Sex During Pregnancy

• Introduction
• Changes in Libido
• Safety
• Talking to your Health Practitioner

Introduction

Sex during pregnancy is safe and enjoyable for the vast majority of couples. However, pregnancy is a time of many changes, both physical and emotional. These changes may alter a woman’s sexual interest or desire. In addition, physical discomforts of pregnancy or fears of harming the baby can affect a couple’s sexual relationship.

Changes in Libido

Many women experience changes in sexual desire and interest during pregnancy. Some factors which may play a role in changing sexual desire include:

• In the first trimester: fatigue, morning sickness (vomiting or nausea) can reduce interest in sex;
• In the second trimester: increased pelvic blood flow and increased breast size can increase interest or pleasure in sex;
• In the third trimester: fatigue, backache, or physical discomfort during sex can again reduce interest.

Overall, most (but not all) women experience a decrease in sexual desire as their pregnancy progresses. This is normal, and in most cases sexual desire returns to normal some time after delivery. (see Sex After Childbirth). Other women experience no change in sexual drive or even an increased interest in sex during pregnancy. This, too, is normal and healthy. Men may also experience changes in libido throughout a partner’s pregnancy. These may include increased arousal due to the physical changes occurring in his partner, or fear and anxiety about harming the baby or becoming a father. Whatever changes occur, it is important for a couple of be able to openly discuss sexual matters throughout pregnancy. Rapid physical changes can mean that something enjoyable and comfortable one week is painful the next. If sexual interest or desire decreases, couples may be able to explore other options for non-sexual closeness, such as cuddling or massage.

Safety

For the vast majority of women, sexual intercourse and orgasm are safe during pregnancy. Some exceptions do apply. Sex may not be safe if a woman has:

• Unexplained vaginal bleeding;
• Abdominal pain, cramping or contractions;
• Ruptured membranes (ie. if her waters have broken);
• Premature dilation of the cervix; or
• Any other factor placing her at high risk of premature labour (eg. a past history of premature delivery, or a multiple pregnancy).

If you experience any of these, or have any concerns, contact your health professional for advice. Without any of these risk factors, however, sex is safe throughout pregnancy, including during the third trimester. While many women believe that intercourse during pregnancy may ‘bring on’ premature labour, this is not true. In fact, some studies have even shown that sex during pregnancy may reduce the risk of premature labour! Sex while pregnant cannot harm the baby; the foetus is protected by the mucus plug of the cervix. Some safety concerns do still apply.
Sexually transmitted infections (such as HIV or gonorrhoea) can still be caught while a woman is pregnant, and the infections may place the baby at increased risk of early labour, infection or death. The use of barrier protection such as condoms remains important. In addition, many women find that certain sexual positions are uncomfortable, particularly as their pregnancy progresses. Some practitioners recommend avoiding the ‘missionary position’ (with the woman lying flat on her back) during the third trimester, due to the risk that the pregnant womb may compress blood vessels returning blood to the heart. Other positions may be more appropriate and comfortable.

Talking to your Health Practitioner

Many women find discussing sexual matters with their health practitioner very uncomfortable. However, if you have any questions regarding the changes you are experiencing, your health practitioner may be the best person to respond to your concerns. If he or she does not raise the subject of sex during pregnancy with you, do not feel embarrassed about bringing it up yourself. Your questions about sex are as valid and important as questions about other aspects of your health.

References

1. Bartellas E, Crane JM, Daley M, Bennett KA, Hutchens D. “Sexuality and sexual activity in pregnancy,” British Journal of Obstetrics and Gynaecology. 2000;107(8):964-8
2. Byrd, JE et al. “Sexuality during pregnancy and the year postpartum,” The Journal of Family Practice. 1998;47(4):305-8
3. De Judicibus M, McCabe MP. “Psychological factors and the sexuality of pregnant and postpartum women,” The Journal of Sex Research. 2002;39(2)94-103
4. Read JS, Klebanoff MA. “Sexual intercourse during pregnancy and preterm delivery: Effects of vaginal microorganisms,” American Journal of Obstetretics and Gynecology. 1993;168:514-9
5. Sayle AE et al. “Sexual activity during late pregnancy and risk of preterm delivery,” Obstetrics and gynecology. 2001;97(2):283-9
6. Trutnovsky G, Haas, J, Lang U, Petru E. “Women’s perception of sexuality during pregnancy and after birth,” The Australian and New Zealand Journal of Obstetrics and Gynaecology. 2006;46(4):282-287
7. Von Sydow, K. “Sexuality during pregnancy and childbirth: a meta-content analysis of 60 studies,” Journal of Psychosomatic Research. 1999;47(1):27-49