Is sexual intercourse safe during pregnancy?

From the Guidelines

Sexual intercourse is generally safe during pregnancy for most women with uncomplicated pregnancies, as long as they are comfortable and their healthcare provider hasn't advised against it. You can continue to have sex throughout all three trimesters, and some positions may become more comfortable as your pregnancy progresses, particularly those that don't put pressure on your abdomen, such as side-lying or woman-on-top positions. Your partner should be gentle, especially in later pregnancy.

There are certain situations where sex during pregnancy may be restricted, including:

• Placenta previa
• Cervical insufficiency
• Unexplained vaginal bleeding
• History of preterm labor
• If your water has broken It's essential to discuss any concerns about sexual activity during pregnancy with your healthcare provider, as they can provide personalized guidance based on your specific situation 1.

Additionally, pregnant women should be screened for HIV and other sexually transmitted diseases (STDs) to prevent maternal postnatal complications and STDs in the infant 1. HIV testing is recommended for all pregnant women, and retesting in the third trimester is recommended for women known to be at high risk for acquiring HIV 1.

It's normal to experience changes in sexual desire during pregnancy due to hormonal fluctuations, physical discomfort, and emotional factors. Some women may notice increased vaginal discharge or mild cramping after orgasm, which is typically normal. If you experience severe pain, heavy bleeding, or amniotic fluid leakage after intercourse, contact your healthcare provider immediately.

Always prioritize your health and the health of your baby, and follow the guidance of your healthcare provider regarding sexual activity during pregnancy.

From the Research

Safety of Intercourse During Pregnancy

• The safety of intercourse during pregnancy has been studied in various research papers, with some indicating that sexual activity can be considered a natural way to prevent post-term pregnancy in the absence of complications 2.
• A study published in 2019 found that the experiences, frequency, and timing of sexual intercourse had no significant impact on any obstetric or neonatal outcome compared with those of women without sexual intercourse 3.
• Another study from 2000 reported that vaginal intercourse and sexual activity overall decreased throughout pregnancy, with most women experiencing a decrease in sexual desire 4.
• Research has also shown that women often have concerns regarding sexual activity leading to preterm labor or premature rupture of membranes, and many wish to discuss these issues with their doctor but may not feel comfortable raising the topic themselves 4, 5.
• In high-risk pregnancies, there is limited evidence to support specific sexual activity restrictions, and clinicians should engage in conversations with patients regarding specific sexual activity based on evidence-based guidelines 6.

Effects of Intercourse on Pregnancy Outcomes

• A study from 2015 found that gestational age at the time of delivery was significantly lower in the intercourse group compared with the control group, suggesting that sexual activity may be associated with the onset of labor 2.
• However, another study from 2019 found no significant difference in neonatal weight based on the presence of sexual intercourse or contact with semen at the last week of pregnancy 3.
• The impact of sexual intercourse on obstetric and neonatal outcomes has been found to be minimal, with no significant correlation between intercourse and cause of admission or type of delivery 2, 3.

Sexual Activity During Pregnancy

• Sexual behavior modifies as pregnancy progresses, influenced by biological, psychological, and social factors 5.
• A study from 2010 reported that the first trimester was considered the most frequent period of sexual intercourse, followed by the second trimester, and that 55% of women reported a decrease in sexual activity during the third trimester 5.
• Fear of sexual intercourse was referred by 23.4% of the women questioned, and sexual satisfaction was unchanged in 48.4% of the subjects and decreased in 27.7% 5.