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Sex during pregnancy: When is it safe?

Sex during pregnancy: When is it safe?

8 min read

If you're pregnant and curious about whether or not it's okay to continue some form of sexual intimacy, depending on your pregnancy, sex can be a good and safe outlet for you.

In this article, we'll guide you through what research and experts have to say about sex during pregnancy, risks to watch out for, tips on how to maintain sexual activity as your body changes, and what to expect after giving birth.

The big picture

  • Sex is a safe activity throughout most pregnancies, but your libido and comfort level with sex may ebb and flow during the three trimesters.
  • Folks experiencing complications like placenta previa or bacterial tract infections, or who have a history of preterm labor or miscarriages, should consult their healthcare providers before engaging in any type of sex.
  • Although penetrative sex (aka vaginal sex) and orgasms can cause minor uterine contractions, there's no evidence to suggest either are strong enough to induce labor.
  • There's no general rule for when it's safe to return to sex after giving birth. It's common to wait 3-4 months before resuming any sexual activity.
  • Sex can be uncomfortable or painful postpartum, but lubricants and kegels can help.

Is sex during pregnancy safe?

There are lots of myths around this topic, from sex causing miscarriage (not true) to sex harming the uterus (also false). The truth is that sex, including penetrative, oral, anal, and masturbation, can be a healthy part of most pregnancies.

The muscles of the uterus and the amniotic sac were designed to protect the fetus as it develops. And the cervix acts as an additional barrier between the uterus and any vaginal activity.

According to Dr. Jenn Conti, OB-GYN, medical advisor for Modern Fertility, and adjunct clinical assistant professor at Stanford University School of Medicine, "Sex in pregnancy is absolutely safe, provided there aren't specific concerns about issues like preterm birth, placenta previa, or vaginal bleeding present. You may find that certain positions are more comfortable than others, particularly with a growing belly, and good communication with your partner is key to keeping things enjoyable."

It's still important to take precautions against sexually transmitted infections (STIs) and urinary tract infections (UTIs). Being pregnant doesn't protect you from STIs, which can cause health problems for both you and the fetus. The Mayo Clinic advises using a barrier method of contraception (i.e., condoms, dental dams) if you're having sex with new or multiple partners, or if your current partner has been diagnosed with an STI. (Keep in mind that STIs can be spread through oral and anal sex, too.)

It's also important to maintain proper hygiene (like washing sex toys after use) to prevent bacterial and yeast infections which can cause complications during pregnancy.

The American Pregnancy Association (APA) says that anal penetration, whether through a penis, a hand, or a toy, increases the risk of contracting a digestive infection such as Giardia or Group B Streptococcus. Using lubrication and thoroughly cleaning the penis or toy before switching from anal to vaginal penetration can help decrease the risk of infection.

Are there times when sex during pregnancy isn't safe?

There are specific situations when a healthcare provider might suggest avoiding penetrative sex during pregnancy:

  • If you've experienced unexplained vaginal bleeding
  • If you have leaking amniotic fluid
  • If you have placenta previa — when your placenta covers your cervical opening
  • If you have a lower genital tract infection, like mycoplasma hominis or trichomonas vaginalis (research has shown an increased risk to preterm labor)
  • If you have a history of preterm labor

In any of the above circumstances, talk to your healthcare provider before having penetrative sex.

Dr. Jenn Conti explains further: "There is no evidence that sex increases the risk of miscarriage or preterm labor. With preterm labor, we ask people to avoid intercourse because orgasm can lead to preterm contractions or infection if the cervix is prematurely open."

Is bleeding after sex during pregnancy "normal"?

Bleeding after penetrative sex is common during pregnancy. There's an increased blood flow in your vagina, labia, and cervix which can cause an increase in the fragility of those tissues and lead to light bleeding.

"You should check in with your provider about any vaginal bleeding in pregnancy," says Dr. Conti. "Sometimes it's nothing, but sometimes it's a sign of issues like preterm labor or problems with the placenta. It's never wrong to err on the side of caution and check in."

How can sex during pregnancy feel different?

During the first trimester: There's often a decrease in an interest in sex during the first trimester as a result of fatigue, nausea, and other physical and emotional changes.

During the second trimester: By the second semester, things can change. Many pregnant people will experience an increase in sexual interest again. During this period, there's often an increase in energy and overall health. Your estrogen levels will continue to rise which leads to more blood flow to the vulva that can increase sensitivity and pleasure during sex.

During the third trimester: By the third trimester, we generally see a decrease in sexual interest again, especially in the last weeks leading up to delivery. Due to the fetus' growing size and lowered position, folks tend to feel less comfortable. There can be more overall pain and discomfort, such as backaches and increased pressure on the bladder.

While you're in these phases, different sex positions or even types of physical intimacy may be more comfortable and pleasurable than others — like oral sex, cuddling, or sensual massages.

Also note, that any and everything is possible depending on the pregnant person and if your sex drive doesn't rise or fall as detailed above, it doesn't mean that anything is necessarily "wrong."

"Another less talked about phenomenon is the impact that the changing body has on sexual desire," says Dr. Conti. "We are so ingrained with societal ideas of the ideal body image, that it can be difficult for many folks to adjust to their growing belly and its association with their perceived sexual desirability or overall body confidence. The truth is — the pregnant body is powerful and beautiful, and absolutely okay to view in both a motherly and sexually desirable form."

Can penetrative sex during pregnancy trigger labor? What about orgasms?

No — there's no evidence to suggest that sex or orgasms can trigger labor. While it's true that nipple stimulation, orgasms, and specific hormones found in semen (prostaglandins, which are structurally similar to some interventions doctors use to induce labor) can cause uterine contractions, the effects of these activities are too small to initiate premature labor, according to OB-GYN and research scientist Dr. Jonathan Schaffir, MD.

How long after birth is it okay to have sex again?

There's not a specific time frame when it's safe to start being intimate again with a partner after birth — it depends on your unique circumstances (including any complications you may have experienced). But healthcare providers tend to recommend waiting “four to six weeks after delivery, regardless of the delivery method.” And if you’ve experienced vaginal tears, you'll need to wait until they’ve healed.

But just because you're medically cleared to be sexually active again doesn’t mean you're necessarily ready for it (either emotionally or physically) — when you start again is up to you. According to a large medical review, 90% of individuals started having sex three or four months after pregnancy.

Following birth, you may also experience pain during sex or find that sexual activity feels different than it used to. Reduced estrogen levels, especially if you're breastfeeding/chestfeeding, can lead to vaginal dryness and tenderness. Pregnancy and labor can also weaken and injure the pelvic floor muscles. Over-the-counter lubricants and pain-relievers can help with discomfort during sex and Kegel exercises can help to restrengthen the pelvic floor muscles. If this doesn’t work, some providers even offer the same estrogen cream that can be helpful to people going through menopause (another time when low estrogen can make the vaginal tissue drier).

According to Dr. Conti, go directly to your healthcare provider if you have questions about sex after delivery. "No question is off-limits," she says. "Do not be afraid to speak up with your provider about any concerns you may have resuming sexual intercourse after birth. I like to have partners actively listening for this part of the visit as well, as they too often have questions. Like with sexual health before baby, good sex goes hand in hand with good communication, and facilitating any of these concerns between partners can be helpful."

What sex during pregnancy is like for 3 Modern Community members

We wanted to hear from pregnant people themselves what the experience of having sex was like while pregnant, so we turned to the Modern Community — our online space for unfiltered convos about fertility, overall reproductive health, and pregnancy.

Katie, who's 34 and at 19 weeks of pregnancy, says that sex during pregnancy has been pretty "infrequent." "It hasn't been bad, per se," she explains, "it just doesn't happen as often as it used to between the hormones and the fatigue." Katie's sex drive took a "complete nosedive" during her first trimester. While that hasn't changed in the second trimester, she's hoping it will by the third. One upside to this shift, though, is that Katie's husband "seems more in tune with my needs and making sure I'm comfortable during sex, which has been great!" She's thankful that in her first prenatal appointment, her midwife proactively cleared up any fears about sex hurting the fetus and recommended she and her husband's sex life could continue on as usual.

32-year-old Lena is 11-weeks pregnant, but up until about 9.5 weeks, spotting after sex made her feel nervous. "Now that I'm a bit further along, I haven't noticed any spotting, which is great!" she says. "However, the nausea that’s been kicking up both in the morning and before bed has become a bit of a deterrent." Lena says she's usually interested in sex, but her drive has definitely changed. When she's feeling in the mood, she and her husband "take advantage." Lena's doctor has helped her feel comfortable with sex during pregnancy by normalizing occurrences of spotting and shifting sex drive.

Another Modern Community member who's also 34 says that sex during pregnancy has been a little complicated. "I live at my parents' right now, so I can't have as much sex as I'd like," she explains, "but the sex itself hasn't changed." She and her partner are still having sex a few times a week, but she acknowledges that her favorite positions might be a bit trickier later on in her pregnancy. As for sex drive? That definitely went up — though it goes down a few days throughout the month. While she hasn't talked with her doctor about sex while pregnant, "I'm just listening to my body and doing what feels right," she says.

The bottom line: Sex and other forms of intimacy are safe during pregnancy for most people

Sex in its many forms can continue to be a way that you destress or connect to your partner throughout pregnancy. The most important things are to continue regular check-ups with your healthcare provider to safeguard against complications and to listen to your body. Also, remember that sex isn't the only type of intimacy out there — this can be an opportunity to experiment with different types and find what feels right for you and your partner (if you have one).

If you're pregnant and looking for a supportive online space to talk sex, your health, or anything else you're thinking about, the Modern Community has dedicated channels for the #first-trimester and #pregnancy-and-beyond. Send a request to join our Slack community and get connected with pregnant people all across the country.

This article was medically reviewed by Dr. Jenn Conti, MD, MS, MSc.

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Jera Brown

Jera Brown is a sexuality columnist, editor for the Chicago-based feminist publication Rebellious Magazine, and web editor for Sacred and Subversive — a blog that explores queerness and faith.

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