Sex During Pregnancy: What You Need to Know
Once you become pregnant, sex might be the last thing on your mind. It’s natural to wonder about what is and isn’t okay for you and your growing baby, and that includes the issue of sex. So, is it safe to have sex during pregnancy? And how different is pregnant sex from sex when you’re not carrying a baby? Relax—stress will do nothing to enhance the mood. We’ve got all the info you need to help put your mind at ease about pregnancy sex, and hopefully get you back into the groove.
Save for a few exceptions, it’s generally encouraged that you keep up the same sex life that you had before you got pregnant (provided you’re feeling up to it, of course). “We want people to continue their sexual relationship during their pregnancy,” says Jessica Shepherd, MD, MBA, FACOG, an ob-gyn and minimally invasive gynecologic surgeon in Dallas. That’s true for sex during early pregnancy and for sex during late pregnancy. However, Shepherd points out, your growing belly might make certain sex positions uncomfortable near the end of your third trimester, so you may need to experiment with pregnancy sex positions to see which ones you feel the most comfortable with.
Is sex safe during pregnancy?
You’re not the only one wondering if sex is safe during pregnancy: The American College of Obstetricians and Gynecologists (ACOG) lists it among their frequently asked questions about pregnancy. The reassuring answer is that, yes, it’s safe to have sex during pregnancy—unless your doctor tells you otherwise.
It’s rare that your doctor would say you should avoid sex while pregnant, but certain conditions can increase your risk of complications if you have penetrative sex. Those include placenta previa, a condition that occurs when the placenta partially or completely covers the cervix, a strong history of preterm labor or cervical weakness (a condition that happens when the cervix isn’t able to stay closed during pregnancy), Shepherd says.
You might be questioning if it’s possible for your partner’s penis to hit baby during sex, but luckily, the answer is no. “We get that question a lot,” Shepherd says. “But your cervix provides a protective barrier between baby and your vagina.”
In general, no pregnancy sex positions are considered unsafe, especially early on in the first and second trimesters, but doctors typically recommend that, from about 20 weeks onward, you should avoid positions where you’re lying flat on your back. That’s because your uterus is larger and heavier than usual, and when you lie on your back it puts pressure on your aorta (your main artery), and that can interfere with blood flow to the placenta. Instead, try spooning (your partner enters you from behind as you both lie on your sides), you on top or rear entry (having your partner enter you from behind while you support yourself on all fours). Pregnancy sex doesn’t have to feel mechanical or premeditated; you can be spontaneous and experiment.
Is oral sex safe during pregnancy?
Oral sex is during pregnancy is generally safe as long as partners are free from sexually transmitted infections (STIs), experts say. “One main concern is if the partner performing oral sex has a history of oral herpes or cold sores,” says Sara Twogood, MD, FACOG, a board-certified ob-gyn in Los Angeles. “If so, performing oral sex can transmit the infection to the pregnant person and they can get a new genital herpes infection—this can be dangerous during pregnancy.”
Is anal sex safe during pregnancy?
Anal sex while pregnant is also generally considered safe. However, if you have hemorrhoids—a fairly common pregnancy affliction—you should avoid it, advises Alejandra Lucatero, LCSW, a licensed clinical social worker specializing in sexual health at the Hawaii Center for Sexual and Relationship Health in Honolulu. “Hemorrhoids are painful and when skin is broken and bleeding, can increase risk during anal sex,” she says.
Lucatero suggests using a water-based lubricant during anal sex to decrease discomfort and increase pleasure. “Always remember hygiene!” she adds. “Remember: Front to back, not back to front.” Of course, if anal sex is at all painful, it’s best to avoid it during pregnancy, adds Twogood.
As long as your pregnancy is healthy and your doctor hasn’t specifically advised against doing the deed, sex is absolutely fine (and even encouraged!). What’s more, pregnant sex may even be good for you—physically and emotionally.
Oxytocin, often called the love hormone, is released when you orgasm, and that may have a positive effect on you and baby, says licensed marriage and sex therapist Kat Van Kirk, PhD. “The warm sense of security and love experienced during sex may have a pleasant indirect effect of soothing the baby in utero as well,” she adds.
Still not convinced? As it turns out, there are even more benefits of sex during pregnancy. Here are a few reasons to consider getting it on when you’re expecting:
- Kick-start labor. If you’re full term and want to induce labor, experts say that orgasms (as well as the prostaglandins in semen) can encourage uterine contractions. When you’re approaching labor, your cervix will start to soften and open, and prostaglandins in semen can help move this process along if you’re close to labor, Shepherd says. In healthy, uncomplicated pregnancies, the prostaglandins will not, however, actually push you into labor, she adds.
- Connect with your partner. Of course, pregnancy sex offers an opportunity to connect with your partner in a way only the two of you can share. “You don’t have to have sex during pregnancy, unless you want to, but if you’re in a relationship, you likely want to maintain the intimate side of your connection,” says Jess O’Reilly, PhD, a Toronto-based sexologist and the creator of the Sex with Dr. Jess podcast. Shepherd agrees: “Sex is a very important part of a relationship and a person’s normal life… We definitely think it should be an integral part of a pregnancy if a patient so desires.”
- Enjoy extra sensitivity. Pregnancy hormones and an increase in blood flow to your vulva may enhance arousal and heighten sensitivity. Your breasts and nipples may be extra-sensitive too.
- Strengthen your pelvic floor. Orgasming can strengthen your pelvic floor and may even help your body heal postpartum, Van Kirk says.
Obviously every person and every pregnancy is different. “A low and high sex drive is normal throughout pregnancy, just as it is when not pregnant,” notes Lucatero. “Conditions that influence sex drive are that of the relationship with the baby’s co-parent, hormones, stress, medical concerns [such as] nausea, mental health, self-esteem [and] schedule.”
Low sex drive during pregnancy
It’s not unusual to have a low sex drive during pregnancy, experts note. If you have morning sickness during the first trimester, you just might not feel like having sex as much as you did pre-pregnancy. But your libido typically rebounds by the second trimester as morning sickness tapers off, Shepherd says. Lucatero adds that many pregnant people experience another decrease in their sex drive toward the third trimester. And if you’re suddenly feeling insecure about your changing body? Know that you’re beautiful and embrace your pregnancy curves. “Focus on what you love about your new body,” O’Reilly says. Hang in there—this is all completely normal!
High sex drive during pregnancy
Shepherd says that because you have a higher blood volume in your body during your pregnancy, the blood flow increases to your genitals as well as other parts of your body. That, coupled with the hormonal shifts, can increase your sex drive during pregnancy and ability to reach orgasm. But again, everyone is different. Also know that self-pleasure is absolutely on the table. “It’s normal to masturbate during pregnancy as long as it’s comfortable, safe and pleasurable,” says Lucatero.
Again, everybody’s experience is unique. “Some women say sex during pregnancy is more pleasurable,” says Rachel Needle, PsyD, a sex therapist, and the founder and executive director of the Whole Health Psychological Center in West Palm Beach, Florida. This may be due to extra blood flow and increased sensitivity. Others report no change in sensation.
It may feel a bit different, but the key to enjoying sex during pregnancy is communication. Talk to your partner about what does and doesn’t feel good, and keep an open mind; a little creativity and experimentation can help make things more enjoyable.
Painful sex during pregnancy
Some discomfort is normal, but you can often do something about it. Shepherd says painful sex during pregnancy typically derives from your position. “Pregnancy can change the tilt of the pelvic bone structure, and your muscles may become more sensitive,” she says. So try changing positions, particularly to ones where you can control the depth and entry of the penis. If the pain persists or you experience it regularly during sex, call your ob-gyn and don’t feel weird about it. “You shouldn’t be afraid to talk about sex during pregnancy with your doctor,” Shepherd says. “We’re here to help.”
Bleeding or spotting after sex during pregnancy can happen and, while it may understandably freak you out, it’s not necessarily cause for alarm. “Your cervix is very sensitive during pregnancy,” Shepherd says. Regardless, you should still check in with your doctor if you experience any kind of bleeding when you’re pregnant. If the bleeding is minimal (meaning you can almost get away without a pad) and stops within a few hours, your doctor will likely tell you it’s nothing to worry about. But if you need a pad and have to change it within an hour or less, or you’re passing blood clots bigger than a cherry, you’ll need prompt attention. No matter how much bleeding you experience, you shouldn’t have sex again until you see your doctor, just in case the bleeding is due to something serious, Shepherd says.
Your doctor or midwife will let you know if you shouldn’t have sex. More often than not, it’s completely fine. Unfortunately, there are times when sex during pregnancy should be avoided. According to the Mayo Clinic you should refrain from pregnant sex if:
- You have placenta previa
- Your cervix has started to open prematurely
- You have unexplained vaginal bleeding
- You’re leaking amniotic fluid
- You have a history of preterm labor
Additionally, if your partner has an STI, you’ll want to avoid having sex during pregnancy, as it can create serious health issues for you and baby. And if you’re having sex with a new partner, you’ll want to use a condom and take precautions.
Frequently Asked Questions
Can sex cause preterm labor?
“Thankfully, sex and semen in the vagina have not been shown to increase the risk of preterm labor,” says Twogood. “However, there are some conditions in pregnancy a doctor may recommend avoiding sex, such as a shortened cervix.”
Is it normal to have sex less often while pregnant?
Low sex drive during pregnancy is completely normal due to issues like morning sickness and fatigue, experts say. Your sex drive typically rebounds by the second trimester—although it might take another dip toward the end of pregnancy.
Do you need to use a condom while pregnant?
Lucatero recommends using a condom in situations where you’d need to avoid potential STI transmission to you or baby. Twogood agrees: “This situation could occur when having sex with a new partner or if the current partner has risk factors for STIs, such as non-monogamous couples.” She also recommends using a condom when one of the partners has genital herpes.
What type of lubricant is best to use when having sex during pregnancy?
Lucatero suggests using a water-based lubricant. Twogood cautions to avoid “specialty” lubricants, such as ones that are tingling or scented. “These have additional ingredients that may alter the vaginal pH and increase the risk of vaginal infections,” she says.
What are the best sex positions during pregnancy?
The best sex position during pregnancy is one that’s comfortable for you and your partner. It’s important to experiment and modify sex positions that you might already enjoy, says Lucatero. “You can go on all fours into doggy with a pillow underneath the belly for support, you can jump on top in cowgirl position and hold onto your partner’s thighs behind you for support, the penis can enter the vagina from behind and a pillow can be added under the knees or legs to put less strain on the vulval owner’s body to allow entry, and missionary is still possible with a pillow behind the vulval owner’s lower back for support and easier entry,” she says. She adds that she recommends a prop to make things more comfortable: “I recommend a sex wedge or pillow or stool to provide support and help getting that right angle.”
When you’re pregnant, sex can suddenly seem intimidating. But it’s important to communicate with your partner about what feels good and what doesn’t. While having sex during pregnancy can make you feel great and keep your relationship strong, it’s 100 percent OK if you’re not feeling it. You can find other ways to be intimate—kiss, cuddle and enjoy meaningful conversations. And if you’re feeling extra frisky? Keep the flame burning and enjoy!
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Alejandra Lucatero, LCSW, is a licensed clinical social worker specializing in sexual health at the Hawaii Center for Sexual and Relationship Health in Honolulu.
Rachel Needle, PsyD, is a sex therapist, as well as the founder and executive director of the Whole Health Psychological Center in West Palm Beach, Florida. She earned her PsyD in clinical psychology from Nova Southeastern University in Fort Lauderdale, Florida.
Jess O’Reilly, PhD, is a Toronto-based sexologist and the creator of the Sex with Dr. Jess podcast. An award-winning speaker, O’Reilly has worked with thousands of couples from all corners of the globe to transform their relationships via her Marriage As A Business program.
Jessica Shepherd, MD, MBA, FACOG, is an ob-gyn and minimally invasive gynecologic surgeon in Dallas. She received her medical degree from Ross University School of Medicine in 2005.
Sara Twogood, MD, FACOG, is a board-certified ob-gyn at Cedars Sinai Medical Center in Los Angeles, and has more than 20 years of experience in medicine. She’s also the author of LadyParts Blog.
Kat Van Kirk, PhD, is a licensed marriage and sex therapist and the author of The Married Sex Solution: A Realistic Guide to Saving Your Sex Life. She received her PhD in clinical sexology from the Institute for the Advanced Study of Human Sexuality in San Francisco.
American College of Obstetricians and Gynecologists, A Partner’s Guide to Pregnancy, January 2023
The Ohio State University, Should You Sleep on Your Back While Pregnant?, September 2023
Mayo Clinic, Sex During Pregnancy: What’s OK, What’s Not, July 2022
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