Sex During Pregnancy
When you’re pregnant, your interest in sex can change a lot! Some women are more interested, some women less, and some are just worried that having sex may not be ok. Let’s talk about sex during pregnancy, what might be affecting your interest, what is safe, and other common questions our patients ask.
Is it ok to have sex during pregnancy?
For women with an uncomplicated pregnancy, the answer is yes! As long as you feel comfortable and are interested in sex (and your doctor has not recommended against it), go for it! It will not hurt your baby. This includes stimulation, penetration and orgasms.
When is sex not ok during pregnancy?
A complication during pregnancy that would affect whether you should have sex is if you have placenta previa spectrum disorder. If your placenta lies low in your uterus and/or blocks the opening to your cervix, then penetrative sex is not recommended (it is contraindicated).
At your 20-week ultrasound, your provider will look at your cervix. If your cervix appears to be thinner than it should be, your OBGYN may also recommend abstaining from all sexual intercourse.
Another time when your OBGYN may recommend abstaining from sex while pregnant is to help ease your anxiety if you have vaginal bleeding in your first trimester. Intercourse won’t cause a miscarriage, but it could cause more bleeding, which in turn can create unnecessary anxiety. (20% to 35% of women experience light bleeding and spotting in their first twelve weeks.)
If you experience spotting or light bleeding after penetrative sex, but no cramping or pressure, there is little cause for concern. Sometimes, surface vessels in your cervix can rupture during intercourse, which causes bleeding. This is not harmful. If you have not had penetrative intercourse AND you are bleeding, if you experience severe cramps, or if the bleeding is heavy (like your period) then you should contact your OBGYN.
What about orgasms?
Orgasms are ideal at any time of your life! Unless your OBGYN has recommended against it, you are cleared to enjoy orgasms. Every woman is unique in the way she experiences orgasm during pregnancy. For some, it is more intense and for others less so.
Orgasms may also feel different as your pregnancy progresses and your baby grows. Your uterus may lightly contract after you orgasm, much like Braxton Hicks contractions.
If you have a placenta previa and experience bleeding after orgasm, contact your provider.
Benefits of sex during pregnancy
Pregnancy is often a stressful time. It can put a strain on any relationship. Having sex with your partner is one way that you can maintain intimacy during this time.
Oxytocin, which is a hormone that is released when you orgasm, is sometimes called the “love hormone.” It can help you feel closer to your partner. Oxytocin gives you feelings of emotional warmth and love. Some women report it can help ease some pain, such as backaches.
You may have heard that having sex (in this case penetrative heterosexual sex) when you’re close to your due date (or overdue!) could help you go into labor. While this hasn’t been studied closely, anecdotally this could be due to the presence of prostaglandins in semen and in the membranes (bag of water) that sit atop the cervix. Prostaglandins can make the uterus more contractile, but it is not known how many are required or how many are released during penetrative intercourse.
Changes to sex drive during pregnancy
Like so many other experiences during pregnancy, changes to your sex drive are highly individualized. Some women may report a higher sex drive during the second trimester. (Often, by the second trimester women feel more energy and are no longer experiencing the morning sickness associated with the first trimester.)
During the third trimester, especially as the due date approaches, women tend to report decreased sex drive. For some, they simply don’t feel comfortable, they’re more tired, or they may have some vaginal dryness due to changing hormones.
Having a lower sex drive during pregnancy is normal. Remember, intercourse isn’t the only way to maintain intimacy. Being open and understanding in your communication with each other is important. You want to do what you can to solidify your relationship especially as you are heading into the newborn phase.
You can also:
- trade massages
- cuddle or hug (this also releases oxytocin)
- find activities to do together that will be difficult when the baby arrives
- laugh together
Pain during sex while pregnant
If you experience pain during penetrative sex, it could be related to vaginal dryness caused by changes to your hormones. A good lubricant is typically all you need to offset this and make intercourse more comfortable. Visit a local store that specializes in women’s health, or ask your provider for a recommendation. Here in Madison, we often send our patients to A Woman’s Touch.
If the position is uncomfortable, or you don’t feel supported under your belly, experiment with different positions or pillow placements. Clear communication with your partner will help as well.
How soon after giving birth can you have sex?
Physically, your body could accommodate sex as soon as two to four weeks after giving birth. However, that doesn’t mean the rest of you is ready. Your life has just changed drastically with a newborn! In fact, most women do not resume having sex until after their post-partum follow-up appointment around 6 weeks.
If you had a vaginal delivery with no tears, then you could have sex anywhere from two to four weeks after giving birth. If you had any tears (lacerations) that required stitches (sutures), then four weeks would be the earliest you should have penetrative intercourse. This is because the sutures don’t absorb for at least four weeks.
If you had a C-section, then you may be cleared to have sex after two to four weeks.
Read more about C-sections vs. vaginal births.
It’s OK to wait and take it slowly
Most of all, it’s important to wait until you feel ready. Many women wait six weeks or more to have sex after giving birth. Go slowly and make sure it’s the right moment. It’s important that you are aroused. In other words, don’t have sex simply because you feel badly that it has “been a while.”
Arousal causes relaxation of the vagina. But if you’re nervous about having sex, your brain may unintentionally send a message to your muscles — including your vagina — to contract. This could make penetrative intercourse uncomfortable or even painful.
The key to comfortable post-partum penetrative sex is lubrication, especially if you are breastfeeding. This is because when your body is not ovulating, your estrogen levels are low, which leads to vaginal dryness.
In summary, if your OBGYN provider has not recommended otherwise, enjoy sexual intercourse with your partner. If it causes you stress or anxiety, find another way to maintain intimacy with each other. Choose a good lubricant and be creative with positions if you experience discomfort. Finally, make sure you are emotionally and physically ready for sex after giving birth. There’s no rush!
Dr. Beth Wiedel has been providing healthcare to women in Madison since 2002 and is a founding partner of Madison Women’s Health. She shares the vision of all the partners of being a strong healthcare advocate for her patients, emphasizing compassion and communication throughout her practice.