Now that I’m pregnant, can I still have sex?
This is a common question from our obstetric patients. For most women, the answer is “yes!” However, there are exceptions. Many patients feel uncomfortable discussing sex or sexuality with their physicians. The purpose of this installment is to dispel any myths and reiterate any truths concerning sex during pregnancy.
During intercourse and orgasm, pregnant women may experience mild cramping. This is normal and is not associated with miscarriage. Some women experience vaginal spotting after intercourse. Spotting is usually due to the softening and increased blood flow to the cervix and does not lead to miscarriage. Any heavy bleeding or leakage of fluid more than semen should be reported to your physician. It is natural to begin having breast discharge later in pregnancy. Some women may have milky breast secretions during orgasm later in pregnancy.
Talk about it
Women’s emotional and physical bodies undergo incredible change during pregnancy. In regards to sex, women may notice increased vaginal 
lubrication, engorgement or swelling of the genitals, and a change in the character of orgasm. Some women experience more intense and more frequent orgasms during pregnancy. Despite these positive effects, women may be less interested in sex at times.
During the first trimester, women have increased fatigue and may be battling morning sickness, both of which can decrease desire. By the second trimester, women are feeling better, but their bodies have begun to change with a noticeably growing belly. Towards the end of pregnancy, women experience increased pelvic pressure and general discomfort. Given all the physical and emotional factors that affect a woman’s desire to have sex, it is important for partners to communicate their changing expectations for sex during pregnancy.
Mama Sutra
For the times when it feels right, couples will certainly encounter the need to change positions to accommodate for the baby on board. The missionary position or woman lying on her back is difficult by the second trimester due to blood flow requirements of the growing uterus. The following positions are recognized as more conducive to comfortable intercourse while pregnant: woman on hands and knees, couple spooning, partner lying or sitting with woman on top, and partner behind with woman side lying with knees drawn to chest. If the woman experiences vaginal dryness during pregnancy, water-based lubricants are best. In regards to alternative forms of intimacy, manual or oral stimulation of the clitoris and vagina are safe in most pregnancies. Sexual accessories such as vibrators and dildos can be safely used during pregnancy. Patient’s advised to avoid vaginal or anal sex should also avoid insertion of these devices.
Slow down Mama
Although sex is safe in the majority of pregnancies, there are conditions in which your physician may advise abstinence. In the first trimester, these may include women experiencing bleeding or threatened miscarriage, a history of cervical incompetence, or immediately following a surgical procedure such as a colposcopy or cerclage. Some physicians may instruct patients with a history of preterm labor, threatened preterm labor, or a dilated cervix to avoid vaginal intercourse. All women with ruptured amniotic membranes or a placenta previa (placenta covering or near the cervix) should abstain from any penetrative intercourse.
Sex induced contractions
At the end of pregnancy, many women are anxious to deliver and inquire into “natural” methods for inducing contractions. Many cultures believe that sex and orgasm can induce labor. I have reviewed the research available for term pregnancy and induction. At this time, there is little to no evidence to suggest that vaginal sex with a male partner can lead to labor or decrease length of pregnancy. Orgasm and nipple stimulation have been shown to cause contractions, but do not necessarily lead to labor. For those healthy women who wish to try anyway, we say “go for it.”
by: Gweneth Lazenby, M.D.
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