Sexual Intimacy Is Generally Safe During Pregnancy
Sexual intimacy can be part of a healthy pregnancy. Depending on how far along the pregnancy is, some adjustments may need to be made to keep things fun and comfortable.
Avoiding sexually transmitted diseases (STD) is the chief concern when it comes to risks for most pregnancies. If you have a high-risk pregnancy, discuss pregnancy sex risks with your doctor.
Trimesters and Pregnancy Sex
There is very little evidence suggesting that there are risks associated with having sex during pregnancy.1 Despite this, several risk factors may cause doctors to encourage pregnant individuals to abstain from intercourse during the first trimester.2 These include vaginal bleeding and a history of early pregnancy loss.
Although research does not suggest that vaginal intercourse is associated with either of these outcomes, many doctors take a cautious approach to pregnant sex for couples who have experienced one or more losses.
Couples that are non-monogamous or where one has a sexually transmitted disease should be aware that it is important to appropriately manage STD risk during pregnancy. Several sexually transmitted infections have the potential to affect pregnancy outcomes.
If there is any risk of STD transmission during pregnancy, it is advisable to use barriers. Before taking a new sexual partner during pregnancy, STD screening is also a good idea.
Over the course of a pregnancy, certain types of sex can become less comfortable or enjoyable. Couples who wish to continue with sexual intimacy can try different sexual positions to figure out what works best for them as the pregnancy continues to develop.
Positions where the pregnant person is seated or lying on their side may be more comfortable than where they are lying on their back, particularly later during pregnancy.
Risks of Pregnancy Sex
There is remarkably little data about the risks of different types of sexual intimacy during pregnancy. In general, there is no reason to anticipate that sex during a low-risk pregnancy will cause problems, particularly in monogamous couples where both partners have been tested for STDs.
Doctors tend to be more concerned about high-risk pregnancies, but again there is very little data. People who are concerned about pregnant sex should discuss their individual risk/benefit calculations with their providers.
Theoretical risks that people are concerned may be associated with pregnant sex include:3
- Preterm labor: Studies have not demonstrated an increased risk of preterm labor from having sex during pregnancy. The exception is where sexual activity increases the risk of genital tract infections, including bacterial vaginosis, associated with pre-term labor.
- Pelvic inflammatory disease (PID): PID may be a risk for individuals exposed to STDs during pregnancy. PID is associated with an increased risk of pregnancy complications, and pregnant people with PID may need to be hospitalized for antibiotic treatment.4
- Bleeding: No research has demonstrated a risk of antepartum hemorrhage (bleeding after the 20th week of pregnancy) caused by pregnancy sex, although it could theoretically be a risk for those with placenta previa.
- Venous air embolism: This is an extremely rare pregnancy complication where an air bubble gets into the bloodstream. Studies estimate that it occurs in fewer than one in one million pregnancies, although where it does occur it can be fatal.3
Pregnant people are sometimes advised to avoid air being blown into the vagina during oral sex, which could potentially lead to a venous air embolism. Air can sometimes also be forced into the vagina during penile or other penetration.3
Coping With Pregnancy Sex
Sexual desire and interest can change substantially over the course of a pregnancy. For some people, pregnancy may be a time when they feel highly sexual. They may seek out more sexual intimacy with their partners.
Other people may feel less sexual during pregnancy. This can be because of changes in how they feel about their body and their overall sense of wellbeing. It can also be because of increased sensitivity to certain smells, tastes, and sensations that may occur during sex.
Couples for whom sexual intimacy is important should consider exploring different types of sexual intimacy during pregnancy if their usual menu of sexual choices isn’t working as well for them. This can include activities such as mutual masturbation or one partner holding the other while they masturbate.
Couples who want to continue to have intercourse during pregnancy may also need to explore different positions as the pregnant person’s body changes over the course of gestation. It is not uncommon for the frequency of intercourse to decrease, even in couples who continue to be sexually active throughout pregnancy.5
Perineal Massage and Vaginal Birth
Couples experiencing their first pregnancy may hear about the benefits of perineal massage. Perineal massage has been shown to reduce the risk of both an episiotomy and requiring stitches after a tear during delivery.6
Although perineal massage doesn’t have to be sexual, it certainly can be. In many ways, perineal massage is like careful fingering and other types of digital sex. Just make certain that any hands involved are clean, you’re using appropriate lubricant, and you’re not going any faster than is comfortable for the pregnant person.
Research on perineal massage is focused on using the practice once or twice a week, starting at 35 weeks.6 While clear benefits have been shown for people who have not previously undergone a vaginal delivery, that’s less true for those who have.
Still, if it’s something couples enjoy during a first pregnancy, there’s no reason they shouldn’t continue to do perineal massage during later pregnancies.
Can you have sex during pregnancy? Yes, if you want to. Although there isn’t all that much research about sexual activity during pregnancy, most of what’s out there says that pregnant sex doesn’t noticeably increase the risk to either parent or infant.
The exception is where sex during pregnancy can lead to a new infection with herpes, syphilis, or another STD that increases the risk of poor pregnancy outcomes. In a mutually monogamous relationship, where neither partner has an outside exposure, pregnancy sex is generally considered low to no risk.
However, in the case of high-risk pregnancy, couples should consult their doctor before engaging in pregnant sex.
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