during pregnancy is extremely safe for most women with uncomplicated, low-risk pregnancies,” says Dayna Salasche, MD, an associate professor of obstetrics/gynecology at Northwestern University Feinberg School of Medicine and an obstetrician at Northwestern Specialists for Women, both in Chicago. “Some people feel like they enjoy sex during pregnancy more and others enjoy it less,” she tells WebMD.
Trimester by Trimester Guide to Sex During Pregnancy
During the first trimester, many women report no great desire for sex because they feel tired and nauseous, but during the second trimester, “they are feeling better, there is more lubrication, and they have engorgement in the genital area,” says Monica Foreman, MD, an obstetrician at Montefiore Medical Center in the Bronx, N.Y. This makes sex more appealing and potentially more satisfying. What’s more, most women are still fairly comfortable during second trimester because their stomach is not overly rounded yet. This is not quite true during third trimester. As the stomach grows and fatigue returns with a vengeance, sex may seem less attractive -- not to mention physically difficult during the final weeks of pregnancy.
If the dad-to-be is nervous about having sex with his increasingly pregnant partner, “we tell them that their baby is well protected. It is an egg surrounded by a pillow and another pillow and that there is no way they will hurt the baby, and that usually makes them feel much better,” Salasche says.
Whether or not having sex close to your due date during third trimester can bring on labor is an old wives’ tale, but having an orgasm causes the release of prostaglandins, which can theoretically cause contractions.
“At 40 weeks, this can’t hurt,” Foreman says.
Sexual Positions During Pregnancy
“As she grows, the traditional man-on-top position is more uncomfortable for pregnant women,” Foreman says. Other, more comfortable sexual positions during pregnancy may include intercourse from behind or side-to-side (spooning).
And “at some point, a pregnant woman should not be flat on her back because the growing uterus can compress major blood vessels,” Salasche says. This can cause pelvic pressure and pain. This phenomenon typically occurs during the third trimester. Lying flat on her back can also cause "supine hypotensive syndrome," which results in a change in heart rate and blood pressure that can lead to dizziness and other symptoms or signs.
One sexual act to avoid during pregnancy is blowing during oral sex, Foreman adds. “If oral sex is performed on the pregnant woman while blowing air into the vagina, the woman can develop an air embolus, which can travel to the lung and have potentially fatal consequences.”
Reasons to Avoid Sex in Pregnancy
Sex during pregnancy may not be safe for women with a history of repeated miscarriages, preterm labor, bleeding, or an incompetent cervix (a condition in which the cervix effaces and dilates without contractions in the second or early third trimester, when the baby’s weight puts increasing pressure on it), she says.
That’s not all. Women with placenta previa (a condition where the placenta is covering the cervix) are at risk of hemorrhaging if they have sex during pregnancy. Women with premature rupture of membranes (PROM), which occurs when the sac containing the developing baby and the amniotic fluid bursts or develops a hole before labor, should also avoid sex during pregnancy, Salasche says.
“If there are not any contraindications, a woman can have intercourse throughout her whole pregnancy,” Foreman says.
Other red flags that sex during pregnancy may not be wise may occur after intercourse. “If you have bleeding or foul-smelling discharge after sex during pregnancy, tell your doctor right away,” she says. Discharge may be a sign of an infection that can travel upward to the uterus, and bleeding may be a sign of a problem in general.
“Most people think, ‘I am pregnant, I don’t need contraception,‘ but you still need a barrier method for protection against STDs,” says Manju Monga, MD, the Berel Held Professor and the division director of maternal-fetal medicine at the University of Texas Health Sciences Center in Houston.
Let’s Talk About Sex During Pregnancy
“We discuss intercourse in the general prenatal discussion because a lot of women feel uncomfortable bringing into up,” Foreman says. “We tell them what is and isn’t OK.”
“I do bring up sex during pregnancy when it is contraindicated,” says Monga, who sees mainly high-risk patients. “Physicians who see low-risk pregnant patients on a day-to-day basis discuss sex at the first prenatal visit, but I tend to see women later in their pregnancy, when they develop complications.”
The bottom line when it comes to sex during pregnancy is “to have fun, listen to your body, and be open with your partner,” Salache says.