Sex During Pregnancy: Answers to Common Questions

“If partners have different beliefs or misconceptions about sex during pregnancy, that can create barriers in the relationship,” says Megan T. Battin, D.O., a board-certified ob-gyn with OhioHealth in Marion, Ohio. “That’s why it’s really important to just have open and honest communication about each other’s desires, concerns, [and] expectations throughout the pregnancy.”

Here, doctors answer common questions about sex during pregnancy, and share what you should know for healthy, safe, and satisfying sex while pregnant.

Can You Have Sex While Pregnant?

In short: It’s generally safe to have sex during pregnancy. But some people might be advised not to. These may include people who have:

• A history of recurrent miscarriages
• Unexplained vaginal bleeding
• Certain conditions, such as placenta previa, where the placenta is over the cervix
• A preterm labor diagnosis

Understanding what’s true about safe pregnancy sex means you won’t miss out on important pleasure, explains Carrie Terrell, M.D., a board-certified ob-gyn and associate professor at the University of Minnesota Medical School in Minneapolis.

Can Sex Cause Miscarriage?

Overall, no. Sex can’t cause you to have a miscarriage.

Terrell specifies that sexual activity includes oral, vaginal, and anal sex, as well as general sexual arousal and orgasm—none of which will cause a miscarriage in healthy pregnancies.

“In general, having sex during pregnancy, especially if it’s a healthy pregnancy, is not the cause of a miscarriage,” Battin agrees. “Miscarriages are most often caused by chromosomal abnormalities or a developmental issue in the embryo or fetus—not by having sexual activity.”

The American College of Obstetricians and Gynecologists (ACOG) also shares that sexual intercourse and other penetrative sex with fingers or toys are safe. Your fetus is protected by the amniotic sac and your uterus.

Can Sex or Orgasm Cause Early Labor?

For healthy pregnancies, neither sex nor orgasm will cause you to go into early labor, reassures Terrell.

It’s understandable how this myth came to be, though. “Sex and orgasm can cause a temporary contraction of the uterine muscles,” says Battin—what are known as Braxton Hicks contractions. They occur throughout pregnancy, but they’re not associated with preterm labor, she explains.

Some people who are full-term think that having sex could jumpstart labor, as well. But research comparing pregnant women who had sex to those who didn’t suggests that’s not true.

Do You Need to Use Protection When You’re Pregnant?

Yes, if you’re having sex while you’re pregnant, be sure to take protective measures against sexually transmitted infections (STIs). “We always recommend safe sex practices, [including] barrier methods of contraception, like condoms,” Battin advises.

Pregnancy does not protect you from sexually transmitted infections if you’re exposed to them. It’s possible to become infected with gonorrhea, chlamydia, herpes, HPV (a strain of which can result in genital warts), and other infections.

Also important: Communication. If you’re with a new partner, ask about their STI status, and let them know if you’ve been exposed. If you do think you have an infection, be sure to address it with your provider so you can get tested and treated.

In general, screenings for STIs like hepatitis B, HIV, and others are part of regular early prenatal care, according to the ACOG. This is important for the health of the pregnant person and their pregnancy, allowing for prompt treatment and a decreased risk of complications for the baby, Battin says.

Does Sex Drive Increase or Decrease During Pregnancy?

This experience is really individual, Battin says. Some people may see an increase in sex drive, others might have a decrease and some may not have any change at all.

If you do notice a difference in your sex drive, changes in your body may be the reason. For instance, the influx of certain hormones coupled with increased blood flow and circulation to the vaginal area can up your desire for sex.

As Terrell explains, “It’s not uncommon, especially early in pregnancy, for women to really feel heightened sex drive or sensation.” In fact, she says that some women become more likely to have an orgasm because of these changes.

On the flip side, pregnancy can sometimes cause sex drive to dip. That may be because of factors like breast tenderness, weight gain, feeling nauseous or tired, or stress and anxiety, Battin says. For some people, the sensitivity from that increase in vaginal blood flow can actually cause discomfort and lower sex drive, she says.

Is It Normal to Bleed After Sex During Pregnancy?

Some spotting can happen after sex during pregnancy. Spotting is light bleeding—not a flow like a period. There’s a term for spotting after sex: postcoital bleeding.

There are several reasons why spotting or bleeding may happen, and some are more or less concerning than others. Either way, it’s important to tell your provider if this happens so they can guide you on what additional monitoring or testing you may need.

Vaginal irritation, dryness, lack of lubrication, and increased blood flow to the cervix and vagina can cause spotting. This typically isn’t dangerous or alarming for your provider, Battin explains.

Some types of cervical polyps, sexually transmitted infections, or injury due to minor tears during penetrative sex can cause bleeding, too. These are cases where you should be evaluated and seen, Battin says, “but they’re resolvable and not necessarily alarming.”

Of course, bleeding can sometimes mean there’s a problem with the pregnancy. You should also contact your provider immediately if you show signs of a more concerning issue, which include:

• Bleeding that’s heavier than spotting
• Abnormal pain
• Contractions or significant cramping
• Unusual discharge, particularly watery discharge

Should You Avoid Certain Pregnancy Sex Positions?

There’s not much evidence suggesting that certain sexual positions are more harmful than others.

“In general, we tell people to use whatever positions are comfortable and heighten their sexual response,” Terrell says. That said, she does typically advise people to avoid lying flat on their back for long periods of time as their pregnancy progresses (late in the second trimester and then through the third trimester).

That’s because the weight of the uterus may compress the major vessels in the back of your body and restrict blood flow, according to ACOG. However, the risk is thought to be small.

The key is to make sure you’re happy with whatever position you choose. Side-lying positions and positions where you’re on top may be more comfortable when you’re pregnant, says Terrell. These positions can more easily accommodate your growing belly.

When Should You Stop Having Sex During Pregnancy?

While most people can safely have sex throughout pregnancy, there are some reasons not to. For example, not wanting to have sex is a good enough reason to stop at any point.

Also, if you have recurrent miscarriages, unexplained vaginal bleeding, or are diagnosed with certain issues with your placenta such as placenta previa, your provider might suggest you stop or limit your sexual activity, too.

Sex can mean different things to different people, and it’s not just limited to vaginal intercourse with a penis, Terrell says—so if your provider mentions that you should avoid sex, be sure to ask them what activities they mean by that.

“Should a pregnancy complication arise where there is a recommendation to limit putting something into the vagina, for example, then we should say that [specifically],” Terrell explains. Other sexual activities may not be off-limits, and you should know your options.

How to Talk to Your Provider About Sex During Pregnancy

Talking about sex with your doctor or midwife can sometimes feel uncomfortable. But it’s important, especially if you have questions or concerns.

Remember: Your healthcare provider’s office is a safe space, Battin says. Providers talk about sex with patients all the time, so you’re not going to make them uncomfortable by bringing it up.

If you’re feeling shy, email your questions or concerns to your provider before your visit. This way, your provider can be the one to bring it up, helping to reduce any awkwardness you might feel.

You can also ask your questions about sex during pregnancy here in the pregnancy community, where healthcare professionals can give you answers based on the latest medical knowledge.