Excerpt from The Birth Center Client Manual
Intercourse and other forms of sexual activity are permitted throughout pregnancy with only a few exceptions. While this sounds simple and straightforward, couples have many concerns about it. For a good resource book, we recommend Making Love During Pregnancy by Elizabeth Bing, of which there are two or three copies in our library. Following are some common questions and concerns regarding sex during and after pregnancy.
Can we bring on a miscarriage in the first trimester as a result of intercourse?
A healthy pregnancy cannot be interrupted by sex in the first trimester. When miscarriage occurs soon after intercourse, the intercourse is just the trigger that starts the expulsion process and not the cause of a miscarriage.
What about bleeding after intercourse? Does this mean we have to stop having sex for the duration of the pregnancy?
The amount and color of the bleeding should be discussed with the CNM. If it seems abnormal, we may ask you to come for a visit or have lab work or an ultrasound done. However, barring excessive, bright red bleeding, it is very common for women to experience a little blood with intercourse as the cervical blood vessels can rupture during intercourse. The blood volume of a pregnant woman is increased by 30-50%; the cervical blood vessels thus become quite swollen. Any pressure on them (i.e. the penis or even a pelvic exam) can cause them to rupture and bleed. The rule of thumb is that if you bleed after intercourse, put a pad on, lie down, and assess the blood flow over a short period of time. If it acts like a nosebleed, bright red blood followed by blood turning brown (indicating the vessels have clotted), there is every reason to believe that the bleeding is simply a broken vessel. This has no impact on the pregnancy. If, however, the bright red bleeding continues, increases, or seems excessive, do not hesitate to call TBC. If the spotting turns out to be coming from the cervix and not the placenta, it does not need to impede your sexual activity.
What about the contractions I feel after intercourse, especially if I have an orgasm?
These contractions are normal and are caused by your body’s release of oxytocin in response to pressure on the cervix (the penis), a large amount of the hormone prostaglandin, and becoming sexually stimulated or reaching orgasm.
Oxytocin from all these sources makes the uterus contract. There is no evidence that with normal pregnancy these contractions are sufficient to start labor prematurely or cause oxygen deprivation to the fetus.
When should we refrain from intercourse, assuming a normal pregnancy and birth?
If one partner is uncomfortable with it physically or psychologically, then refrain from intercourse. However, it is important to communicate sexually in other ways so that the partner who still desires intercourse does not feel upset, frustrated, or rejected. Good communication, tender words, loving touch, and alternate forms of sexual activity can go a long way to keeping a relationship healthy.
If you have any concern that your amniotic fluid is leaking, do not have intercourse until you have been seen by a CNM. If the sac is leaking, nothing should be placed in the vagina, including tampons.
Have additional questions? Never hesitate to ask a midwife at your next appointment!