Sex during pregnancy: Q&A

Many couples who are expecting a child have questions about their sex life. We discuss some of the most common issues in this article.

Can you have sex during pregnancy?

Most couples can safely continue to have sex during pregnancy. Orgasm and breast stimulation may cause the uterus to contract, but if the pregnancy is going well, there is no risk of miscarriage or premature delivery. Contractions, however, are sometimes accompanied by bleeding, which may worry the couple.

It’s important to note that the penis does not touch the baby during penetrative sex. The baby is well protected by the uterus and the amniotic membrane. Furthermore, the mucus plug at the entrance to the cervix prevents bacteria and semen from reaching the uterus.

Some people worry that prostaglandins, the hormones found in semen, may trigger premature delivery. However, the presence of the mucus plug prevents sperm from entering the cervix. This may change in the final weeks of pregnancy as the cervix begins to open; your doctor or midwife will tell you if you need to minimize vaginal sex at this point. Similarly, if your cervix is open during your pregnancy, rest—including a break from sexual activity—will likely be recommended.

To be safe, it’s best to stop sexual activity if you feel any pain or discomfort. Should this happen, be sure to speak to your doctor to determine the cause. While it may be something as harmless as vaginal dryness, pain can also signal cervical contractions, in which case your doctor or midwife will need to assess your pregnancy risk.

When should I avoid vaginal sex?

A health care professional may recommend avoiding vaginal or other forms of penetrative sex in the following circumstances:

• You’ve noticed bleeding or amniotic fluid loss.
• You experienced preterm labour in a previous pregnancy. The oxytocin released during orgasm causes uterine contractions, which can trigger preterm labour.
• The membranes that protect the baby have ruptured. In this situation, vaginal sex is dangerous because it increases the risk of infection.
• The placenta is sitting too low. This can lead to heavy bleeding and preterm birth. It can also occur even if you avoid vaginal sex.
• You’re carrying multiple babies. Your doctor may suggest that you stop having sex sooner.
• Your doctor has asked that you take a break from everyday activities. This usually includes putting sexual activity on hold.

Does a woman’s sexual desire change during pregnancy?

Every pregnancy is unique. A pregnant woman’s feelings about sex may change over time. Pregnancy may or may not affect sexual desire, need, and satisfaction. Feelings and reactions to sex can shift with each trimester.

Here are some of the common changes that pregnant women experience:

• Exhaustion, hormonal surges, hypersensitive breasts, and discomfort caused by weight gain, all of which can affect libido.
• Many women find that the hormones activated in pregnancy actually increase their sex drive, leading some couples to have sex more often during pregnancy. Other women become more interested in masturbation to satisfy these new, more physical urges. Their new-found curves can also make pregnant women feel more desirable.
• Some women experience breast pain or hypersensitivity. If you notice this symptom, encourage your partner to explore other parts of your body.
• Increased blood flow to the pelvis can cause genital swelling, which increases sensitivity. Some women enjoy this sensation, while others find it uncomfortable.
• Some women experience vaginal dryness and a decrease in natural lubrication. There are a number of lubricants available in pharmacies that can help with this issue. Talk to your doctor or pharmacist to find the best solution for you.

Sexual desire by trimester

First trimester

Due to the discomfort associated with early pregnancy (e.g., fatigue, nausea, tender breasts), many women lose interest in sex during the first trimester. That said, cuddles and touching in areas other than the breasts may feel good. The risk of miscarriage in the first trimester may be a source of worry and can inhibit a woman’s desire for sex.

Second trimester

The discomfort that many experience in the first trimester often recedes in the second trimester, which may lead to a higher sex drive. Sexual desire may also get a boost from increased blood flow to the vagina and increased vaginal discharge. Some women may even experience greater sexual satisfaction than pre-pregnancy.

On the other hand, some women feel less attractive because of their growing belly and are less interested in sex. Fatigue, having to look after their other children, and the sometimes changing gaze of their partner can also affect sexual desire. A pregnant woman may also feel more attractive and feminine because of her more generous curves. Sharing the joy of pregnancy with the person you love can also foster intimacy.

Third trimester

A woman’s libido often decreases during the third trimester because of the baby’s increasing size and the discomfort that comes with it. You may experience shortness of breath, fatigue, a more frequent need to urinate, leg cramps, and pressure in your pelvic area as the baby descends into the pelvis.

Toward the end of pregnancy, however, some women experience stronger orgasms, which can lead to greater sexual pleasure. Furthermore, oxytocin—a hormone released during orgasm—causes uterine contractions, which can speed up labour at the end of the third trimester. These contractions may also cause cramping after the orgasm. This is a normal phenomenon.

Does a man’s sexual desire change during pregnancy?

Sometimes a man’s sex drive is affected, and sometimes it isn’t. Some men continue to find their partner desirable as her body changes throughout the pregnancy, potentially even finding her more attractive.

However, a man’s level of desire may change for a number of reasons: fear of hurting the baby, changes in his partner’s appearance, difficulty imagining his partner as a sexual being while carrying a child, etc.

Many men refuse to talk about this subject. Some women have an easier time accommodating the change because their own libido has taken a hit. Others have difficulty accepting it. If this is the case for you, talk to a health care professional. You might also consider a few sessions of couples therapy to discuss the issue and come up with solutions.

Are some sexual positions more comfortable than others during pregnancy?

For penetrative sex, there are a multitude of possible positions. Depending on the trimester, a woman may find some more comfortable than others as her uterus expands. Once in your fourth month of pregnancy, for example, it’s recommended to place a pillow under your right hip when lying on your back in missionary position. This adjustment will prevent any dizziness caused by the weight of your uterus on the inferior vena cava.

Other positions may be more comfortable than missionary. Examples include the woman lying on her side or on all fours with the man behind her, or the man lying on his back with the woman astride, facing him.

Couples who practise anal penetration should not alternate with vaginal penetration, as this can introduce bacteria into the vagina that can cause infections.

Sex without vaginal penetration

Vaginal intercourse is not the only way for couples to be physically intimate. If the woman is not interested in penetration, if it causes her discomfort, or if the doctor has recommended avoiding penetration, there are many other ways to show love and give pleasure.

• Baths, gentle massages, touching, and cuddling are all great ways to maintain physical contact with your partner.
• You can also discuss the option of solo or mutual masturbation as an alternative to vaginal penetration.
• Oral sex (e.g., cunnilingus for women and fellatio for men) is another alternative. However, it’s important to note that blowing air into the vagina can be dangerous, especially during the final weeks of pregnancy.

How can I avoid making my partner feel rejected?

Dealing with a lack of sexual desire in a relationship can be difficult.

It is essential that neither you nor your partner interpret these changes in desire as changes in how much you love each other. Pregnancy is a demanding time for both of you, and you need to support one another.

If you’re concerned about your sex life, you need to talk about it. Have an open and loving discussion about your respective needs and concerns, and try to come up with solutions that make you both happy. You can also talk to the doctor who is monitoring your pregnancy or to a sex therapist.

Things to keep in mind

• Most couples can safely have sex during pregnancy.
• Pregnancy can affect desire in both the mother-to-be and the father-to-be.
• Communication is key to adapting your sex life to meet both your and your partner’s needs.

Scientific review: Geneviève Parent, sexologist, psychotherapist, and parental counsellor Research and copywriting: The Naître et grandir team Updated: September 2021

Photos: GettyImages/LSOphoto and GettyImages/Dean Mitchell