Sex during pregnancy: safety, changing desire and communication

Sex during pregnancy is something many couples wonder about but find hard to bring up. There is no need to feel embarrassed; these questions are very common and your care team hears them often. In short: in most healthy pregnancies sex is safe, but every pregnancy and every couple is different.

Can it harm the baby?

The baby is protected inside the womb by amniotic fluid and strong muscle, and a mucus plug at the cervix forms a barrier against infection. So for most people, sex does not harm the baby and does not cause miscarriage or early birth. In some special situations your doctor may still advise against it (see below).

• A penis cannot reach the baby.
• Mild contractions can occur during orgasm; in a healthy pregnancy they usually pass quickly.
• Condoms can still be used in pregnancy to protect against sexually transmitted infections.

Why does desire change?

During pregnancy desire may rise or fall. That is very common.

• In the early months nausea, tiredness and tender breasts can lower desire.
• In the second trimester many people feel more energetic and comfortable; increased blood flow to the pelvic area can raise desire.
• In the last months a bigger belly, breathlessness and back pain can make positions harder.
• Body image, worries and mood swings play a part too.

Feelings change for partners as well. Fear of hurting the baby or the weight of a new responsibility can affect desire. Both of you are reacting naturally.

Talking: the most helpful tool

Silence often leads to misunderstanding. “I do not feel like it” does not mean “I do not love you,” and saying so openly protects closeness.

• Share which days and times feel easier.
• Say gently what feels good and what does not.
• Accepting a “no” without pressure or blame builds trust.
• Closeness is more than sex: hugging, massage, kissing and spending time together also strengthen your bond.

Comfortable positions and practical tips

As the belly grows, some positions become uncomfortable. In later weeks, lying flat on the back for long is usually not advised; lying on the side or using pillows for support may feel better.

• Side-lying or side-by-side positions do not press on the belly.
• Pillows under the back and belly add comfort.
• Avoiding deep penetration and going slowly suits many people better.
• If there is dryness or sensitivity, a water-based lubricant can be tried.
• If you feel pain, stop; your comfort comes first.

Close to birth and afterwards

When to resume sex after birth varies from person to person. Your doctor or midwife will guide you based on the type of birth and your recovery. Not rushing until you both feel ready is a good way to protect the relationship.

Emotional closeness and body image

The body changes quickly in pregnancy. Some people feel attractive and strong, others uncomfortable. When a partner voices love and appreciation in concrete words, it becomes easier to adapt to the change. Differing expectations about intimacy are also common; one may want more closeness and the other less. In such moments you can find a middle path together and keep the relationship warm without pushing anyone. If you wish, talking about it with your doctor or midwife can help as well.

When to contact your doctor

In the situations below, avoid sex and contact your doctor or midwife without delay; call 112 (or your local emergency number) for heavy bleeding or severe pain.

• Vaginal bleeding or brown spotting
• Leaking fluid, or the suspicion of it
• Contractions, abdominal or lower back pain
• Pain, burning or foul-smelling discharge
• Risks your doctor has already named: with placenta praevia, a history of preterm birth, a weak cervix or a multiple pregnancy, sex may be restricted or advised against

If you are unsure about your own situation, ask; these are very ordinary questions. This article is for information only; for your personal situation, your doctor's or midwife's advice comes first.