Sex During Pregnancy

Many couples worry that sex during pregnancy is dangerous. If your pregnancy is normal or low risk, intercourse is safe and will not harm you or your baby.

That said, there are a number of instances in which sex may not be safe in pregnancy. If you are experiencing vaginal bleeding, for example, your healthcare provider may advise pelvic rest, which includes refraining from intercourse as well as any aerobic activity.

If you are at risk for preterm labor or have been diagnosed with placenta previa (if the placenta is covering the opening of your cervix), you will likely be advised to avoid intercourse as well.

You should also avoid sex if your amniotic sac has ruptured or broken. Once this barrier between your baby and the outside world is gone, the risk for infection increases. In this situation, strict avoidance of anything in the vagina is advised.

Initiating Labor

Women can use intercourse to begin labor or aid in cervical ripening” if they’ve gone past their due date. Prostaglandins — often used for inductions — are also found in semen.

When the cervix is exposed to these substances, it can soften and become more malleable, preparing it for labor. In addition, oxytocin, sometimes called the love hormone, is released during orgasm. This hormone can cause uterine contractions, which can initiate labor if your body is ready.

Postpartum Sex

It is advisable for new mothers to avoidintercourse for at least six weeks after giving birth. For some, this is a welcome request. For others, it may feel like an eternity. Regardless, the cervix needs time to close and the uterus needs time to involute, or shrink down, to its nonpregnant size. Refraining from intercourse allows your body time to heal.

If you are breastfeeding, often you are not ovulating, which means you are not experiencing monthly hormonal fluctuations that can affect your libido and vaginal secretions. This can create vaginal dryness, which can often be relieved by using external lubricants available at any drugstore.

Decreasing Discomfort

Many women report that intercourse feels different or is uncomfortable at various points during and after pregnancy. Interest in sex can wax and wane throughout each of the trimesters and the postpartum period. Experimenting with different positions may help to decrease any discomfort.

It is important to remember that pregnancy and the postpartum period are emotional times. Even if you are physically healed, you may not be emotionally ready to engage in intercourse. This is normal. Take things slowly. Communicate with your partner about what feels good and what doesn’t. Tell your provider if you experience persistent dyspareunia, or painful sex. You may be a candidate for pelvic floor physical therapy.

Most important, trust that the tincture of time will ease most initial discomforts and you will be able to engage in sex that is enjoyable and pleasurable again.

Sarah Kleinman, CNM, is a Certified Nurse Midwife in Boston who delivers babies at Beth Israel Deaconess Medical Center.