Q: Can having sex in pregnancy harm the baby in any way?
A: Unless you have been told by your midwife or doctor to avoid intercourse because of specific problems, such as a history of miscarriage, preterm labor, or unexplained bleeding, then sex is perfectly safe since your baby is cushioned in fluid in the amniotic sac inside your womb and protected by a cervical plug, and even deep penetration isn't harmful. Enjoying intimacy with your partner will also be beneficial for your relationship.
Q: I'm either uncomfortable when we make love or not in the mood. Should I fake it?
A: Levels of sexual desire in pregnancy vary greatly, with some women finding their sex drive is heightened, while others feel too ill, anxious, hormonal, or just too uncomfortable to attempt sex at all. If you really don't want sex, be as honest and open as you can about your lack of sex drive. Don't be pressured into doing something you really don't want to do, since this could complicate your relationship. Communication is very important at this time, so talk to your partner about how you are feeling—you may find that he is completely unaware of your feelings, anxieties, and worries.

You could use the presence of your growing belly as an ideal excuse to experiment with different positions, since most couples find the missionary position very uncomfortable in late pregnancy. Some couples prefer it if the woman is on top as this allows her more control over the amount of penetration and there is less weight on her abdomen. A “spooning” position, with your partner behind you, also allows for shallower penetration and removes pressure on your uterus. Having a baby is all about adapting to new experiences, and most couples find they need to adapt their sex life too.

Q: Since we hit the second trimester I've wanted sex more than ever—why is this?
A: Often, in the second trimester, women find that once early pregnancy symptoms wear off they feel far more energetic and sexier than ever! However, this may not be the case for everyone since each woman is affected differently by the physical and psychological changes that occur in pregnancy, and women have different views about their changing bodies, which can affect their libido.

From a physiological point of view, an increased blood flow to the pelvic area combined with an increased lubrication of the vagina means that, in theory, having sex can be better than ever. So if you and your partner are quite happy with your increased sex drive, this is not a problem.

Q: My placenta is low and I've been told to avoid sex. Why is this? I'm only 30 weeks' pregnant.
A: As the baby develops and grows so does the uterus. The result is that the placenta is carried upward and away from the cervix. However, in about 10 percent of women, the placenta remains low-lying during late pregnancy and then poses a risk because of potential bleeding . A low-lying placenta is often first detected at an early ultrasound and, if this is the case, it is usual for a repeat scan to be carried out at around 28 weeks of pregnancy to determine if the placenta is still low and exactly where it is situated in respect to the opening to the cervix (neck of the womb).

The biggest risk from a low-lying placenta is bleeding and if you have already experienced any bleeding, it is usual to recommend that you avoid sexual intercourse, since contact with the cervix and contraction of the uterus, which happens during sex, can encourage more bleeding. If you're in any doubt, it's probably best to discuss your particular circumstances with your midwife or doctor.

Q: My partner hasn't wanted sex at all since I've become pregnant. Will he ever be interested in me again?
A: It isn't uncommon for either partner to experience a reduced sexual desire in pregnancy for a variety of reasons. It is important that you talk to your partner and ask about his feelings while also explaining your own thoughts and feelings.

Some partners find pregnancy a little scary, and some of these fears center around sex and concerns about harming the baby or you. Sometimes, these worries may be based on real concerns, for example, if there have been any problems in early pregnancy such as threatened miscarriage, bleeding, pain, or excessive morning sickness. Equally they can be based on misunderstanding, and this is where discussion between the two of you will help. Although you may feel more attractive and sexy, perhaps your partner is feeling clumsy and uncomfortable. Each couple is different and you will need to talk to each other to find your way through this. You may also feel that you want to talk to someone who isn't so closely involved, such as your midwife, doctor, a trusted friend, or a relative.

Q: Is it best to stick to oral sex during pregnancy?
A: Research on the benefits and risks associated with oral sex in pregnancy is limited and the findings are very often contradictory. There is nothing that indicates that oral sex is recommended in place of penetrative vaginal sex unless you have been advised to avoid sexual intercourse because of the risk of bleeding, threatened miscarriage, or premature labor, when avoiding orgasm is also advisable and so complete abstinence is the better option for a while. Apart from this, it is important to remember that some infections can still be passed on easily by oral sex.
Q: Will having an orgasm cause me to go into labor?
A: In a pregnancy without problems, an orgasm alone will not cause premature labor, and at full term orgasm will only cause the onset of labor if your body is ready for labor anyway. If you have had any signs of premature labor, or if you have had premature rupture of your membranes, you will be advised to avoid sexual intercourse. This is because the hormone oxytocin increases during sexual arousal and the effect from the oxytocin is to cause the muscles of the uterus to contract.

During pregnancy, the muscles of the uterus experience practice contractions, known as Braxton Hicks, which are not harmful, and orgasm may increase these practice contractions.

If you have gone past your due date and are at a point when your body is ready to go into labor, some experts feel that sexual intercourse may help things to start for two reasons: the prostaglandins in semen will help the cervix to soften at this stage of pregnancy, and the contractions stimulated by orgasm have more chance of developing into early labor contractions.

Q: I've got problems with my pelvis—is there a comfortable way for us to have sex?
A: Problems with the pelvis, particularly symphysis pubis dysfunction or SPD, tend to be made worse by moving your legs too far apart, so it is a matter of finding a position that you feel comfortable in that doesn't involve too much stress on the pubic area. Many women find the “missionary position” the most difficult as it involves significant parting of the legs, plus there is the weight of a partner to consider.

Some, although not all, women find an all-fours position for intercourse more comfortable, both for sexual intercourse and for giving birth. If intercourse is really proving difficult or painful, then it could be that while you are experiencing significant problems you will need to find alternative ways for you and your partner to be intimate that do not involve penetrative sex.

You can talk to your midwife or doctor for a referral to a physical therapist, which may be beneficial and help you to achieve a greater degree of comfort during pregnancy. However, it may encourage you to know that many women find that pelvic discomfort improves significantly once they have had their baby.

Q: I'm 36 weeks. My boyfriend insists on regular sex and has been a bit abusive. Is this normal?
A: It is not normal for someone to be abusive to another person or to force them to have sexual intercourse when they don't want to. You should never be forced to do something that is against your will. In almost 30 percent of all domestic abuse cases, the first incidence occurs in pregnancy. It is very important that you talk to someone about how your boyfriend is treating you, perhaps to a close friend or relative. There are also organizations that offer confidential advice and help you if you really feel there is no one you can talk to or trust. You could also try talking to your health-care provider, who will treat everything you say in the strictest confidence and will have details of local organizations that can help and advise you.

Talking to each other Maintaining a healthy relationship

It is essential that you and your partner keep the lines of communication open during this time of change and uncertainty.

  • If you don't want to have sex at all, you should reassure your partner that this is a temporary situation and explain how the pregnancy is making you feel mentally and physically.

  • Likewise, if your partner seems reluctant to initiate lovemaking, don't take it personally. Try to find out how he is feeling.

  • Don't allow a quieter sex life to stop you being affectionate at other times.

Comfortable lovemaking

You and your partner may need to experiment more during pregnancy to find lovemaking positions that are comfortable for you and your rapidly growing belly. As pregnancy progresses, most women find that lying on their back in the missionary position becomes increasingly uncomfortable. You may find being on top an enjoyable position, which allows you to control penetration and does not put pressure on your belly. Lying in the spoons position, with your partner behind you, can be pleasurable and puts no pressure on your abdomen. Other positions that don't restrict your pleasure and are comfortable include sitting together, kneeling while your partner enters from behind, and lying side by side with your legs bent over your partner's legs.

Time to explore:

As your body changes, you and your partner may have to use your imagination during lovemaking to find comfortable positions. You may both find you enjoy this time of discovery.

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