B​​eing pregnant does not diminish the desire for intimacy between couples. However many couples have concerns that sexual intercourse may harm the pregnancy in some way. 

Is Sex Safe in Pregnancy? 

Yes, if you are having an uneventful pregnancy. Sex is safe and has no harmful effects on the pregnancy or the fetus. Although there are concerns that the womb may experience contractions after an orgasm, these are harmless in most instances and would not precipitate labor in a pregnant woman. 

Will it Hurt My Baby? 

No, sex in an uncomplicated pregnancy is safe and will not hurt your baby. The baby is surrounded by an “amniotic sac” as well as a thick womb wall which cushions it from any motion. The mucus plug in the cervix prevents any infection from entering the uterus. 

Will My Sex Drive Be Affected in Pregnancy? 

This varies among different women. As a general rule, the sex drive increases in most women in the second trimester as they are able to adapt better physically and emotionally to their pregnancy by then. Some women feel more attractive during pregnancy, and want to be more intimate with their partners. Conversely, some couples may be concerned about the possibility of sex endangering the pregnancy. This results in decreased libido. ​

​Normal pregnancy conditions like nausea, vomiting and tiredness in the first trimester​ may result in the mother feeling less desire for sex. Many women experience increased libido when the first trimester is over. Late in pregnancy, the increasing abdominal girth may make some women physically uncomfortable. They may be more concerned about impending labor, or are just too tired for sex. 

Why is My Partner Not Keen for Sex? 

This could be due to the partner being worried about “hurting” the baby, or harming the pregnancy. If the pregnancy is smooth and uncomplicated, there is no scientific evidence which indicates that sex is unsafe in pregnancy. He may not be used to the physical changes which you are going through. This concern may be more pronounced nearer the end of the pregnancy for fear of hitting the engaged fetal head. It may be a wise option to avoid any intercourse during this time if it gets too uncomfortable for the both of you. 

Alternatively, there are many men who feel an increase in their desire for their partner’s changing bodies during pregnancy, and they may feel an increased need to express their emotions in a physical manner. 

Will Sex Feel Any Different for Me? 

Many pregnant women will feel that sexual intercourse is slightly better due to the increased blood flow in the pelvis, which heightens sensation and increases sensitivity. However, some will perceive this as an uncomfortable fullness in the lower abdomen. Some women may even experience womb cramps after intercourse, especially in the third trimester and this alarms them. Transient cramps after orgasms are normal, but please see your doctor should the cramps get worse in intensity or become more frequent. 

The increased breast engorgement in early pregnancy may result in some tenderness should they be fondled. It may be advisable to omit this from the foreplay with your partner should this tenderness affect you. 

Due to higher estrogen levels, some women experience more vaginal lubrication, which can be pleasurable for some, but increases irritation for others. 

Bleeding After Sex? 

If you develop any bleeding after sex, it is best to see your obstetrician. It may be normal to have a bit of spotting after sex when you are pregnant due to the increased blood flow to the genitals and cervix from the higher levels of the circulating estrogen. However, any bleeding must be fully evaluated by a ​​simple examination and an ultrasound scan to ensure there is no serious cause for it, e.g. threatened miscarriage ​or preterm labor, lesions in the birth canal such as a polyp, or a low lying placenta. 


When Should Sex be Definitely Avoided? 

If you have placenta previa (a condition where the placenta lies over the internal opening of the cervix), avoid penetrative intercourse as this could result in bleeding. If your amniotic sac has ruptured and your waters have broken, avoid intercourse as infection could ascend to your baby. If you are in preterm labor, avoid intercourse as well, as orgasm and chemicals in the semen could increase uterine contractions. 

You should also avoid sex in pregnancy if you have abnormal vaginal discharge, or if either of you has an outbreak of herpes ​or any sexually transmitted infection. Avoid sex in the third trimester if your partner had genital herpes in the past, even if he is now well and has no sores. Avoid receiving oral sex if your partner has cold sores on his mouth.​ 

​​​What are the Comfortable Positions for Sex? 

In later pregnancy, positions like the missionary position might be difficult due to his weight on your abdomen. Deep penetration may also become more uncomfortable in the third trimester. 

Alternatives include lying sideways in the spoon position as this prevents deep penetration. Being on top of your partner allows you to control depth of penetration as well and keeps the weight off your abdomen. 

Having your partner enter you from behind while you are on all fours may also work for you. Having your partner enter you from a sitting position manages to keeps weight off your abdomen as well. Experiment with various positions till you find something that works for the both of you. ​

Is Oral Sex Safe in Pregnancy? 

Yes, it is perfectly safe to perform oral sex on your partner. Avoid having air blown forcefully into you due to the rare possibility of an air bubble developing in a blood vessel in the area. 

Are There Any Alternatives to Intercourse? 

Sexual intercourse is not the only way to convey affection and desire for your partner. Some couples also engage in various other activities like hugging, kissing, massage, oral sex and masturbation. 

Can Orgasms Trigger Premature Labour? 

Mild cramping may follow sexual intercourse and orgasm. Orgasms cause contractions of the womb but these contractions are different from labor pains. Also, this cramping is due to the prostaglandins in semen. If your pregnancy is going well, orgasms don’t lead to premature labour. These crampings, however, should be mild and short-lived. If cramping persists or intensifies to regular contractions, you should contact your obstetrician. 

Should My Partner Use a Condom? 

Condoms are safe in pregnancy and prevent the transmission of sexual diseases from your partner. These diseases can affect you and your baby’s health. If you have a new sexual partner during pregnancy, do consider using a condom when you have sex. 

Acknowledgement

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008. ​

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