Is it safe to have sex during pregnancy? Some cultures, like the Nigerians and the Japanese, say yes, sex during pregnancy makes delivery smoother; some cultures like the Vietnamese say no.1 2 Medical science says sex is safe if you have a low-risk pregnancy. But if you do have certain complications, say a weak cervix or a history of miscarriages, sex is best avoided. Your OBGYN is the best person to ask, right at the beginning of your pregnancy and at each trimester, depending on your health and pregnancy profile.
Having Sex Is Safe In Low-Risk Pregnancies
Both the American Pregnancy Association and the National Health Services, U.K., say it is absolutely safe to have sex during pregnancy, unless you have specifically been told not to by your doctor or a healthcare professional helping with your pregnancy.3 4
Second Trimester May Be The Best Time For Sex
[pullquote]Sex can actually be a pleasurable experience in the second trimester.[/pullquote]
If you don’t have any pregnancy complications, you can have sex through the course of the pregnancy. The only obstacles might be your changing libido and physical condition.
In fact, during the first and second trimesters, your body is primed for sexual pleasure as your sexual organs, including the nipples, the clitoris, and the vagina, receive more blood and become more sensitive. The vaginal passage also becomes naturally lubricated.
This is great news for some couples, but for some women, increasingly tender and sore breasts and genital engorgement (swelling) make sexual activities more painful than pleasurable.
[pullquote]Usually, the sex drive diminishes in women in the third trimester, but if it’s a healthy pregnancy, there’s no harm in having sex.[/pullquote]
- First trimester: What with the morning sickness, fatigue, and getting adjusted to a new way of life, you may find little interest in sex.
- Second trimester: As the nausea and fatigue subside, sex becomes enjoyable.
- Third trimester: The desire for sex usually goes down, with your growing abdomen, fatigue, and your negative body image becoming major roadblocks.
A few myths related to sex also play a part in making it taboo during pregnancy. Here’s a look at the facts:
Sex During Pregnancy Does Not Hurt The Baby
A common fear the father or the male sexual partner has about hurting the baby has no scientific basis. There is no risk of the baby being injured by penetration – the penis cannot go beyond the vagina. Plus, the baby itself has triple layers of protection – the amniotic fluid, surrounded by the muscles of the uterus, and then a thick layer of mucus called the mucus plug that seals off the cervix, allowing nothing to enter the womb.5
[pullquote]The baby is too well protected in your womb to be affected.[/pullquote]
Another unfounded fear that keeps expecting parents from having sex is that the baby will understand what’s going on. In a normal pregnancy, the baby is so well cushioned inside the mother’s womb that sexual activity will not affect it at all. As for knowing, at this stage, the baby’s brain is yet to mature to its full extent; so cognition of such events is highly unlikely.
Sex During Pregnancy Does Not Induce Miscarriage
There has been no evidence of miscarriage associated with sexual activity during pregnancy. Miscarriages in the first trimester are mostly a result of a genetic defect in the fetus or other pregnancy complications.
[pullquote]The keyword here is normal, low-risk pregnancy. There are chances of miscarriage or bleeding in high-risk pregnancies such as where the mother has placenta previa or a dilated cervix.[/pullquote]
In the second and third trimesters, stimulating the nipples and the genital area does release the hormone oxytocin, which can induce contractions in the uterus. The prostaglandins in the semen and those released by stimulation of the cervix can also cause uterine contractions and soften the cervix. You will feel your uterus hardening as the muscles go taut, but these are Braxton Hicks contractions, not real labor. In a normal low-risk pregnancy, coitus will not result in labor before time.
While some couples do engage in sex nearer to delivery, there is little evidence to prove that it is an effective method to induce labor.6 7
However, Sex Should Be Avoided In A Complicated Pregnancy
All said and done, there are some instances where intercourse during pregnancy is better avoided. There may be circumstances beyond these, depending on your specific case, where a doctor may advise against it. Needless to say, if that’s the case, you should definitely wait till childbirth.
- Bleeding: If you have experienced heavy bleeding while pregnant, sex could increase the risk of further bleeding, especially if you have a hematoma (collection of blood outside the blood vessel) or a low-lying placenta.8 Heavy vaginal bleeding without pain itself is a sign of a low-lying placenta.
- Low-Lying Placenta: Even if you have not had any bleeding but have been informed by your doctor that you have placenta previa (a low-lying placenta), sex might be off-limits.9 In this condition, the placenta lies near the bottom part of the womb, almost covering the cervix. Penetration can cause severe bleeding. Check if you can still have orgasm.
- Incompetent Or Dilated Cervix: For the baby to be delivered normally, the cervix needs to be dilated. If the cervix is already dilated before labor, then sex is best avoided as it can release oxytocin and prostaglandins that contract the uterus and soften the cervix. An incompetent or weakened cervix can also cause miscarriage or premature delivery.10 11
- History Of Premature Births: If you have been pregnant in the past, and have had premature births or gone into labor early, then you may want to avoid running the risk of triggering this by having sex while pregnant.12
- History Of Miscarriage: If you have a history of miscarriages, it may be wise to abstain to avoid creating any scenario that might accidentally put yourself or the baby in harm’s way.13
- Ruptured Membranes Or “Waters Broken”: If the waters have broken, that is the amniotic sac has ruptured, the membranes that protected your baby from possible infections are no longer there to act as a barrier. This exposes the baby to possible infection.14
- Sexually Transmitted Diseases: If your partner is infected with a sexually transmitted disease, unprotected sex can pass it on to you. Though your cervix is protected by the mucus plug, your upper genital tract is still at risk in the first trimester. Even unprotected oral sex is not safe as it can pass gonorrhea, genital herpes, and syphilis. Ideally, you should avoid all sorts of sexual contact.15 16 But if you must, use condoms and dental dam.
Make Sure You Have Safe Sex During Pregnancy
Even if you are in good health, it is better to err on the side of caution. Here are few things to be careful about if you decide to indulge in some “couple time” while you have a baby on board.
Talk To Your Partner
It’s totally okay not to want to have sex. But first talk to your partner about your concerns. If either of you are hesitant, because of fears of risking the pregnancy or because you feel unattractive while pregnant, share your fears. A partner can help ease your worries and be supportive and make the experience more pleasurable.17
Use Condoms With A New Partner
If you are not in a monogamous sexual relationship or are having sex with a new partner, use a condom. Even if you are in a monogamous relationship, use a condom if you or your partner has a sexually transmitted disease, though, ideally, it’s best to avoid sex in such a case.
Find Your Type Of Sexual Activity
If your OBGYN asks you to abstain from sex, find out exactly what is being forbidden – penetration or orgasm? If penetration is prohibited, you can engage in oral sex, masturbation, or mutual pleasuring. If orgasm is prohibited, you can still go ahead with sexual intercourse and withdraw before orgasm. If both are prohibited, you can still make the most of your couple time with cuddles, caresses, and kisses. Sex is just one way of showing love.
Find Comfortable Sex Positions
Don’t use positions that make you uncomfortable. The usual man-on-top position becomes difficult as the pregnancy progresses. Moreover, lying on your back when pregnant is not advised. Try these following positions or get innovative and find some of your own where you are comfortable.
- Lie side by side, with your partner behind you or facing you.
- Sit on your partner’s lap, facing him.
- Sit on your hands and knees, with your partner kneeling behind you.18 19
Use Adequate Lubrication
One of the advantages of pregnancy is a naturally lubricated vagina. But some women may experience vaginal dryness in the third trimester. Use adequate lubrication to make the experience more pleasurable for you both. A lubricated condom can serve the dual purpose of providing lubrication and protecting against infection. Alternatively, use any water-soluble lubricant jelly with or without a condom.20
Don’t Let Your Partner Blow Into Your Vagina
While this condition is very rare, blowing air into your vagina (through oral sex) during pregnancy or shortly after childbirth can cause an air bubble to be trapped inside a blood vessel. This is known as an embolism. It may then block a blood vessel and be fatal for the mother and the baby. The rear-entry position in the later stages of pregnancy also has some risk of embolism.21
Don’t Have Vaginal Sex After Anal Sex
Anal sex during pregnancy can be tricky. It is definitely not advised when you have placenta previa or pregnancy-induced piles or hemorrhoids. Anal sex followed by vaginal sex increases the risk of spreading infection from the bacteria in the rectum. This is one of the causes of urinary tract infections.
Relax When You Have Contractions
Not all contractions mean labor. The Braxton Hicks contractions, or “false labor,” are common in the second and third trimesters of pregnancy, especially after sex. These are completely natural. Lie down and use relaxation methods learned in prenatal classes or yoga or meditation techniques.22
Consult A Doctor If You Bleed Heavily After Sex
Though sex is usually safe in a normal pregnancy, stop and speak to your OBGYN immediately if you experience the following:23
- Heavy bleeding after intercourse
- Severe cramps or contractions that don’t resolve
- Amniotic fluid leak
While there’s no reason to abstain from sex during pregnancy on the basis of irrational fears, if you do have to abstain from it, don’t let it affect your relationship with your partner. Remember that sex is a wonderful way to express your love for each other, but not the only way.
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