Sex in Pregnancy

Many women and their partners worry about having sex in pregnancy. Concerns are often centred around any potential harm to the baby or themselves.  However, unless they have been advised not to have sex, it’s generally safe to do so.  Babies in utero are well protected by the amniotic fluid and the muscles which make up the uterus and mother’s abdomen. 

What’s important is that you both feel comfortable having sex and being open to making some position changes as your tummy gets bigger.

Changes during pregnancy

During pregnancy, there is increased blood flow to the genitals, including the vulva, clitoris, vagina and entire pelvic region.  Depending on the individual woman, this surge in blood flow can cause increased feelings of pleasure, or irritation.  For male sexual partners, the increased vaginal fullness can be felt during penetrative sex.

Reasons why sex in pregnancy may not be okay

If your maternity care provider has advised you not to have sex, there will be a reason for this. Potential reasons include:

1. Threatened premature labour or a history of premature labour or birth.
2. Unexplained vaginal bleeding.
3. Cervical incompetence – where the cervix is dilating prematurely.
4. Ruptured membranes, also known as ‘the waters have broken’.
5. Placenta praevia.

When is the best time to have sex during pregnancy?

During the first trimester, pregnancy hormones often cause a peak in nausea and tiredness. Many women don’t feel particularly interested or motivated to have sex. As they settle into the second trimester, there is a generally a lifting of energy and many women feel a renewed sense of interest in getting up close and personal with their partner again.

The second trimester is often a time when sex is back on the agenda for many women and their partners.  In the third trimester, a large belly can make the logistics of sex more challenging. This means expectant couples need to be open to new positions. 

Does sex in pregnancy feel any different?

Pregnancy hormones cause tissues to relax and loosen in preparation for labour and childbirth. Many women have a sense of having a ‘looser’ vagina which is softer and less tight than when they are not pregnant. Increased vaginal secretions mean that lubrication is increased and women may find they become more easily aroused and orgasm more readily because of these changes. 

Some women experience orgasms for the first time when they are pregnant, because of increased blood flow and hormonal influences.  It’s also not unusual for pregnant women to orgasm when they are dreaming.  There is no harm caused to either a pregnant mother or her baby when she has ‘sleep orgasms’.

On the flip side, some women experience heightened sensitivity because of a tightening of their vaginal muscles. This can make penetrative sex very uncomfortable.  Often, spending more time during foreplay or using lubrication (if it's needed) can make sex more pleasurable.

8 facts about sex in pregnancy

1. Unless advised otherwise by your maternity care provider, there is no harm in having sex during pregnancy, as long as it’s pleasurable for all involved and it is consensual.
2. Some women find their libido peaks when they are pregnant, others aren’t as interested in sex.
3. In the absence of complications, having sex in pregnancy is safe.
4. Having sex in pregnancy will not cause a miscarriage.
5. Orgasm during pregnancy increases blood flow and a surge of calming hormones. These are beneficial for the mother and her baby.
6. Sometimes women are advised to have sex to ‘bring on’ or initiate labour. This is because semen contains prostaglandins which can help to soften and dilate the cervix. However, there is not enough evidence to support this is an effective strategy to start labour.
7. Expectant parents can worry that their baby can see or feel them having sex, though this cannot happen.
8. It is important to not have air blown into a woman’s vagina by her partner during oral sex. This can be dangerous and lead to an air embolus forming.

Breast discomfort

Many women notice their breasts become uncomfortably painful and sensitive during pregnancy, especially in the first trimester.  This makes any touching or massage, even the gentlest of strokes, to be very uncomfortable. Speak openly with your partner about what works for you. There are many ways to maintain intimacy and closeness without having to tolerate being uncomfortable. 

Bleeding after sex

Many women experience ‘spotting’ after sex, or their vaginal mucous is streaked with blood. In the absence of other concerning symptoms, such as contractions or losing fluid, it is generally reasonable to assume slight spotting is due to cervical sensitivity. However, any bleeding during pregnancy needs to be checked by a doctor or maternity care provider.

There may be benefits in avoiding deep, penetrative sex if you have cervical discomfort, or you find you regularly spot after sex. This could help to reduce any anxiety you’re feeling about bleeding after sex.

Sex positions during pregnancy

As your tummy expands, it will be more comfortable to avoid positions where your partner’s weight is pressing down on you. The ‘missionary’ position can be one of the more uncomfortable ways to have sex, especially during the third trimester.

Sex positions to try:

1. ‘Doggie style’ with your partner behind.
2. Side-by-side sex.
3. You on top.
4. You lying on the side of the bed.
5. Sex when you’re standing or sitting.
6. Spooning.
7. On a chair in a ‘reverse cow girl’ position.

Remember

To be open to: 

1. Trying new positions to keep your partner’s weight and pressure off your belly.
2. Having non-penetrative sex if you’re uncomfortable. Masturbation, using sex toys and oral sex are good alternatives.
3. Using pillows and lubricant if you’re finding sex painful.
4. Using other ways to feel intimate and close to your partner. Massage, kissing, cuddling and talking are other ways to feel connected.
5. Telling your partner if you don’t want to have sex. There may be some (or many) weeks when you just don’t want to have sex and this is perfectly acceptable.  Most loving and supportive partners will be completely understanding.

One final thing about sex in pregnancy

Many women and their partners feel that regular, satisfying sex helps to support their stable mental health.  As long as you are not experiencing any pregnancy complications, or have been advised not to have sex, there is no reason why you need to stop.

About the Author:

Written for Nourish Baby by Jane Barry. Jane has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 35 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association and Australian College of Children and Young People’s Nurses.

References

Sex during pregnancy | Pregnancy Birth and Baby (pregnancybirthbaby.org.au)

Sex During Pregnancy: A Guide to Safe Sex Positions and 10 FAQs (healthline.com)

Sex in pregnancy: information for men | Raising Children Network  

Sexual activity | Australian Government Department of Health and Aged Care