Pregnancy sex

What is pregnancy sex?

Pregnancy sex is sex during the period you are pregnant, from making love to stroking and everything in between. With a healthy pregnancy it is almost always safe, because the baby sits protected inside the womb. What mostly changes is your desire and your comfort, and those differ a lot by trimester.

Is sex during pregnancy safe?

Yes. With a healthy, uncomplicated pregnancy, sex is almost always safe. That is what both the Dutch midwives and the American college of obstetricians and gynecologists, ACOG, say. The baby sits safely behind the membranes, the amniotic fluid, and the strong muscle of the womb, so during penetration you do not even come close. An orgasm can give a short, hard feeling in your belly, a contraction, but those are not labor pains. A little spotting after sex can happen and is usually harmless. If you bleed heavily, like a period, call your midwife. Your partner cannot reach the baby either. The penis goes no further than the vagina, and the cervix is closed. Plenty of couples still do not dare, purely out of fear of damaging something. That fear is understandable. And almost always unnecessary.

When it’s better to check first

Not every pregnancy is the same. Sometimes caution is warranted, and it is better to check with your midwife or GP first, or to hold off on penetration for now, if one of these is going on:

• You have unexplained bleeding.
• Your membranes have broken, because then there is more chance of infection.
• You have a placenta previa or a low-lying placenta.
• You have had a preterm birth before, or there are signs of threatened preterm labor.
• You or your partner has an untreated STI.

Not sure whether something is okay in your situation? Call your midwife. She knows what is safe for you, and asking that question is never silly.

How desire changes by trimester

Your libido rarely runs evenly through the pregnancy. In the first trimester desire is low for many women, from nausea, tiredness, and the first hormone storms. In the second trimester it often bounces back, because the nausea is gone, your energy returns, and the extra blood flow to your pelvis can even make sex more intense than you were used to. Then it drops again. In the third trimester desire fades for most, with a growing belly and more discomfort. A systematic review by Fernández-Carrasco and colleagues from 2023 found exactly that pattern: desire peaks in the second trimester and declines after. So a common situation is that a couple, after a sluggish first stretch, notices around the fourth or fifth month that desire comes back on its own. Your partner’s desire shifts along too. In partners, desire is often lowest in the last trimester, sometimes out of awkwardness, sometimes out of fear of forcing something. That the two of you feel like it at different moments is then the rule rather than the exception.

Misconceptions

“Sex hurts the baby.” No. The baby notices nothing of the sex itself, sits safely protected behind the membranes and the amniotic fluid, and does not feel the contractions after an orgasm as pain, however firm they sometimes feel to you.

“An orgasm brings on labor.” Not with a healthy pregnancy. The mild contractions after a climax are not real labor pains, and there is no strong evidence that sex starts a healthy pregnancy sooner.

“If desire disappears, something is wrong.” Also not true. Less desire belongs to certain phases, just as much as more desire does, and it says nothing about your relationship or your coming motherhood.

Intimacy while your body changes

Sex is more than penetration. Couples forget that sometimes. If your desire or comfort changes, then stroking, talking, skin against skin, and being with each other with full attention all still stand. In the last trimester, other positions help, like spooning or you on top, to give the belly room. Go slowly, and stop the moment something does not feel good. A pillow under your hip or your lower back sometimes makes a position comfortable all at once. And if penetration is not what you want for now, there is still plenty: hands, mouth, or just lying against each other for a long time. Nothing is required. If your desire differs, and that happens often, then talk about it instead of tucking it away. I’m a gigolo and a psychotherapist myself, not a midwife. So about the medical side I say nothing. But about staying close while a body and a life change, I’ll gladly think along with you.

Where you can turn

For everything to do with the safety of you and the baby, your midwife or GP is the right address, and that question is always allowed, however small. Even a seemingly stupid one. There is no such thing. For the intimacy around it, how you stay close as desire and body shift, you can come to me. How an appointment for intimate togetherness goes is on that page. I’m a gigolo, not a doctor, so about the medical side I make no claims.

Sources

• Is it safe to have sex during pregnancy?. American College of Obstetricians and Gynecologists (ACOG). Gives that sex during a healthy pregnancy is safe, that the womb and the membranes protect the baby, and that cramps after an orgasm are normal.
• Seks tijdens de zwangerschap. De Verloskundige, KNOV. Gives the Dutch line that sex during pregnancy is almost always safe and healthy, and when to call your midwife.
• Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners. F. J. Fernández-Carrasco et al., Public Health Reviews, 2023. Gives that sexual desire is highest in the second trimester and declines after.

Related terms

• Libido. The desire for sex that goes up and down by trimester during pregnancy.
• Menopause. The other life phase where hormones shake up your desire hard.
• Sexual response cycle. How arousal unfolds, something the extra blood flow in the second trimester can amplify.
• Sexual acts. The broader field pregnancy sex is a form of, with all the forms besides penetration.