Assoc. Prof. Süleyman Eserdağ, MDCosmetic Gynecologist & Sexual Therapist
Fellow of European Committee of Sexual Medicine (FECSM)
Editor of the Book ‘Female Aesthetic and Functional Genital Surgery’
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Sexual Life In Pregnancy

Sexual Life In Pregnancy

Pregnancy is a very different process which affects a woman’s life radically. In addition to physical changes, many psychological changes occur during this period. Sexuality and sexual life, which are of great importance in every phase of life, are often negatively affected by pregnancy.

Especially the expectant mothers who have their first pregnancy may have sexual frigidity during the adaptation period. Sexuality and sexual desire are in fact one of the innate instincts in people. The purpose of this motive is the desire of human and other beings to continue their own descent.

Does sexual intercourse in pregnancy harm the baby?

By the recognition of pregnancy, maternal instinct becomes more dominant in women.

The idea that any kind of external intervention in women with their first pregnancy can harm the baby may blunt expectant mother’s sexual desire. However, there is positive effect of sexual intercourse in a normal pregnancy. It can prevent premature delivery. Because during sexual intimacy some utero-relaxant mediators are released.

Although there is a widespread idea among people that early sexual intercourse causes disability or death of the baby and pregnancy will result in abortion, this has no scientific evidence. As pregnancy progresses and the mother adapts to this change, sexual desire may increase, but intercourse becomes technically difficult by the uterine gets larger. This may occasionally lead to pain and ache in the expectant mother. For this reason, sexual desire may be reduced again in the final stages of pregnancy. There is no restriction in sexual life until birth when everything goes normally.

Who can be restricted to have sexual intercourse?

In some cases, there is a restriction for intercourse.

Vaginal bleeding: If a woman has vaginal bleeding at any period during pregnancy, sexual intercourse is definitely not allowed for women with abortion and premature birth risk. This restriction will continue until the risk is determined to be completely eliminated.

Placenta previa: In the case of placenta previa, which is in the category of risky pregnancies, it is necessary to avoid intercourse due to bleeding risk.

Breaking out of amniotic sac: Breaking out of water at an early time causes risk for infection and premature birth. Sexual intercourse is not allowed in this case.

Cervical insufficiency: If cervical canal is shorter and wider than normal, it causes risk for premature birth.

Premature birth risks: Existence of premature birth and abortion risk or those who previously had these problems under the risk. Sexual intercourse is not recommended for these pregnant women.

Genital infections: In case of a diagnosed genital infection in man or woman, sexual intercourse should not be allowed until an accurate treatment is completed.

If vaginismus and pregnancy at the same time: Vaginismus patients can sometimes become pregnant without experiencing sexual penetration. This is caused by swimming capacity of sperms.

Vaginismus patients who become pregnant in this way can apply for our clinic in 3th-7th months of pregnancy (second trimester) for vaginismus treatment. In this way, they gain the freedom to have sexual intercourse in pregnancy and also undergo gynecological examination and have the chance of making normal delivery. On the other hand, they will not postpone the solution to their problems.

Is it right to have sex in pregnancy?

If there is no risk of premature birth or abortion, if the placenta is located normally, if couples do not carry genital infection, sexual intercourse can be recommended until the delivery. However, people who have frequent abdominal, inguinal pain and bleeding complaints should avoid sexual intercourse.

Does sexual intercourse cause miscarriage?

Many couples think that having sexual intercourse in the first three months of pregnancy can lead to miscarriage. However, most of the abortions occurring during this period are not related to sexual intercourse but related to genetic defects of the fetus.

Does orgasm cause premature birth?

Orgasm can cause uterine contraction. However, according to the majority of the studies, orgasm does not lead to premature birth.

But be careful. If you have had premature birth before, stimulation of nipples may trigger your birth pain.

Does sexual intercourse harm the baby?

Definitely no. During intercourse, man’s penis does not physically touch to the baby. Because the baby is well protected by uterine muscles, amnion fluid and amnion sac.  In addition, mucus plug (cervical mucus) at the entrance of the uterine duct prevents the passage of semen and bacteria into the uterus. However, if deep intercourse or forcing cause pain, this should be avoided.

Until which week is sexual intercourse free during pregnancy?

It is free until the last week of pregnancy. Moreover, a large-scale meta-analysis study showed that hormones secreted during intercourse reduce uterine contractions and prevent premature birth.

Is condom use recommended in sexual intercourse during pregnancy?

All polygamic women who have sex with new or more than one person should use condoms to protect against sexually transmitted diseases whether they are pregnant or not.

All pregnant women who have sexually transmitted diseases are susceptible to infections that may harm the baby and have the possibility of premature birth.

Hepatitis B, Hepatitis C, HIV (AIDS) and Herpes microorganisms are sexually transmitted agents and can be transferred to the baby through birth.

How is the sexual desire of women affected in pregnancy?

The pregnancy has three different trimesters; the first three months, the second three months and the last three months. As the characteristics of each period are different, sexual desires and desires in these periods are different.

First three months: In the first trimester of pregnancy, which is the adaptation period, there may be a general decrease in sexual desire and this may affect the sexual life of the couple. In this period, changing hormone balances, exhaustion, fatigue, nausea and vomitingcan make the woman feel weak and ugly, thus affecting the sexual desires negatively.

Second three months: During the second trimester, a number of sexual impulses begin to occur. By the increase in the blood flow to nipples and sexual organs, sexual drives become denser. Increased blood flow to nipples and sexual organs can cause the woman to feel herself permanently ready for sexual intercourse. Sexual desire is  quite enhanced and orgasm is facilitated in this trimester.

Last three months: In the last three months, pregnant women generally feel that their sexual desire is starting to decrease again. A large abdomen can make sexual intercourse physically difficult. In addition, increased fatigue, back-waist-abdominal pains, increased vaginal discharge and fungal infections, pain during sexual intercourse because of edema on vagina may fridge the pregnant woman from sexual intercourse again. Couples in their last pregnancy period can try to have sex in positions where they can move easily without forcing each other.

Which positions can be tried in sexual intercourse during pregnancy?

Trying different positions may be beneficial during pregnancy. For example, the position where the man is on the top of the woman, which is mostly preferred method, will disturb both the mother because of abdominal pressure in pregnancy and disrupt blood circulation of the baby. In further pregnancy weeks, such positions should be preferred where the woman and baby are on the top or sides and woman can control her movements.

How can couples deal with all these sexual desire changes?

The pregnant woman can expect compassion from her spouse without having sex. But, man can perceive this reluctance as a rejection. The important point is that couples should speak clearly with each other about their desires and wishes. Other sex methods can also be discussed. For example, oral sex, massage or masturbation can be different options for the satisfaction.

Why people do not speak much about sex during pregnancy?

Scientific publications on the subject are confusing. Another reason is that some physicians may be uncomfortable on talking to their patients about sexual issues. For these reasons, couples may take the message that they should avoid sexual intercourse during pregnancy. Actually, sexuality and sexual desire are one of the innate instincts in human beings. The purpose of this motive is the desire of human beings to continue their own descent. However, unfortunately, this issue is still a taboo.

How long after delivery can couples have sexual intercourse?

The correct answer depends on the couple. Generally, if there is no disturbing problem and everything goes well, sexual intercourse can be started 3 weeks after normal birth or cesarean section. But couples, after becoming a parent, also have some changes in their sexual relations. This is very normal, and if there is some question in their minds, it is best for them to contact a doctor who they trust in.

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Assoc. Prof. Süleyman Eserdağ, MDAssoc. Prof. Süleyman Eserdağ, MDCosmetic Gynecologist & Sexual Therapist
Fellow of European Committee of Sexual Medicine (FECSM)
Editor of the Book ‘Female Aesthetic and Functional Genital Surgery’
+90 (530) 763 34 00
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