This is a topic we don’t talk about enough, as questions about sex during pregnancy often arise. Some couples find sex during pregnancy enjoyable, while others simply feel they don’t want it. I often encounter situations where the pregnant woman, her partner, or both experience a fear of sex during pregnancy, even when the desire is high. Couples often mention a fear of harming the fetus, and men occasionally experience a “psychological barrier,” feeling they can’t have sex because the baby is right there.
Sex during pregnancy is safe for most couples. Your partner’s penis cannot penetrate beyond your vagina, and the baby cannot feel what is happening; you won’t hurt them during intercourse. The amniotic sac and strong uterine muscles protect the baby, while the mucus plug provides protection against infection.
It’s normal for your sex drive to change during pregnancy. Don’t worry too much about your libido, but I find it helpful to talk about it, as well as any other “inhibitions,” with your partner.
General information about sex during pregnancy
Many women report that sex during pregnancy feels different than before. Some find it more enjoyable at times, others less so, and some report different sensations at various stages of pregnancy. Increased blood flow to the pelvic area can cause swelling of the genitals, which can heighten pleasure. You might have more vaginal discharge and your vagina will be more lubricated, which mostly has a positive effect on how sex feels. Understandably, for some women, the swelling of the genitals triggers a feeling of discomfort and fullness, and mild abdominal cramps or even contractions (more on this later in the text) can occur during or immediately after sex or orgasm.
It’s not unusual for your breasts to be tender and unusually sensitive to touch, especially in the first trimester. The tenderness usually fades, but breast sensitivity often remains in the later stages of pregnancy. Some women perceive this sensitivity as extra arousal, while others find it bothersome and prefer that their partner doesn’t touch them in sensitive areas during this time.
If you feel uncomfortable, it’s important to tell your partner, even if it’s something you’ve done before. If you feel aroused but don’t enjoy intercourse, consider other sexual activities, such as mutual masturbation or oral sex. Try different things and experiment so it’s pleasant for both of you. Remember, there are other forms of physical intimacy besides just intercourse. If you’re not in the mood for sex or your doctor/gynecologist has advised against it, you can still hug, kiss, and cuddle to maintain intimacy.
Pregnancy and sexual desire at different stages
There is a wide spectrum of individual experiences when it comes to the desire for sex during pregnancy. Some women have a higher libido during pregnancy, while others find they aren’t interested in sex at all. It’s normal for your sexual appetite to fluctuate during pregnancy, depending mainly on how you feel physically and emotionally.
In the first trimester, you might be tired and overwhelmed by the physical and emotional changes you’re going through, and there may be no real desire for sex. Often, your libido returns in the second trimester once morning sickness and fatigue have settled down, and the desire for sex returns.
In the third trimester, especially in the last month or two, the desire for sex usually decreases. At this point, many women report feeling “too big” and exhausted for comfortable lovemaking, or they are too preoccupied with the upcoming labor and birth.
Men and sex during pregnancy
Most men find their partner as attractive as ever during pregnancy, or even more so, like a Venus of Willendorf in the bloom of fertility. Of course, not everyone feels this way. Some men are worried about the burden of upcoming parenthood, and anxiety can negatively affect their desire for sex; others have an (unjustified) fear of harming the fetus (which I wrote about above), and some fear they will hurt their partner. It’s important to talk about your thoughts and feelings with your partner to help overcome these hurdles.
Sexual positions during pregnancy
While sex is safe for most couples during pregnancy, it might not be as easy in practice due to the woman’s physical changes. You’ll likely need to try different positions. This can be a time to explore and experiment together.
The sexual position where the partner is on top (missionary position) can become uncomfortable very early in pregnancy and almost impossible in later stages, not only because of pressure on the belly but also due to breast sensitivity. If you use this position after the first trimester, place a pillow under yourself so you are tilted and not lying flat on your back. Make sure your partner isn’t leaning on you and that his weight isn’t on your belly.
Deep penetration during pregnancy can also trigger feelings of discomfort. It’s recommended to lie on your side, either facing each other or with your partner behind you (NHS-Sex in pregnancy, 2015).
Oral sex is mostly safe (I’ll mention when it’s not below), but under no circumstances should anyone blow into the vagina, as this can cause an air embolism—an air bubble that enters the bloodstream. This is rare, but it can be life-threatening for you or your baby.
Avoid oral sex if your partner has an active outbreak of oral herpes or feels one coming on. In the third trimester, avoid oral sex entirely if your partner has ever had oral herpes, regardless of the presence or absence of symptoms.
During sex in pregnancy, your usual positions might become unusual, awkward, and a bit more challenging as your belly grows. This doesn’t mean sex is no longer possible, but it will require more flexibility and improvisation.
Here are some ideas with illustrations to help you get started.
- On your side, at an angle
Both lie on your sides, with your bodies forming a V-shape. Place a pillow behind your back for support, face your partner, and rest both your legs over your partner’s hip. This position prevents most of the partner’s weight from being transferred to the belly.
- Pregnant woman on top, sitting
This position is mostly possible throughout the entire pregnancy; the partner lies on his back while you sit on him. This way, the partner’s weight isn’t transferred to the belly, and you can control the depth of penetration.
- On a chair
The partner sits on a chair, and you sit on the partner with your legs spread. Place the chair against a wall or furniture for support when getting up from this position.
- On your side, from behind
The partner lies behind you and enters from the back. You might need pillows for extra support. In this position, penetration is shallower. This is good in the later stages of pregnancy, as deep pressure can be uncomfortable then.
- Missionary position
If you try the missionary position after the first trimester, place a cushion or pillow under yourself so you are propped up and not lying flat on your back. Your partner should make sure to support himself so his body weight doesn’t press on your belly.
- On the edge of the bed
Move to the edge of the mattress or bed with your knees slightly bent. After the first trimester, support yourself with a pillow or cushion so you aren’t lying flat on your back. Depending on the height of the bed, your partner can kneel or stand.
Photo6- From behind, “doggy style”
Prop yourself up on your knees and elbows/hands while your partner kneels and enters from behind. A pillow can provide necessary support for the belly.
- When intercourse isn’t an option
If penetrative sex is uncomfortable, find other ways of intimacy and satisfaction with your partner (e.g., mutual masturbation).
Photo8If there is a risk of sexually transmitted infections—e.g., if you are not in a monogamous relationship with an uninfected partner—it’s better to abstain from sex or ensure protection with a condom every time.
Can sex during pregnancy trigger labor or cause a miscarriage?
No, as long as it’s a low-risk pregnancy. Sexual stimulation or orgasm cannot trigger labor or cause a miscarriage.
In the later stages of pregnancy, orgasm or even sex itself can trigger contractions (known as Braxton-Hicks contractions). Similarly, nipple stimulation and prostaglandins in semen can also trigger them. If and when this happens, you’ll feel a hardening of the uterus. This is completely normal and there’s no need to be alarmed. If you feel uncomfortable, try your relaxation techniques or simply lie quietly until the contractions pass (NHS-Sex in pregnancy, 2015).
When to avoid sex during pregnancy?
Your midwife or doctor/gynecologist will likely advise you to avoid sex in the following cases (NHS-Sex in pregnancy, 2015):
– if you have had heavy bleeding during pregnancy, as sex can increase the risk of further bleeding,
– in the case of a low-lying placenta,
– if you have a hematoma (a localized collection of blood outside the blood vessels),
– if your water has broken (rupture of membranes), as this can increase the likelihood of infection (PPROM and PROM),
– your cervix is shortening (ICI),
– recurrent miscarriages,
– you have previously had a premature birth (before the 37th week of pregnancy – PPI).
It’s normal to feel some cramps during or immediately after sex or orgasm, but if they don’t go away after a few minutes, or if you have pain or bleeding after sex, you should see a doctor.
Don’t hesitate to talk to your doctor or midwife whenever you have questions or concerns about sex during pregnancy, especially if you’re not sure whether you should abstain or if you’re afraid of harming the fetus. If your doctor tells you to stop having sex during pregnancy, ask whether you should avoid penetration, orgasm, or both entirely.
Pregnancy is not a period when you should have to abstain from sex. It’s a time for extra bonding with your partner, and intimacy in the form of sex has a range of positive effects on the body and mind, so I can conclude that sex during pregnancy is normal.
Source 1, Source 2, Source 3, Source 4, Source 5, Source 6, Source 7, Source 8
