Sex and Pregnancy
posted: 06/01/2006 12:00 am
Dear Dr. Myrtle,
I’ve just gotten pregnant again (whew!), and my partner is very worried about sexual activity during this pregnancy. Is sex okay during pregnancy, and is there anything I/we should watch out for?
Congratulations! Generally speaking, sexual activity is okay during "normal" pregnancy, as long as your health care provider hasn’t advised against it. Here are some ways to think about your specific situation.
- General Considerations:
- Vaginal penetration is fine during pregnancy, although deep penetration might feel uncomfortable during the last 2-3 months because of the growth of the pregnancy. Some pregnant women particularly enjoy sexual arousal with penetration since the blood can pool more easily with the uterus pressing on the outgoing flow veins. This causes increased sensation and increased lubrication.
- Some extra care in washing the part doing the penetrating is important so as not to introduce infections, or upset the bacterial/yeast balance. Vaginal penetration with penises, dildos and fingers is okay, but fingernails may need more trimming so as not to cause tears or abrasions which can lead to infections. Make sure anything that enters the vagina during pregnancy is clean - hands washed with soapy warm water; dildos and vibrators washed with soapy warm water and/or covered with a fresh condom.
- If vaginal delivery is a consideration, some women and health care providers feel strongly that regular hand-vulva massage, with particular attention to the perineium (skin between the vaginal opening and the anus) is highly beneficial to enhance the flexibility and durability of the skin and underlying muscles. To make this massage even more effective, incorporate a moisturizing lubricant like Liquid Silk.
- Water based lubricants are fine to use during pregnancy. Some women like to use Liquid Silk for vulva massage because it both lubricates the skin and decreases the friction of sex. Also, the pregnancy may make you more prone to yeast infections, and non-glycerin lubricants can help you avoid them by not feeding the yeast.
- Orgasms do need to be monitored (and discussed with your health care practitioner) in women whose pregnancies are at moderate or high risk due to cervical insufficiency (risk of pre-term labor), or in women who are having difficulty controlling blood pressure. Other medical conditions can also warrant holding off on orgasms too, so if you think this applies to you, please ask your health professional some questions.
- Oral sex is fine, but don’t have your partner blow air into the vaginal space. It can cause something called "air embolisms" which can be very dangerous to the mother.
- Anal sex with shallow penetration (because the uterus has moved into the way) is okay, but let comfort be your guide. If anything hurts or is uncomfortable, stop. All of the other "guidelines" for anal sex apply as well (no oils, use latex and water-based lube, don’t spread fluids into the vagina from the anus, etc.).
- Flogging, increased pressure on the belly of the pregnancy (someone lying on top of you, for example), and any type of bondage of the belly is definitely a risk to the woman and the pregnancy. While other body parts can still enjoy these behaviors, it’s best to stay away from the abdomen all together. (Even bondage on the wrists and ankles is often uncomfortable - in a bad way - because of the common increase in fluid under the skin. Your body may be more sensitive to behaviors that you usually enjoy with abandon.)
- Be kind to your cervix. It is the muscular gateway that helps hold the pregnancy in position until it’s time to be delivered. It also has developed a "mucus" plug to reduce the transmission of fluids into the uterus. Deep thrusting, fingernail cuts, vaginal fisting, and repetitive pressure are all relatively unhealthy for the "pregnant" cervix, and can dislodge the plug. So, be kind to it, and let it do its new job safely.
- Recognize that orgasmic contractions can promote labor late in the pregnancy, particularly in women at risk of pre-term labor. If you’ve been asked to stay on your back (to reduce the risk of labor), orgasms are something you may want to hold off on. Ask your health care professional.
- Specific things to do:
- Get a complete screening for sexually transmitted infections. Cure the ones that you can cure. Sexually transmitted infections such as trichomonas, syphilis, HIV, Herpes, chlamydia and gonorrhea can have major negative impacts on the health of the pregnancy.
- Make sure your partner(s) get screening for sexually transmitted infections! (It doesn’t help if you get screened, if someone else wasn’t and gives you an infection.)
- Along with all of your reading for the baby, consider how you are going to explain sex, sexuality, and human bodies to her/him(s). Sure, you have a few years to think about it, but it gives you something else to ponder while you’re waiting. :) There are also lots of great books about sex for moms, to help you prepare for your love life after this pregnancy. Now’s a good time to read up!
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