Sex During and After Pregnancy

Sex During Pregnancy

Many couples experience some changes in their sexual relationship during the nine months of pregnancy. Changes may vary throughout the different stages of pregnancy, enhancing the sexual relationship for some, while disrupting the relationship for others.

Questions you may have:

Q. Is it safe to have sexual intercourse throughout pregnancy? 

A. Yes. The uterus is a protective muscular organ which encloses the developing baby completely, so that the penis does not touch the baby. In addition, early in pregnancy, a mucous plug forms at the cervix or entrance to the womb. This blocks bacteria from entering the uterus and allows women to bathe, swim and have sex safely.

The most common time for miscarriage is the first three months of pregnancy. If there is reason for concern a couple may feel more comfortable delaying sexual intercourse. Doctors may advise against intercourse during this time if a woman has had any spotting of blood or has miscarried previously. Intercourse itself cannot cause a miscarriage. It may be reassuring to know that up to approximately 1/3 of women have some bleeding at the time of an expected period and proceed to have a normal pregnancy.

It is a good idea to report any bleeding to your doctor and seek his recommendation regarding intercourse.

Q. Can intercourse cause labour to start? 

A. No. Labour will begin naturally at the end of a normal pregnancy. Intercourse is usually safe until labour begins. Should labour start following intercourse, it is simply a coincidence and not a cause of premature or early labour.

Q. Does pregnancy affect a woman’s sexual desire, needs and satisfaction? 

A. Perhaps. A woman experiences many hormonal, physical and emotional changes throughout her pregnancy. The following are examples of these changes as they may occur in each trimester.

The First 3 Months:

Early symptoms of pregnancy such as fatigue, nausea, vomiting and breast tenderness may make sex less desirable. Breast stimulation may need to be postponed during sexual activity if uncomfortable.

The Middle 3 Months:

As the above symptoms disappear, a woman may begin to "feel more like herself".  With increased vaginal blood supply and discharge occurring at this time, a woman’s sexual feelings and desire for sex may also increase.

For others, the increasing size of their belly as the baby grows may be uncomfortable.  A woman may also be feeling less attractive or desirable which may contribute to lack of interest in intercourse.

The Last 3 Months:

In the last weeks of pregnancy, discomforts like breathlessness, fatigue, increased size, and a downward pressure as the baby settles into the pelvis may again make sexual intercourse less comfortable.

Q. Does pregnancy affect a man’s sexual desire, needs and satisfaction? 

A. Sometimes. A man may continue to find his pregnant partner sexually desirable and, in addition, find pregnancy especially arousing. The pregnant figure, to another, may be less attractive.

The latter reaction may be related to feelings of fear about harming the baby or causing early labour or miscarriage.  (Labour or miscarriage does not happen as a result of intercourse.) A man may also feel left out when his pregnant partner receives more attention from friends, relatives, and even strangers. Feelings of rejection may grow if the woman is also disinterested in sex.

Suggestions

• If intercourse is not advised or is uncomfortable, practise mutually satisfying caresses, body contact, or oral sex. Loving feelings may be expressed without penis/vagina intercourse.

• Enjoy exploring other ways of touching and giving sexual pleasure to each other.

• Be creative and find various positions that make intercourse more comfortable.

• Identify feelings as they occur in your sexual relationship. Discussion and acceptance of each other’s feelings will contribute to closeness and help avoid misunderstandings.   

Sex After Pregnancy

Just as pregnancy may alter a couple’s sexual relationship, so may childbirth.

Childbirth is the source of both physical and emotional changes for the new mother and can affect her sexuality.

Some women have little or no interest in sex after childbirth, while others resume intercourse quickly. Some men feel the same and temporarily lose their ability to maintain an erection. After several months, if one of you still feels reluctant to resume your sexual relationship, ask for help. Your doctor may not automatically discuss the issue, so if you need advice, don’t hesitate to ask.

Doctors’ guidelines will vary from permitting sex as soon as it is physically comfortable to resuming intercourse following the six week checkup. Some couples may prefer to wait until the bleeding has stopped after delivery and your doctor may suggest this as well. This can vary from two to six weeks after delivery.

Physical and Emotional Changes Following Pregnancy

Episiotomy –incision (cut) made during labour to enlarge vaginal opening; incision is closed with stitches after birth of baby

Effects 

 • An Episiotomy may cause discomfort.

• A woman may feel uneasy about resuming sex.

• The usual healing time lasts 2-3 weeks.

• The area may remain sensitive to stretching or pressure for many weeks.

What You Can Do 

• Use sitz baths to increase comfort.

• Use alternate sexual activities, suggested in section "Sex During Pregnancy."             

• Avoid penetration until incision is completely healed.

• Vary positions during intercourse to put less pressure on the incision.

Hormonal Changes

Effects 

• Vaginal dryness may lead to painful intercourse (usually improves within 8-12 weeks after delivery).

• Breastfeeding mothers may experience this dryness for a longer period of time.

• Some women may have no sexual desire at all for several months following the  baby’s birth.

• Sexual arousal after delivery may take longer.

• Emotional changes may continue for weeks, possibly months and may decrease sexual interest.

What You Can Do 

• Use a lubricant such as spermicidal cream or jelly or K-Y jelly to increase ease of intercourse.

• Include a longer period of foreplay before penetration.

• Consult you doctor about prescribing estrogen cream, applied to the vagina, for short-term use. This may not be recommended for nursing mothers.

Breasts

Effects 

• Nipple tenderness and decreased breast sensation occur in some breastfeeding mothers. Touches that were previously stimulating may be irritating or have no effect.

• Bottle feeding mothers may experience the same for shorter periods of time

• Sexual arousal may cause milk to leak from breasts. This will settle once nursing is well established. (approximately 3-4 months)

What You Can Do 

• Stimulate breasts only as comfortable. Breast milk will not be affected.

Decreased Vaginal Muscle Tone

Effects 

• The vagina may feel less tight during intercourse.

What You Can Do 

• Tighten the muscles used to stop the flow of urine and hold for a count of 5. This helps you to landmark the muscles you wish to tighten.  Once you know which muscles you want to exercise, practice tightening them several times a day when you are not going to the bathroom.  Do a set of five exercises at each session so your muscles do not tire easily.

Emotional Changes and Fatigue

Effects 

• Demands of parenting and family adjustments may decrease sexual interest.

• The physical contact in the care and handling of a baby may decrease interest in other physical contact. Breastfeeding mothers, especially, may feel touched out.

• Mothers may feel frightened, wondering if they have given up sexuality to motherhood.

• Interrupted sleep and caring for a new baby can be exhausting.

• Some new mothers feel sexually undesirable due to visible after effects such as stretch marks, remaining weight, episiotomy or scar from Caesarian section.

What You Can Do 

• Discuss feelings honestly and openly with partner before the baby arrives and afterwards when problems develop; this helps prevent problems in the relationship.

• Plan couple time as soon as possible after birth of baby, to enjoy each other.

• Rest often throughout the day. Getting enough rest helps mothers cope with changes and interrupted sleep during the night.

Birth Control Needs

Fertility can return immediately after delivery. If a woman is bottle feeding, her menstrual period will likely begin about six weeks after delivery. Ovulation (the fertile time) almost always occurs before this period so a birth control method must be used anytime after delivery.

If a woman is breastfeeding, ovulation and the return of menstruation is less predictable. Many factors will influence this, but breastfeeding is not a method of birth control and there is always a risk of pregnancy.

For more information about birth control methods, visit the sexual health section of this website or call Public Health and speak with a public health nurse in the sexual health program.  Contact us

 

REFERENCES

If you wish to do any more reading, the following books are available at your library or book store.

  • Woman’s Experiences of Sex. The Facts and Feelings of Female Sexuality at Every Stage of Life. Sheila Kitzinger. 1983.
     
  • The Joy of Sex. Edited by Alex Comfort. 1972.
     
  • Is There Sex After Childbirth? Teresa Pitman. Health Sharing, Winter 1987.
     
  • The New Our Bodies/Ourselves Book. Boston Women’s Health Book Collective. 1984.
     
  • Pregnancy and Birth Book. Dr. Miriam Stoppard. 1985. 
     

Acknowledgement to Simcoe County District Health Unit

 

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