Pregnancy sex can be an amazing thing -- if you have a healthy, uncomplicated pregnancy. But having sex during pregnancy isn't always a good thing and, in fact, if any of the following conditions are a concern during your pregnancy, your health-care provider may recommend that you stop having sex.
Sexually transmitted diseases (STD). If your partner has tested positive for a bacterial or viral illness that you could contract from genital, oral, or anal sex -- such as chlamydia or syphilis -- you'll want to avoid intercourse and even genital contact throughout your pregnancy. Some STDs can reach your baby through the placenta, during delivery, or when your water breaks, potentially causing serious problems, not to mention raising your risk of miscarriage, preterm birth, and even stillbirth. A past STD that has been treated successfully shouldn't pose a problem.
Unexplained vaginal bleeding. Be sure to tell your doctor if you've been spotting or outright bleeding. Although it could be from something as simple as a broken capillary on the cervix or a polyp, a benign growth on the cervix, you'll want to rule out something more serious, such as a vaginal infection, an STD, a miscarriage, an ectopic pregnancy (when the embryo grows outside the uterus, often in one of your fallopian tubes), or a problem with the placenta. Unless the cause of the bleeding is found to be benign, you may need to avoid sex as a precaution.
Incompetent cervix. This is a condition in which your cervix, the lower part of the uterus, begins preparing for delivery too early. Normally closed and rigid, it starts to soften, shorten (efface), and open (dilate), raising your risk for early premature birth (before 32 weeks) or even loss of the pregnancy. If you have an incompetent cervix, your doctor may prescribe preventive medication, frequent checkups, or what's called a cerclage -- strong stitches to keep your cervix closed -- and, obviously, a hiatus from sexual activity.
Previous premature labor or birth. Although doctors don't know for sure why some women go into labor early (before 37 weeks), the biggest risk factor is having had premature labor before. Other possible risk factors include carrying multiple babies, having an abnormal uterus or cervix, being younger than 17 or older than 35, smoking or using recreational drugs, having certain STDs, and having a medical condition such as diabetes or heart disease. Depending on your risk factors, sexual activity may be off-limits throughout your pregnancy or only at a certain point.
Placenta previa or low-lying placenta. With this condition, the placenta -- the organ that supplies nutrition to your baby during pregnancy -- grows low down in the uterus, covering all or part of the cervical opening. It's common and harmless early in pregnancy, but if the placenta hasn't moved to the top of the uterus by the third trimester, you might start bleeding suddenly from your vagina and be at increased risk of early birth. You might be put on bed rest or advised to deliver via C-section if you're at least at 36 weeks.
Dilated cervix. Contractions have triggered the uterus to begin opening in preparation for birth, though how quickly it opens can vary widely. Dilation can happen gradually over weeks or just when active labor begins. Toward the end of your pregnancy, your OB will manually check for dilation. To prevent infection, you'll want to avoid inserting anything into the vagina once the cervix starts opening.
Ruptured membranes, or water breaking. Near labor, your membranes (the walls surrounding the amniotic sac) may tear, causing a gush -- or sometimes a trickle -- of amniotic fluid to leak out, signaling the start of labor. Your ob-gyn may also tear the membranes manually to kick-start labor or speed things along. If you suspect that your membranes have ruptured, see your doctor for an evaluation as soon as possible, and don't introduce anything into the vagina in order to avoid the risk of infection.
Always call your health-care provider if you have any questions about symptoms or sexual activity. And if you want to have sex, but are experiencing any of the above conditions? Ari Brown, M.D., co-author of Expecting 411: The Insider's Guide to Pregnancy and Childbirth, encourages women to ask exactly what "no sex" means -- is it no intercourse? Nothing inserted into the vagina? No orgasm? Clarifying your doctor's orders could open up other opportunities for intimacy and satisfaction.
Of course, if you don't want to have sex because you're nauseous or exhausted, or plain old don't feel like it, that's okay, too. Just be sure to take care of your relationship even as you honor your body.
"It's vital to your marriage to maintain an intimate relationship during the physical and emotional stressors of pregnancy," Dr. Brown says. "That may mean intercourse, it may mean just some foreplay, or it may mean taking a bath or having a massage together -- as long as you keep that fire going."
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