Some advice on sex during pregnancy

Should you be concerned about having sex while pregnant? we asked medicine specialist, Diana R. Danilenko-Dixon, M.D., for advice for expecting couples.



We: Is it OK to have sex while you are pregnant?

Dr. Danilenko-Dixon: Yes, in most cases. If your pregnancy is proceeding normally and your health care provider has not told you that you're at risk for premature labor, incompetent cervix or placental problems, your lovemaking can proceed well into the third trimester. If you're at all uncertain whether you're at risk, ask your obstetrical care provider.

We: Could intercourse result in a miscarriage?

Dr. Danilenko-Dixon: Many expectant parents are primarily concerned that intercourse will cause a miscarriage, particularly in the first trimester. Most miscarriages during this time, however, are unrelated to sexual activity. They commonly result from genetic defects in the developing fetus.

We: Can having intercourse harm the baby?

Dr. Danilenko-Dixon: No. A penis does not physically contact the fetus, which is well-protected by uterine muscle and amniotic fluid. The cervical mucous plug prevents bacteria and semen from entering the womb. However, if deep penetration causes pain, it should be avoided.

We: Can orgasms result in premature labor?

Dr. Danilenko-Dixon:Orgasms may cause uterine contractions. However the vast majority of studies indicate that in a normal pregnancy, orgasms (with or without intercourse) do not lead to premature labor or premature birth.

We: Is there any time doctors advise against intercourse during pregnancy?

Dr. Danilenko-Dixon:Your physician may recommend abstinence during the last weeks of pregnancy as a precaution. There is one study which suggests that intercourse more than once a week in the last month of pregnancy may increase the risk of intrauterine infection, but this has not been corroborated by subsequent studies.

If vaginal bleeding, an incompetent cervix (a weakened cervix that dilates prematurely), preterm labor or placenta previa (a placenta that covers the cervical opening) develops at any point in your pregnancy, your health care provider will most likely advise against intercourse. Other conditions of pregnancy, such as expecting twins, also may preclude intercourse during the late second and early third trimesters, when the consequences of preterm birth are greatest.

Your health care provider also may advise against intercourse if you have a history of recurrent miscarriages or premature labor.

We: Is the use of condoms advised?

Dr. Danilenko-Dixon:All women (including those who are pregnant) who have new or multiple sexual partners should use condoms to prevent sexually transmitted diseases (STDs). Pregnant women exposed to STDs are at increased risk of infections that can be harmful to the baby and can lead to premature labor.

We: How may a woman's sexual desire be affected by her pregnancy?

Dr. Danilenko-Dixon: Decreased interest in sex early in your pregnancy may play a significant role in your sexual activity. Changing hormones, added weight and a decrease in your energy level may take their toll on your desire.

The lackluster interest may continue through the first trimester, when exhaustion and nausea are most likely to occur. During the second three months, however, you may find your interest changing. Increased blood flow to your sexual organs and breasts may rekindle your desire, or even increase your normal interest in intercourse. You may even experience a moderate feeling of sustained readiness due to the effects of increased blood flow to your sexual organs and breasts.

As you enter the final trimester, you may find your desire waning again. Besides a large abdomen that makes intercourse physically challenging, increased fatigue or back pain can dampen your enthusiasm for lovemaking. You may need to experiment with positions that make intercourse comfortable for you and your partner.

We: How can couples deal with these changes in sexual desire?

Dr. Danilenko-Dixon: Communicate. Pregnant women may want affection from their partners without wanting intercourse. Partners, however, may read that lack of interest as a sign of rejection. It's important to communicate one's needs, and to discuss other forms of lovemaking, such as oral sex, massage and masturbation.

We: Why is sex during pregnancy so rarely discussed?

Dr. Danilenko-Dixon:The literature on the subject is often confusing, and some physicians are uncomfortable discussing matters of sexuality with patients. For these reasons, couples often get the message that they should refrain from sex during pregnancy. It's still too often a taboo subject — but it shouldn't be.

We: How soon after delivery of a baby may couples resume intercourse?

Dr. Danilenko-Dixon:The answer varies. In general, sexual intercourse can be resumed by the third postpartum week — if comfortable and there are no complicating factors. However, couples often face changes in their sexual relationships as new parents. It's normal, and if you have questions you should ask a trusted health care provider.

Labels: Pregnant and Sex