Pregnancy is an adventure unlike any other. Your body will go through some incredible changes, and you’ll have questions as your belly grows—including plenty about having sex while pregnant.
Here’s some great news: Sex is perfectly safe during most pregnancies, so you shouldn’t hold back if you’re in the mood. (And surprisingly, you may even find yourself feeling super turned on!)
In addition to relieving the stress that comes with pregnancy, having sex is a great way to strengthen and maintain the emotional connection you have with your partner, which can be tough to do during this hectic time, says Leah Millheiser, M.D., F.A.C.O.G., board-certified ob-gyn at Stanford Health Care and clinical professor of obstetrics and gynaecology at Stanford Medicine.
But understandably, there are moments when sex will be the last thing on your mind, and you may have to fight the urge to scream if anyone tries to come near you. Here’s why all of this is totally normal, plus everything you need to know if you end up giving pregnancy sex a go.
First, why can your libido change during pregnancy?
Feeling very pregnant and horny? That’s actually pretty common. “Some people feel pregnancy is a sexual condition,” says Brian Levine, M.D., board-certified ob-gyn and New York practice director for the Colorado Center for Reproductive Medicine. Yes, that means you might feel super ready for sex while expecting, and you can thank your fluctuating hormones for part of that. During pregnancy your body ups its levels of oestrogen, progesterone, and a hormone called human placental lactogen (hPL), but the MVP in this game is testosterone, according to Jamil Abdur-Rahman, M.D., board-certified ob-gyn and chairman of obstetrics and gynaecology at Vista East Medical Center in Waukegan, Illinois. “Your testosterone levels increase during pregnancy, so some women find their libidos go through the roof,” he says.
Sex can also feel better during pregnancy since “there’s a tremendous increase in blood supply to the uterus, cervix, and vaginal area,” Dr. Abdur-Rahman says. That helps your nether regions feel more sensitive than usual. Plus, thanks to that increased blood supply, you may find it’s easier to get naturally lubricated as the action goes down.
Plus, if you’re in a monogamous relationship, you probably don’t have to worry about barrier methods like condoms, which can add an exciting sense of freedom and intimacy to your sex life. And revelling in the way your body changes during pregnancy can make you feel physically tuned in and in awe of what you’re capable of—both of which are pretty great feelings to get you in the mood.
With that said, pregnancy isn’t all horniness and rainbows. When you’re not feeling well, doing what got you into this situation in the first place may not sound remotely appealing. Maybe you’re in your first trimester and dealing with morning sickness. Or maybe you’re in the third trimester with a belly that’s basically rendered you immobile. Or maybe you just don’t feel sexy at times, which is a common issue Dr. Abdur-Rahman discusses with his patients. All of this is normal, so your desire for sex may simply wax and wane.
Are there general risks or side effects to be aware of when having sex while pregnant?
If you’re not in a monogamous relationship and have a normal pregnancy, feel free to have sex as long as you use protection, like a condom or a dental dam, as increased blood supply to your uterus and cervix could make it easier for a sexually transmitted infection to get into your bloodstream, Dr. Abdur-Rahman says. Using protection not only helps keep you safe, but it also helps protect your baby since some STIs can be passed from mother to child, according to the U.S. Office on Women’s Health.
Then there is one major thing to avoid: Make sure your partner never blows air directly into your vagina, which could potentially happen if you’re receiving oral sex, Dr. Abdur-Rahman says. Forcing air into a pregnant person’s vagina can lead to an air embolism,1 a dangerous condition that happens when an air bubble enters a blood vessel. The chances of this happening are extremely rare, but better safe than sorry.
When should you stop having sex once you’re pregnant?
As long as you have a normal pregnancy, you can typically continue having sex (just note that it’s always good to check in with your ob-gyn first). Dr. Abdur-Rahman actively tells his patients that pregnancy sex is generally safe, mainly due to all the late-night calls he’s received from confused and worried moms to be.
“If you have a normal pregnancy and you’re considered low risk, there’s no reason you can’t have sex as long as you’re comfortable,” says Salena Zanotti, M.D., a board-certified ob-gyn at the Cleveland Clinic.
However, there are times when you should definitely talk to your doctor about whether it’s safe for you to have sex while pregnant. According to the Cleveland Clinic, these include the following:
You’ve had a prior premature labor: During an orgasm, your brain releases oxytocin, which can stimulate contractions. If you previously had a preterm birth, then your doctor may say it’s safest to avoid sex during certain periods of pregnancy.
You have placenta previa: This happens when your baby’s placenta covers part or all of your cervix, per the Mayo Clinic. In this case penetrative sex may damage the baby’s placenta and cause a lot of bleeding, as the condition already ups the risk of preterm birth or severe bleeding during labor. Which brings us to our next point….
You have a lot of vaginal bleeding: Many people bleed during pregnancy, and sometimes it’s completely harmless. Spotting may freak you out, but it can happen after sex during pregnancy because the cervix is engorged with blood vessels, says Dr. Levine. You don’t necessarily need to panic at the sight of blood, but it’s best to call your doctor about any spotting. And if you’re bleeding heavily, you really want to get medical care as soon as you can just to be on the safe side.
You experience leaking from your vagina: This could signal that the wall of the amniotic sac surrounding your baby may have ruptured. If that happens, you could develop a bacterial infection from having sex during this time. Call your doctor if you have any leakages to make sure it’s nothing too concerning.
You have a sexually transmitted infection: If you get an STI during your pregnancy, talk to your ob-gyn about the best way to handle it. Be prepared to avoid having unprotected sex until you’ve been treated, since an STI can potentially harm your baby.
You feel a lot of pain: Prostaglandins, chemicals found in semen, can lead to some normal uterine cramping for around 20 to 30 minutes after having sex while pregnant, Dr. Abdur-Rahman says. However, he tells his patients to make an appointment if the cramps are persistent or very painful, just to be safe.
Are there certain pregnancy sex positions that feel best?
Both penetrative sex and oral sex during pregnancy are generally safe (as long as you ask your ob-gyn about whether or not you should consider barrier methods first, as we mentioned). If you have a normal pregnancy, sex can’t somehow upset or “scar” the baby. And you won’t be “poking” it either, because your cervix helpfully keeps things like your partner’s penis or sex toy from coming into contact with your uterus.
And you definitely don’t have to worry about the baby being aware that you’re even having sex. “The baby is gleefully floating around in the amniotic fluid and won’t know what’s going on,” Dr. Millheiser says. Many of her patients worry about miscarriage during the first trimester, and they’re extremely cautious of anything that might “jeopardize” the pregnancy, but Dr. Millheiser assures people that sex won’t interfere with their baby’s well-being.
Of course, the best sex positions during pregnancy are the ones that feel best for you, but as your belly grows, you may need to get a bit creative. “Around 20 weeks, your uterus is at your belly button, and it keeps going up from there,” Dr. Abdur-Rahman says. As it shifts up and expands throughout your pregnancy, you might find that missionary position gets less and less comfortable. Instead, you could try other sex positions that don’t put as much weight on your belly (like doggy style or woman on top), according to Dr. Abdur-Rahman. Really, it’s about experimenting to figure out what makes you feel good.
Another thing to keep in mind as your pregnancy continues is that you should generally avoid hanging out on your back, including during sex. “The uterus gets so large that it presses against a vein in the abdomen called the inferior vena cava, which sends blood from the lower body to the heart,” Dr. Abdur-Rahman says. Pressure on the inferior vena cava can obstruct the blood flow, making you dizzy and causing low blood pressure.
If you are going to lie on your back (and take this as a general suggestion, not medical advice), make sure you’re leaning more toward your left side than your right. “The inferior vena cava is on your right and the aorta [the largest artery in your body] is on your left,” Dr. Abdur-Rahman says. “Veins have thinner walls than arteries, so they’re more easily compressed,” he explains, meaning that your aorta can continue the blood flow better than your inferior vena cava. But when in doubt, check in with your doctor about this (or any other pregnancy sex position questions you may have). A good ob-gyn will be more than happy to help you figure it all out.
Can having an orgasm induce labor?
It’s true that certain things, like nipple stimulation or orgasm, can lead to cramps or contractions, and this can feel a bit freaky if you’re not expecting it. However, Dr. Zanotti says those contractions aren’t likely to result in preterm labor if “your body isn’t ready” to have the baby yet. Anecdotally, many people swear that sex has kick-started their delivery, but there isn’t any concrete evidence to support that this method actually gets the baby moving, per the Cleveland Clinic.
What happens to the sperm when a person is already pregnant and having sex?
According to Dr. Zanotti, if your partner ejaculates inside of you during pregnancy sex, the sperm won’t somehow reach the baby or harm it in any way. “It can’t penetrate the amniotic sac,” she says.
The sperm will most likely come out of your vagina with the semen when you stand up or urinate, she explains. Some sperm, theoretically, could get into your fallopian tube. However, being pregnant increases your levels of the hormone progesterone, which immobilises and kills sperm so they can’t even come up inside your cervix.
In very rare cases—in fact, it’s so rare that there isn’t enough data showing how often this happens—there may be the possibility of a second conception, known as superfetation.2 Experts aren’t sure why this happens, but some people might still ovulate very early in their pregnancy (as in, the first few weeks) so another egg could be released and fertilised by the sperm. But again, this is really unlikely.
How soon can you have sex after giving birth?
Generally, your doctor should keep you in the loop about when it’s safe to have sex after giving birth. “By five or six weeks postpartum, everything is usually healed, and we’ll usually clear people then,” Dr. Zanotti says.
But this timeline really depends on a few factors, such as whether you delivered vaginally or via C-section and if you experienced any injuries, such as vaginal tears, which means you might need to wait longer as your body heals.
Even if your ob-gyn gives you the go-ahead to have sex, you may simply not feel like it, and that’s your decision to make. Being a parent can be a huge transition from the life you’re used to, so you’ll probably be a bit stressed and exhausted at first. Postpartum depression—which affects up to one in seven people who give birth—can also tank your sex drive for a little while.
Changes in your body might also make sex less enjoyable or even painful, particularly if you’re nursing your baby. “Breastfeeding lowers your natural oestrogen and testosterone, which will oftentimes lead to vaginal dryness” Dr. Millheiser says. This, in turn, can cause pain during sex.
So if you really want to get intimate with your partner, you may just need to ease back into things with plenty of foreplay and lubricant to make sure you’re having the best experience you can. “If it’s still painful, definitely talk to your clinician, get checked out, and make sure it has nothing to do with the healing process,” Dr. Milheiser says.
After all, having a baby is both exciting and exhausting, so it’s important you take all the time you need to physically and emotionally recover before you get back into bed.
American Journal of Emergency Medicine, Venous Air Embolism Following Orogenital Sex During Pregnancy
Unpredicted Ovulations and Conceptions During Early Pregnancy: an Explanatory Mechanism of Human Superfetation
This article was originally published on Glamour UK.