SEX DURING PREGNANCY- IS IT OKAY?

Is it safe to have sex during pregnancy?

Sex is an important aspect for any healthy marital relationship.  The outcome of this healthy relationship is pregnancy.  However, many may be ignorant concerning sex during pregnancy. There is an overall lacking in sex education in our society and consider this topic a taboo.  Many couples were too shy to ask, do not know who or where to get accurate advice regarding this topic.  Surveys over this part of the world have found that less than 30% of pregnant women discussed this issue with their doctor.  Most women felt uncomfortable to bring up this topic (Bartellas 2000;  Fok 2005).

Some of the questions that beg to be answered include safety of sex during pregnancy; fear of miscarriage and premature labour as a result the sexual act.  Besides being a social taboo, the many misconceptions and myths surrounding this topic further confused couples.

 

What are the effects of sexual intercourse on pregnancy?

Generally, sexual intercourse is not harmful during pregnancy. During pregnancy, the baby lies safely in the muscular wall of the womb and is surrounded by fluid in the amniotic bag. This is the nature’s way of ‘cushioning’ the baby from any violent jolt.  There is also a viscid mucus plug, which seals off the neck of the womb from the vagina. This mechanism prevents any possible ascending infection from reaching the baby in the womb.

There is usually no injury during a gentle, loving sex. Women often experience mild contractions during arousal and orgasm, but these contractions are not powerful enough to start a labour unless it is imminent.  Orgasm itself may be associated with congestion of the pelvis but would not affect the baby. The womb will contract more than usual, but these contractions are different from labour contraction.  While sex would not start labour unless the woman’s body is ready, nipple stimulation may initiate release of hormone (oxytocin) that causes uterine contractions.  Similarly, prostaglandin in the semen released during sexual intercourse may help initiate labour in late pregnancy especially when the baby is overdue.

How pregnancy affects sexual relationship?

Most studies have concluded that sexual frequency is reduced as the pregnancy period advances.  This is mainly influence by the women’s physical discomfort, couple concern on pregnancy safety and change in sexual urge.

During the early stage of pregnancy, the pregnant women often experience symptoms of nausea and vomiting (morning sickness).  Some women may not have the urge or too exhausted to have sex especially if their symptoms are severe.  The urge for sex (libido) improves as the pregnancy enters the second trimester when these symptoms improve.  Towards late second and third trimesters, the abdominal distension becomes more prominent.  This change in self body image may affect the couple’s libido besides the physical limitation.  However, the physical limitations can be overcome by being creative such as changing coital position.

Sexuality and responses to pregnancy differ from person to person. Some women, finally free from worries about conception and contraception, feel sexier than ever.  The change in body image will also affect your sex life.  On the contrary, some couples find it difficult to reconcile the pregnant body with the idea of a sexually attractive woman. The woman may feel far too ill to be sexy, or the man is too worried about harming the baby to attempt sex. Most people find their pregnant partner as attractive as ever. Occasionally, the partner’s desire may be dampened by the anxiety of harming the fetus, or even self-consciousness about making love in the presence of your unborn child.

If you feel less urge to have sex, it is important to reassure your partner that it is the sex that has gone off, and not the marital relationship.  Perhaps, one can explore alternative methods of intimacy together.

Is there any comfortable position to have sex?

Most couple prefers the missionary position where the man lies on top, during early pregnancy.  As the pregnancy progresses, this position may not be comfortable anymore due to the distended abdomen and psychological concern of harming the fetus.

Couple can get creative at this time. With a little experimenting, most couple will find a suitable position that works.  Reports have shown that women tend to be more satisfied when adopting position other than missionary position during pregnancy.  The followings describe some of the position when having sex during pregnancy.

  1. Woman on top.

It puts no weight on your abdomen and allows you to control the depth of penetration.  This position works really well throughout pregnancy and at the very end of pregnancy.

  1. Spooning.

This position requires the man to access penetration from behind his partner.  There is no pressure on the abdomen, and allows for a shallow penetration. Many women find this a very relaxing position for sex during pregnancy and it can be used throughout.

  1. Hands & knees.

This is a very good position for pregnant women again because of the lack of direct pressure on the abdomen.  When the abdomen gets bigger, the pregnant women can rest her abdomen on the bed. Some women find this difficult at the very end of pregnancy, depending on how high they are able to hold their abdomen off the bed and still allow for penetration.

  1. Lie sideways.

By lying sideways and pulling one leg up, allowing room for your partner.  This position keeps most of his weight off your uterus.

5.  Use the bed as a prop.

The pregnant woman lie on her bed at the side or foot of the bed with knees bent.  The partner can either kneel or stand in front of you.

Couple should continue trying until a suitable position is found.  There will be a lot of fun during pregnancy, and this creativity will probably carry over into your postpartum sex life as well.

If you are not in the mood or restricted by your doctor’s advice, remember to take time for intimacy with your partner.  Communication is important and most partners will understand.  Furthermore, being intimate does not necessarily require sexual intercourse.  Love and affection can be expressed in many ways, such as touching, fondling and kissing.

 

When is sexual intercourse unsafe in pregnancy?

Sexual intercourse becomes unsafe in presence of pregnancy complications.  Some of these complications include episodes of vaginal bleeding in early pregnancy, recurrent pregnancy losses, low lying placenta (placenta praevia) or any risk of premature delivery.

You should not have sex with a partner whose sexual history is unknown or who may have a sexually transmitted disease (STD), such as herpes, genital warts, Chlamydia or HIV.  These diseases may be transmitted from mother to baby and is associated with potentially dangerous consequences.

Conclusions

Sexual intercourse is safe in pregnancy except in presence of pregnancy complications.  A successful sexual relationship involves two persons wanting to make love – and that holds true whether one of them is pregnant or not.

 

Reference:

  1. Bartellas E. et al., Sexuality and sexual activity in pregnancy. BJOG 2000 Aug, 107(8):964-8.
  2. Fok WY et al., Sexual behavior and activity in Chinese pregnant women. Acta Obstet Gynecol. Scand 2005 Oct;84(10):934-8
  3. Senkunming N. et al., The changes of sexuality in Thai women during pregnancy. J. Med Assoc Thai 2006 Oct; 89 suppl 4: 5124-9
  4. Lee JT et al., Sexual positions and sexual satisfaction of pregnant women. J Sex Marital Ther. 2010 Oct; 36(5):408-20
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Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.