Is Sex During Pregnancy Safe?

Pregnancy brings a lot of expected changes: Your uterus expands, your breasts become bigger and more sensitive, and you may be fatigued and experience nausea. But something you may not have expected is the change in your libido. Some people find they have a ravenous desire for sex while pregnant, while others find that sex is the last thing on their minds. The good news is all of it is normal.

“You can never give statistics on who is going to feel what,” says Kecia Gaither, M.D., director of perinatal services and maternal-fetal medicine at NYC Health Hospitals in the Bronx. She says each experience is different, just like each pregnancy experience is different. 

Read on to learn about which sexual activity is safe during pregnancy (and shortly after) and when it’s not advised, plus what things to look out for that may indicate a cause for concern. 

Is Sex During Pregnancy Safe? 

Sex during any stage of pregnancy is safe for people with healthy pregnancies. According to the American College of Obstetricians and Gynecologists (ACOG), the amniotic sac and uterine muscles protect the fetus during sex. So, there’s no need to worry about "hurting the baby" during sexual activity.

Misconceptions about pregnancy sex and safety can influence how often people engage in sexual activity while pregnant. A 2016 study of the sexual activity of people in their third trimester found that most participants had sex one to three times per month during pregnancy compared to one to two times a week before conceiving. 

Among the top reasons for lessened sexual activity included fears about fetal health. On where participants got their information on the topic, 64% said their primary source of knowledge was the internet, while only 30% said it was health care providers. Researchers believe health care providers should increase their consultation on this topic. 

Having health care providers initiate the conversation during prenatal appointments could go a long way. “I have a large portion of people who either their partners are inquiring about that, or they’re inquiring on behalf of their partner because they’re scared to ask or too shy or not yet comfortable,” says Aiyana Davison, CNM, Women’s Health Nurse Practitioner-BC, and founder of Vagina Chronicles blog. 

Davison takes the opportunity to have a conversation and reassure her clients that sex is safe during pregnancy while also alerting them to some things to watch out for.

When to Use Caution

According to ACOG, some cramping and spotting after penetrative sex is normal. Davison calls these things “gray” areas. “In the low-risk pregnant person, if they have no complications that have been discussed before, we’ve done an ultrasound that looks good, and the placenta’s in a good place, sometimes spotting will happen.” In these low-risk situations, spotting is not concerning.

Due to the increased blood flow in pregnancy combined with a fuller cervix, blood vessels in the cervix can sometimes break, resulting in spotting, says Davison. However, if you notice a lot of blood—like soaking a pad—that’s not normal, or if you are concerned and want an expert opinion, then you should call a health care provider. Remember: Trust your gut if something doesn't feel right.

When Not to Have Sex

While most of the time, sex is totally safe during pregnancy, there are some situations in which a health care provider will likely advise you to abstain from penetrative sex. According to Dr. Gaither, those situations include:

• Placenta previa or other placenta problems
• History or risk of preterm labor
• Ruptured membranes

“Seminal fluid contains chemicals called prostaglandins, and prostaglandins can cause uterine contractions,” says Dr. Gaither. So, this can present a risk with penis-in-vagina sex if you have any risk factors for preterm labor or placental abruption (when the placenta prematurely detaches before birth).  

Davison adds that newer partners with STD uncertainty or having tested positive for an STI early in pregnancy can be additional risk factors worth discussing with a health care provider. They might recommend holding off on sexual activity until treatment is completed and a retesting confirms you’re cured. 

What About Oral Sex, Anal Sex, Masturbation, and Sex Toys?

According to a handout offered by the Journal of Midwifery and Women’s Health, unless a health care provider has advised you to abstain from sex for medical reasons, all forms of sex are safe during pregnancy, including:

• Vaginal sex
• Anal sex
• Oral sex
• Masturbation
• Sex toys

“I encourage all of those,” says Davison. “The use of toys is something that can be helpful because sex in the second and third trimester is uncomfortable, so sometimes masturbation or toy use is helpful.” But, she cautions that since toys (and body parts, for that matter) can go from one spot to another, it’s important to wash them between uses (for example, between anal and vaginal play). 

Why Your Desire May Vary

You may feel very desirous for sex during pregnancy or during certain times in your pregnancy. Or you may find yourself on the other extreme, not wanting to be touched in a sexual way at all. It’s also entirely possible to fall somewhere in the middle. All of these experiences are normal.

That’s because the physical changes of pregnancy can affect people in different ways. For example, some people enjoy the heightened breast sensitivity, while others find it distracting and overwhelming. Likewise, if you have morning sickness or extreme fatigue, it may be difficult to feel up to having sex. On the other hand, for some people, the increased blood flow to the pelvis increases desire and sexual satisfaction.

What About Postpartum Sex?

Once your baby is born, most OB-GYNs recommend waiting for six weeks to resume having sex. That’s because your body needs time to heal and recover after giving birth. 

“It takes so much to recuperate,” says Davison. “It’s not just the birth that happened. You have accommodated life for that nine to 10 months.” And a wide range of things could lengthen physical healing time, like an episiotomy or tear repair, or C-section incision. 

But, she adds, it’s not just about your body being ready. New parents commonly feel touched out and tired while taking on a pretty steep learning curve of how to parent a newborn. Davison says while some people resume sexual activity by six weeks (or even before), in her experience, most need more time. Often she hears that people are getting back to it by four to six months. 

When you do return to having sex, ACOG advises the following:

• If you don’t want to get pregnant right away, start birth control
• Use a water-based lubricant for penetrative sex
• Try various positions
• If penetrative sex isn’t comfortable, try other forms of sexual activity instead

Masturbating and using sex toys before resuming sex with a partner is a good way to test your postpartum body and see what feels good and what doesn’t. 

The Bottom Line

While sex is often safe during pregnancy, every situation is unique. Therefore, the best way to know for sure is to have an open and ongoing dialogue about sex with a health care provider throughout your pregnancy. 

In addition, honest communication is more critical than ever with a sexual partner when pregnant. Telling your partner what you like and what you don’t and explaining your desire or lack thereof can help them understand and empathize with your experience. These conversations may seem uncomfortable initially, but they can make you feel more empowered in the long run.