The LOWDOWN on S-E-X in pregnancy

As if relationships weren’t complicated enough, pregnancy can throw yet another curve ball at a couple, especially when it comes to sex. It’s sensitive subject with innumerable potential discussion topics.

Some women want more sex in pregnancy, others can’t stand the thought. Even dads to be are sometimes intimidated by the thought of sex during pregnancy for all kinds of reasons. Some couples still desire sex but they wonder about the safety. Whatever you are feeling about sex is completely valid and normal, even if you think you are alone in how you feel. So here we are going to talk about the basics of sex during pregnancy. (And as always, discuss any concerns you may have with your doctor or midwife.)

Sex in pregnancy is safe. Sex is by and large completely safe during pregnancy. There are few situations where a woman should refrain from sex (we will talk about those below.) But for the majority of women, sex, including penetration and orgasm, is perfectly healthy. It even offers some tremendous health benefits in pregnancy including relaxation, lowered blood pressure, and improved sleep and increased immunity.

It’s normal if you don’t want sex. And it’s normal if you do. The way a woman’s body responds to the hormone changes that pregnancy brings is unique to each person. Some love sex, others hate it. Others are completely unchanged. And some women find that some things about sex are ok and others are temporarily off limits. All normal.

Orgasms don’t trigger early labor in a normal pregnancy. During orgasm, a woman’s body is flooded with oxytocin, which is also the hormone that causes contractions during labor. The uterus has oxytocin receptors on it and throughout the majority of pregnancy, these receptors are closed. That means that, as long as these receptors are closed, a woman can have all manner of oxytocin coursing through her body and it will not start labor. At the end of pregnancy when those receptors begin to open as a woman becomes ready to go into labor, orgasms have the potential to encourage labor to start. In these situations, sex can come in handy to help start labor – both for the oxytocin and the prostaglandins in semen.

Try different positions. The basic mechanics of sex change a bit as pregnancy progresses. The belly gets bigger and bigger making several positions harder to utilize. Furthermore, women should not be on their backs for an extended period of time after about 20 weeks. Try having the woman on top (no pressure on the belly), doggie style, or side lying. Couples can also try other means is sexual gratification including oral sex.

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​When NOT to have sex in pregnancy

If you are at risk for preterm labor. There are many contributing factors to preterm labor and each situation is unique. If your doctor has said you are at risk for preterm labor, make sure to follow their recommendations carefully. Some allow penetration but no orgasm. Some allow orgasm, just no penetration. Some say to refrain completely until after birth. Whatever your situation, make the best of it and do everything that you ARE allowed to do to keep the intimacy up.

You have a history of miscarriages. In some women, a history of miscarriages means that sex in pregnancy is risky, though this is not in all cases.

You have Placenta Previa. If the placenta is growing at the bottom of the cervix, it can be unsafe to have sex in pregnancy. With a placenta previa, sex can irritate the placenta and cause it to detach from the uterine wall prematurely which is dangerous for mom and baby. Fortunately, placenta previa is rare and it’s easily detected.

The water has broken. Once the membranes have ruptured, sex is no longer a go. Anything placed in the vagina after the water has broken has the potential to cause infection, including semen.
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In a normal, healthy pregnancy, sex is beneficial and safe. Few situations are cause for concern and your doctor or midwife will lead you through those. In general, enjoy the physical sexual connection as much as the emotional connection with your partner during pregnancy!