• Emily Reul, PT, DPT

Sex During Pregnancy

Hello friends! This week we’re going to discuss the age-old question of “Can I have sex during pregnancy?” So many individuals and their partners are worried about having sex during pregnancy due to fears of miscarriage or causing an early onset of labor.

So is it safe to have sex during pregnancy? In most cases, yes! Unless advised otherwise by your provider, it is safe to have sex throughout healthy pregnancies (ACOG, 2019, 2021).

There are certain high-risk pregnancies where you might be advised NOT to have sex (like if you’re experiencing preterm labor or after 20-24 weeks if you are having twins or higher order multiples (ACOG, 2003; Ellings, 1998; Newman 1998). But it is best to talk with your obstetrician about whether or not your pregnancy is appropriate for intercourse with your partner.

The American College of Obstetricians and Gynecologists supports sex throughout healthy pregnancies, including penetration with fingers, sex toys (ACOG, 2011). In fact, the fetus is protected by the amniotic sac and the strong muscles of the uterus, so there is no need to worry about doing harm to your baby with vaginal penetration (ACOG, 2021).

You may have some cramps (especially after an orgasm) or spotting after penetrative sex. If the cramping is severe or does not go away, or if the bleeding is heavy (like a period) call your obstetrician (ACOG, 2021).

You may or may not feel like having sex—and that’s okay! There are so many changes happening in your body which can make you tired, nauseous, sore, or all of the above. It is common to have a lower sex drive in the first and third trimesters of pregnancy (Fusch, 2019; ACOG, 2021). It is important to be open with your partner and let them know how you are feeling.

While sex during pregnancy is usually safe, it will often look different than sex when you’re not pregnant—especially as you progress farther along. You may need to try new positions as your belly grows and some positions you normally enjoy may be uncomfortable (ACOG, 2019).

During your second and third trimesters, you may need to avoid lying completely flat on your back. Lying in this position for extended periods of time can cause your uterus (with the growing fetus inside) to put pressure on important blood vessels. If this happens, your body will let you know by causing you to become dizzy/lightheaded or nauseous. As an alternative, you can use pillows to support yourself so that you can recline (hallway between sitting and lying on your back).

As your belly grows, you won’t be able to lay directly on it since it is growing bigger and bigger. But there are so many alternatives! Good alternatives to lying on your stomach can include being on your hands and knees, leaning over an exercise ball, or leaning over the bed/furniture.

Experiment (it can be fun!) with your partner to find which positions work best for you throughout your pregnancy. If a position isn’t comfortable for you, talk with your partner and try something new. Watch this video to get some ideas.

While the main purpose of this week’s blog is to talk about sex during pregnancy, I just want to mention sex AFTER pregnancy. There is no set “waiting period” before you can have sex after giving birth (ACOG, 2019). For some it can be as little as two weeks, while others may need to wait 4-6 weeks (ACOG, 2019). Those who have had an episiotomy or tearing may need to wait until fully healed (ACOG, 2019).