8 Questions About Pregnancy Sex, Answered

Pregnancy sex is not only safe, it's encouraged! Here's what's normal and what's not, plus expert advice and tips to make having sex during pregnancy as comfortable and enjoyable as possible.

Pregnant couple sharing a romantic moment
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You've been trying and trying and—finally!—those two lines have appeared on your pregnancy test. Now that the deed is done, you might be wondering: can you have sex while pregnant?

Absolutely, obstetricians say. If your pregnancy is uncomplicated, and you feel up to it, you can dance in the sheets until your water breaks. "We encourage couples to have sex because it helps keep them bonded," says Terry Hoffman, M.D., an OB-GYN at Mercy Medical Center in Baltimore.

Actually, sex can be more fun during pregnancy for some couples who had tried to conceive through sex because the baby-making pressure is off. And if you're part of a heterogeneous couple who has spent most of your reproductive years trying not to get pregnant, well, you're out of the woods there, too. "It was really freeing," says Michele, of San Francisco, mom to 8-month-old Kai. "My husband used to pull out or stop to put on a condom. Once I got pregnant, we didn't have that extra stress."

Ready to get busy? Read on for more answers to your most pressing questions about sex during pregnancy:

1. How Is Pregnant Sex Different?

First of all, sex acts can feel different for the pregnant person thanks to increased blood flow and of course, those famous pregnancy hormones. Your blood volume increases by about 40% during pregnancy, which not only causes swollen breasts, but also heightens sensitivity throughout erogenous zones—and that can mean more intense, even multiple, orgasms.

You'll probably find that your sex drive fluctuates throughout pregnancy; it will likely evaporate during your first trimester when you're tired and nauseated, get livelier in the second trimester when high levels of hormones send your libido through the stratosphere, and then taper off as your due date approaches and you feel achy, unwieldy, and nervous about impending parenthood. "At seven weeks, I felt like crap, and I was not going there," recalls Jennifer, of Downey, California, whose daughter, Megan, is now 2. "But by the second trimester, we acted like we were still dating. I really wanted to be intimate, which was weird for me. We probably had sex six times a week."

Still, the body changes that come with pregnancy can also be a challenge to navigate. Some people may find that physically, things feel different, an experience that can be very normal too. Carla, of Milwaukee, says that when she was pregnant with her daughter Jesse, "it was like I was having sex with someone different. The fit was off, and frankly it just didn't feel that good, so we stopped." The experience was bizarre enough that Carla swore off sex for the rest of her pregnancy—something that's not uncommon.

In fact, 58% of women in a Canadian study reported that their desire dwindled during pregnancy. Partners can be affected, too—there might even be some concern over if they might see and feel the baby move or if they will hurt the developing fetus. While your partner confronts the reality of impending parenthood, concern that the baby is somehow "watching" could take the wind out of their sails. "Most of what causes a change in sex drive is mental and emotional, rather than physiological," says Bruce Rosenzweig, M.D., director of urogynecology at Rush University Medical Center, in Chicago.

2. Is Pregnancy Sex Safe?

Undoubtedly the biggest wet blanket around pregnancy sex is fear of hurting the baby, says Wendy Wilcox, M.D., MPH, assistant professor of obstetrics and gynecology at Montefiore Medical Center, in New York City. Indeed, research shows that somewhere between 50 and 80% of pregnant people worry about that. Partners often also have the same fears about pregnant sex.

So let's just allay that concern right now: Sex in any form doesn't cause miscarriage. If you're having penile-vagina sex or using toys in the vagina, neither will never reach the baby because the baby's not in your vagina. Babies are cocooned in their own little impenetrable vault, within the strong walls of the uterus, behind the cervix and well cushioned by amniotic fluid. If your baby "notices" anything at all, it's probably just a soothing, rocking motion that may even lull them to sleep.

Still, you want to be sensible. "This isn't the time to have the most vigorous sex because you don't want to cause trauma to the vagina or cervix," Dr. Rosenzweig says. You may have to experiment a bit to figure out what works. Using lube or toys such as dildos and vibrators is perfectly safe, says Dr. Hoffman. Just don't push anything too deep or too hard into your vagina, and keep the toys clean to prevent infection.

3. What About Oral Sex During Pregnancy?

Oral sex is okay too. But consider this: As you get closer to your due date, pregnancy hormones and thinning cervical mucus can make things very messy, Dr. Hoffman says. If that doesn't bother your partner, have at it. Just have them avoid blowing into your vagina to reduce the risk of an air embolism, a very rare complication.

There are also a couple of caveats. You should not receive oral sex ending in an orgasm if your OB has put you on "pelvic rest" because orgasms may trigger uterine contractions. Ditto if your partner has a cold sore (aka oral herpes) or feels one erupting. And if your partner has ever had a cold sore, oral sex is completely out in the third trimester because even asymptotic people can still transmit herpes, and then you'd need a C-section to avoid infecting your baby. If you're the "giver" and your partner is STD-free, it's perfectly safe to swallow, Dr. Hoffman says.

4. What Are the Best Sex Positions During Pregnancy?

When it comes to penile-vagina intercourse, doctors often tout pregnant person-on-top, side-by-side, and doggie-style (on all fours or leaning over the bed) positions. Some of these positions may support your belly; others may let you control the depth of penetration, since going deep may not feel good as your pregnancy continues.

By your third trimester, you'll want to skip the missionary position for penile-vagina sex—partly because your belly will get in the way, but also because doctors don't want you on your back. "When you're on your back, the uterus can press on the aorta and the vena cava (the big vein that returns blood to the heart), which can elevate blood pressure and decrease the amount of blood getting to the heart, which then decreases the amount of blood going to the baby," Dr. Rosenzweig explains.

You might also find that positions that can introduce a penis or toy close to your cervix aren't as comfortable as they once were—the cervix has increased blood flow and more blood vessels during pregnancy, plus it can shift positions, so if you're experiencing any pain in your once-fave position, be sure to talk to your partner about changing things up.

5. What If You Cramp or Spot After Sex?

If you start cramping after pregnancy sex, don't freak out. An hour or two of mild cramps isn't unusual because both orgasms and the prostaglandins in semen can cause uterine contractions. "Put your feet up, and drink three large glasses of water," Dr. Hoffman advises. "If the cramping gets worse, call your OB."

The same goes for spotting. Increased blood flow makes blood vessels more fragile on the cervix surface, and they may bleed a bit if a penis or toy rubs against the cervix. However, menstrual-period-like bleeding warrants an immediate call to your OB because the placenta could be breaking away from the uterus. Call, too, if there's fluid discharge, because your water may have broken or may be leaking.

6. What If Your Doctor Restricts Sex?

If you've had preterm labor or birth in a previous pregnancy—or if you're at risk for preterm labor with your current pregnancy—your OB may restrict sex on your end. That's because anything that can lead to uterine contractions (such as nipple stimulation, orgasm, and semen's prostaglandins) also boosts the risk for early labor. "When we need to induce labor, we put prostaglandins in the vagina," Dr. Hoffman explains. "[Penile-vagina sex ending in ejaculation into the vagina] puts them there naturally."

Your OB will also forbid sex if you have placenta previa (where the placenta covers the opening to the cervix) or placenta abruption (where the placenta actually separates from the uterus). And the No Sex Rule applies if your cervix dilates prematurely, since your baby would be at risk for infection from bacteria that can be pushed up into the uterus from the vagina. Your water breaking is another time to abstain, though chances are, sex will be the last thing on your mind at that moment.

If your obstetrician says no sex, ask if that means no intercourse or no orgasms, period. "As long as a woman isn't on pelvic rest because she has preterm labor or placenta previa, there's no reason why she can't have orgasms," Dr. Hoffman says. "You can masturbate or have oral sex."

7. Can Pregnant Sex Cause Labor?

The idea that having sex around your due date will start your labor is old-time folklore that has never been completely validated in scientific studies. Yet many OBs still recommend that restless parents get busy to see if they can move things along. The theory is the same one doctors use to discourage sex for pregnant people at risk for preterm birth—that orgasms and prostaglandins can help promote contractions.

Does this theory hold up? Well, if you're ready to deliver, a little sex might jump-start the process. But if your baby's not ready for their debut, you can make love like rabbits and nothing will come of it. "I've certainly suggested this to patients," Dr. Wilcox says. "But there are people who deliver early. And there are people who have sex and still go past their due date."

8. When Can You Have Sex After Giving Birth?

If your delivery goes smoothly, your OB-GYN will likely give the go-ahead for intercourse after your six-week postpartum checkup. Waiting until then prevents infection, allows your uterus to shrink back to normal, and gives your episiotomy or C-section time to heal.

Of course, whether you'll want to have sex at this point is another matter. Research shows that couples typically resume relations anywhere from seven weeks to six months after their baby is born. But other studies suggest that while the body can be coaxed, the libido lags. And that's hardly surprising. First, there's the fear that sex will probably hurt. And if you had a rough delivery, you might be sore for a while.

Plus, breastfeeding reduces estrogen, which can dry your vagina and might make penetrative sex uncomfortable (though topical estrogen cream can help). You might also simply be exhausted from the stress and sleeplessness that come with caring for a newborn. Swedish researchers who questioned 820 first-time parents found that in the six months after their babies were born, most reported having the energy for sex about once or twice a month—but keep in mind that there is no "normal" frequency when it comes to having sex. The transition into parenthood can be a tough one and it may be a while before you and your partner find our new normal. Keep the lines of communication open and find intimacy in other ways if you're not feeling ready for physical intimacy just yet.

That being said, if over time, your libido seems on permanent hiatus, say something to your OB because low desire can be a sign of postpartum depression. But if you're generally feeling good, don't fret too much. Eventually, sex will seem appealing again.

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