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How Sex May Change Throughout Your Pregnancy

By Linda Carroll
Reviewed by Alyssa Quimby, M.D.
December 18, 2023

During pregnancy, each trimester brings a different set of changes to your body, your mindset, and your comfort level—and these can affect many things, including your sex life.

The good news is that, assuming you want it, sex is safe for most people during pregnancy (it may even be beneficial in some ways). It’s a good idea, though, to first consult your doctor to be sure you don’t have any complications that could make it off-limits. And it’s also important to know that your sexual appetite and enjoyment may change as your body changes.

“It’s quite common for couples to struggle with sex during pregnancy,” says Candice Hargons, Ph.D., an associate professor of counseling psychology at the University of Kentucky in Lexington.

Overcoming struggles is often possible, but you may need to adjust some aspects of your sex life as changes happen during pregnancy and postpartum, says Maureen Whelihan, M.D., a board-certified gynecologist who specializes in sexual medicine and practices in Lake Worth, Florida. “It’s really about being creative and understanding each other’s changes throughout the trimesters.”

To give you a preview of how your sex life might change throughout pregnancy—plus, advice on how to handle it—here's a guide to pregnancy sex, trimester by trimester.

Sex During the First Trimester

The first trimester is a time of change, and for some pregnant people, it’s also a time when nausea and exhaustion might temper your sex drive, says Hargons. It’s important for couples to be able to discuss these changes and allow for them, understanding that they won’t last forever. In fact, she says, they may only last a few weeks. Even as soon as the end of the first trimester, things may shift and you may start feeling some relief from nausea and fatigue, Hargons says.

“As the pregnant person’s body is changing, it may cause an increase in sexual desire and lubrication, typically at the end of the first trimester or at the beginning of the second trimester,” she explains.

Whether you’re feeling an increased or decreased interest in sex, ongoing communication with your partner is key, says Hargons. Also, if intercourse isn’t appealing but you’re still in the mood, think creatively. “[There are] many ways one can have sex (oral, manual, etc.), and not all require penetration,” Hargons says.

It’s also perfectly fine to abstain if you just don’t feel like having sex at this time. But if you’re nervous about safety, don’t be—as long your doctor has cleared it. “It’s not necessary [to refrain from sex],” Hargons explains. “You may get some bleeding in the first trimester with intercourse, because the cervix has a lot of blood flow, and when the penis touches it, it can produce bright red spotting.”

That might scare some parents-to-be, but it doesn’t mean there’s cause for alarm. “If it goes beyond spotting , by all means, they should contact [their doctor],” Whelihan says. Spotting is defined as a few drops of blood or bleeding with wiping that can be red, pink, or brown in color.

Sex During the Second Trimester

Typically, the second trimester is the sweet spot of pregnancy when it comes to sex, says Whelihan. “The uterus has risen out of the pelvis, so there’s not a lot of pressure down there. Your hormones, at this point, [tend to] make you feel happy and excited.”

While the second trimester tends to be the best trimester for sex, your changing body could bring some shifts in self-esteem and comfort. Whelihan says that some bodily changes (such as extra vaginal secretions) can make a pregnant person self-conscious and less likely to want to be intimate. Open discussion may help ease any feelings of shame or embarrassment.

Another issue may be new aches and pains from the growing uterus, says Hargons. This may make some positions that felt good before less comfortable, even in the “sweet spot” of the second trimester, so be sure to speak up and be clear if something isn’t feeling good anymore.

“For people who want more consistent sex during pregnancy, learning what turns [you] on and feels pleasurable at this stage in [your] life is valuable,” says Hargons. “For example, some positions may be painful or difficult during pregnancy, so relearning [your] sexual landscape can make regular sex more likely in a way that isn't obligatory.”

Sex During the Third Trimester

Sex during the third trimester can take some creativity. Your belly will be at its largest, and you’ll likely feel uncomfortable, Whelihan says. You may need to pee more often now that your baby is crowding your bladder, or you may experience discomforts that make sex unappealing. While it’s always fine to choose not to have sex, if you do want to be sexual, there are still options, she explains.

Any position that causes you to lie on your back is going to be difficult–not only will it likely make you feel short of breath, it can also temporarily compress a major blood vessel that brings blood to your uterus and eventually your baby. In order to compensate for this, it’s recommended to position yourself at an incline or to wedge a pillow under one side of your back so you tilt slightly to the side.

It’s a good idea to experiment with sexual positions that don’t cause you discomfort. “The most popular position at this time is [the pregnant person] on top,” Whelihan adds.

Another option that works for some couples is to lie in a spooning position. “[A male] partner can straddle her lower leg,” Whelihan says. “This position is great because the woman’s belly is on the bed.” However, she adds: “The bottom line is that the couple should do whatever is comfortable.”

For some, that may include abstaining. But for those who still desire sex and want to have it, it can be “important,” Whelihan says. “It keeps the bond between the two partners going with the release of prolactin and all the wonderful hormones released during orgasm.”

The Labor Benefit of Sex

If you’ve reached your due date and would like to get the show on the road, sex may help speed up the process, Whelihan says. “Sperm has prostaglandins in it and they can initiate labor—but only if the cervix is already primed and getting ready for birth.”

Another reason to have sex at the end of pregnancy is that once the baby is born, it may be a while before you can have intercourse again, Whelihan says. You may be advised not to have sex for four to six weeks postpartum as your body heals, and some people wait even longer. You may want to use this as an opportunity to connect sexually with your partner before you go a couple months without.

Sex After Giving Birth

When having sex in the postpartum period, Whelihan urges caution. Most doctors advise waiting until six weeks after delivery before having penetrative sex, she says. Once that interval is over, you should still proceed with care. In the postpartum period, estrogen levels are lower, which can lead to vaginal dryness. This can make sex feel uncomfortable due to more friction. Tips to help with this include: taking it slow, incorporating plenty of foreplay, and using lubrication.

This is another place where masturbation—either solo or partnered—could play a role. Just be sure to wash hands or clean any toys before and after using them.

Know that, unless you are exclusively breastfeeding or chestfeeding, you can still become pregnant right after giving birth, Whelihan says, adding: “My mother was pregnant with me at her six-week check-up.” So, use birth control if you’re not ready for another baby just yet.

Each pregnant person and pregnancy will be different, but know that your sex life will likely be different during pregnancy and beyond. Strong communication, flexibility, and openness can help you get past any insecurities and find ways to enjoy sex that work for you during each phase of pregnancy and postpartum. As Whelihan says, it’s important that everyone is able to feel sexually attractive and good about themselves during and after pregnancy.

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