Sex during pregnancy is quite misunderstood that is why it is important to set some ground rules.

Having sexual intercourse during pregnancy is safe unless the physician suggests otherwise. During pregnancy having sexual intercourse will not hurt the fetus because of the protection of the muscular wall of the uterus as well as the amniotic fluid that is used as a cushion inside the sac. However, it is normal for sex drive to change during pregnancy. This is not a worrying issue and it is helpful to talk about it with your sexual partner.

In normal pregnancies without any complications, having sex and orgasm will not increase the risk of going into labor or cause a miscarriage. In later stage of pregnancy though it may cause mild contractions which are called Braxton Hicks contractions. Although uncomfortable there is no need to worry. Resting and trying relaxation techniques can help the contractions pass. If you still worry about it and feel uncomfortable is best to call your physician. One exception of sexual intercourse during pregnancy is women in late pregnancies that are overdue to induce labor due to the fact the that semen has prostaglandins that help “ripen” the cervix [1] [2].

Miscarriages are mostly due to the fetus not developing normally not due to sex during pregnancy [3].

• If during a complicated pregnancy there is heavy bleeding then is best to avoid it due to increased risk of hematoma (collection of blood).
• If your waters broke it can increase the risk of infection. Is best to have a gynecological examination and confirm that the water has indeed broke.
• Problems with cervix are known to have a higher risk on going into labor early or having a miscarriage.
• If the placenta is low and confirmed with an ultrasound (placenta previa).
• In multiple pregnancies or preterm deliveries is best avoided.
• If you or your sexual partner has a sexual transmitted disease (STD) is best to not have sexual intercourse. In cases where sex during pregnancy might occur it is important to use a condom to protect either one of you as well as your baby and that includes vaginal, oral and anal sex [1] [3].

During the three trimesters of pregnancies:

• First trimester: Sex drive can be low during the first trimester due to nausea, fatigue and breast tenderness.
• Second trimester: Libido is increased and thus increased blood flow throughout the body enhances orgasms.
• Third trimester: With a normal developing pregnancy it might feel uncomfortable.

Is best suggested to find comfortable positions to reduce pressure on your belly and lying flat that way avoiding the uterus in pressuring major blood vessels [2].

It is advised to wait up to 6 weeks without having any sexual intercourse and during this period which is called postpartum it might be difficult as well due to:

• Normal postpartum bleeding
• Healing from an incision that might occurred during delivery
• Healing from a c-section
• Fatigue
• Demands of your baby
• Changing of hormonal levels
• Sore breasts from breastfeeding
• Anxiety, postpartum blues, emotional issues of new parenthood

After the healing process of any incisions that have been made which can take several weeks it is safe for a couple to start having sex again. Is best to engage in any sexual intercourse when you feel physically and emotionally stable, relaxed and comfortable. Water-based lubricants can ease any discomfort of vaginal dryness. Intimacy can be enjoyed in other ways as well as cuddling, kissing or massaging each other.

References:

1. https://www.nhs.uk/pregnancy/keeping-well/sex/#:~:text=It%27s%20perfectly%20safe%20to%20have,will%20not%20hurt%20your%20baby.
2. https://www.webmd.com/baby/guide/sex-and-pregnancy
3. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318
4. https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/sex-after-birth/