Sex During Pregnancy: Your Questions Answered

Intimacy questions in pregnancy are one of the main things that people ask me over and over throughout the years. There are many question marks, things are changing, and partners get nervous. It is also complicated to tell which pieces of advice are for you when Google is at the tips of your fingers. These are some of my general tips and tricks when it comes to intimacy during pregnancy, but first and foremost, trust yourself and your body. If you have any concerns, your care provider is a great resource for getting answers for your specific situation.

Is It Safe to Have Sex?

The first question I am frequently asked is if it is safe to continue with penetrative sex. My answer can include vaginal penetration and anal penetration, and for 99% of people, my answer is a firm yes. Who should avoid penetrative sex? Anyone who has a previous history of early labor or who has been told to be on pelvic rest. Someone whose partner is living with HIV or Aids. And anyone who does not wish to have penetrative sex. 

Will Things Touch Baby?

Will a penis or toy touch the baby? No, they will not. If your worry is about size, the answer is still no. We are not worried about the baby being touched. The great news is that, in most cases, the cervix does a pretty impressive job of ensuring nothing goes in or comes out until your baby is ready. The first way a cervix keeps babies in is that it begins and stays facing your back or posterior. This makes it so that the cervix is not being bothered by anything penetrative and provides a lot of work to be done before there is a straight shot exit for your baby.

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Another helpful thing to protect the cervix is that, in most cases, the cervix stays mostly, if not completely, shut until the last few days or weeks of pregnancy. Even if your cervix is dilated, it is unlikely that a toy or body part could penetrate it enough to make contact with the baby. The mucus plug is the last way that the cervix protects against infection or anything entering it. You may have heard that people can lose their mucus plug at the end of pregnancy, but what is cool is that it just keeps producing more until birth occurs. You can lose a mucus plug many times, and regeneration continues, providing a barrier that protects against infection and anything touching a baby's head.

Sex During The First Trimester

Often, we tell people that the best way to get the baby out is the way we get the baby in. This can be helpful information towards the end of pregnancy, but it's scary to hear when you are only a few weeks. The good news is that unless you have a high risk of miscarriage or early labor, sex is not going to bring a baby that is not ready to come. Orgasms indeed tone the uterus and, at the end of pregnancy, can cause contractions that lead to birth. It is also true that sperm contain prostaglandins, which can help with dilating and effacing the uterus. But again, these things are gentle enough that in most cases, if a baby is not due and has not decided today is their birthday, they will not cause labor. 

Can I Continue with BDSM Throughout My Pregnancy?

This question can be more multifaceted and dependent on what your BDSM practice looks like, but in most cases, the answer is yes, with slight adaptations. For example, some positions need to be adjusted to make them safe for pregnancy, and it is best practice for a pregnant person to be able to change positions as needed for their comfort. Lying flat on your back or stomach can be not only unsafe but extremely uncomfortable while pregnant. Staying in one position for an extended period of time can also be unsafe. If something does not feel right, that is your body's way of telling you it is time to change. Other things to consider are the tightness of any bondage activities, it is best practice to err on the side of vanilla, avoid erotic asphyxiation altogether while pregnant as it can be deadly for a gestating baby, and being a bit more gentle with spanking, making sure it is only ever on the bottom and never on the belly. Lastly, it is crucial to feel safe throughout the entire situation. Even roleplaying unsafe situations can lead your baby to think they are not secure and can release cortisol, which is a hormone that we should try to minimize as much as possible while pregnant.

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Do I Have to Have Sex?

Do I have to have sex is another question I get a lot. In any situation throughout your life, the answer to this will always be a hard and resounding no. You should never have sex if you do not whole-heartedly want it. Consent is crucial. You do not need to have sex for you to have a beautiful and safe pregnancy. For some, sex drive is increased and wanted more frequently. If this is you, enjoy! For many others, the libido goes down, and you're already being kicked and touched out from the inside out. Sex just does not feel like it is on the table. If this is you, not only are you very normal, but your lack of desire is valid. Communicate how you feel and what is happening to any partners, and continue to be true to yourself and your needs while pregnant. If you are struggling with discomfort with sex, it could be helpful to use extra lubricant, have more prolonged bouts of foreplay, or use vibrators or toys. One of my favorite books about sex in a body with a vagina is called "Come As You Are" by Emily Nagoski. It has helped many of my clients and changed my own sex life completely.

Whether you are having a wild and sexy pregnancy or taking it slower and even avoiding sex altogether, you are doing great. There is no "right" and "wrong" when it comes to sex and intimacy in pregnancy and in life in general. Unless your doctor has prescribed pelvic rest, it is up to you and your comfort level at what you participate in sexually while pregnant. Most types of sex are safe, and orgasms can prepare your uterus for labor. Non-consensual sex is never okay in any scenario. You do not owe any partner sex, you do not have to participate in sexual activities that you previously enjoyed, and you can say that you are done at any point, even if you gave consent previously. If you think that you may be in a domestic violence situation or feel coerced or forced to participate in sex, help is available. Call 1-800-799-7233 if you are anywhere in the United States.

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