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).
Once you are cleared by your provider to resume sex after delivery, it should not be painful! If sex is painful after pregnancy, this is a sign that your pelvic floor muscles are not working properly. Seeing a pelvic floor physical therapist can help address any issues that may be causing this to allow for you to return to enjoyable sex with your partner. We have a course about returning to pain free sex after having a baby that you can find here, or read our book Sex after Baby: Resume intimacy with confidence and ease.
Here are some great resources to help manage your pregnancy and take good care of your pelvic floor:
Ask your healthcare provider for a referral to a pelvic therapist.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Watch our YouTube playlist on Pregnancy and Your Pelvic Floor
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
Sign up for our email newsletter!
Check out our Amazon Store for pregnancy and postpartum items.
Watch a quick video to learn about your pelvic floor.
For providers, check out these courses to help your clients during their pregnnacy. Consider joining our Ambassador Program and most of our courses are included with your membership!
Prep H: Hemorrhoids in Pregnancy and the Postpartum Period with Lacey Forsyth BA (Hons); MA; MPT
Pregnancy, Hormones, and Pelvic Health with Dr. Jill Krapf MD, Med, FACOG
Pacifying Pregnancy Pain (Part 1) with Dr. Caitlin McCurdy-Robinson PT, DPT
Labor and Birth: Preparing the Pelvic Floor with Melissa Dessaulles, PT
What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.
Written by Emily Reul, PT, DPT
References
1. A partner’s guide to pregnancy. The American College of Obstetricians and Gynecologists website. https://www.acog.org/womens-health/faqs/a-partners-guide-to-pregnancy. Published April 2019. Accessed March 25, 2021.
2. Is it safe to have sex during pregnancy? The American College of Obstetricians and Gynecologists website. https://www.acog.org/womens-health/experts-and-stories/ask-acog/is-it-safe-to-have-sex-during-pregnancy. Published February 2021. Accessed March 25, 2021.
3. Fuchs A et al. Sexual functioning in pregnancy women. Int J Environ Res Public Health.2019;16(21):4216.
4. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 43 Management of preterm labor. Obstet Gynecol. 2003;101(5):1039—1047.
5. Ellings JM, Newman RB, Bowers NA. Prenatal care and multiple pregnancy. J Obstet Gynecol Neonatal Nurs. 1998;27(4):457-465.
6. Newman RB. Obstetric management of high-order multiple pregnancies. Baillieres Clin Obstet Gynaecol. 1998;12:109-129.
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