Many women worry that sex or orgasm may harm their baby or threaten their pregnancy. And men are also afraid of harming their pregnant partner or the unborn child with sexual intercourse. However, for the vast majority of women, sex and orgasm are not only safe during pregnancy, but healthy ways to reduce stress and promote emotional well-being.

Research has shown that sexual intercourse does not cause or increase the risk of negative outcomes for the baby or the mother. In a normal and healthy pregnancy, orgasm doesn’t increase the risk of miscarriage or preterm labor.﻿﻿ Sexual activity may even have positive health benefits for the pregnancy, by boosting feel-good hormones like oxytocin and increasing the amount of blood flow (and oxygen) to the uterus.

Despite the fact that everyone knows that sex is how most people get pregnant, many are still afraid to talk about sex and pregnancy. You may have questions you’d like to ask your midwife or doctor, but feel too embarrassed. And your doctor may be hesitant to bring the subject up.

"Everyone is uncomfortable about sex," says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine. "Doctors don’t ask, patients don’t tell. It’s important for both sides to discuss it openly."

When Sex Is Not Safe

There are some specific situations when sexual intercourse or orgasm may be risky during pregnancy. Your doctor may recommend not having sex if:

You’re experiencing unusual bleeding . Spotting during pregnancy can be normal, and some light spotting after sex can also be normal. This can occur from the cervix getting hit during deep thrusting. However, bleeding during pregnancy may be a worrisome sign. In early pregnancy, bleeding could signal the start of a miscarriage. Your doctor may recommend abstaining from sexual intercourse for a short period of time.

. Spotting during pregnancy can be normal, and some light spotting after sex can also be normal. This can occur from the cervix getting hit during deep thrusting. However, bleeding during pregnancy may be a worrisome sign. In early pregnancy, bleeding could signal the start of a miscarriage. Your doctor may recommend abstaining from sexual intercourse for a short period of time. The placenta has grown over the wrong area of the uterine wall . Known as placenta previa, this is when the placenta attaches itself low on the uterine wall and fully or partially covers the cervix. Sex may be risky in this situation.

. Known as placenta previa, this is when the placenta attaches itself low on the uterine wall and fully or partially covers the cervix. Sex may be risky in this situation. You have been diagnosed with incompetent cervix . This is when the cervix doesn’t remain strong and closed, as it should. The pressure of the baby’s head pressing on the cervix causes it to open prematurely, sometimes leading to second-trimester pregnancy loss. A surgical procedure known as cerclage may be done to hold the cervix closed. Most doctors suggest no sex or very limited sex.

. This is when the cervix doesn’t remain strong and closed, as it should. The pressure of the baby’s head pressing on the cervix causes it to open prematurely, sometimes leading to second-trimester pregnancy loss. A surgical procedure known as cerclage may be done to hold the cervix closed. Most doctors suggest no sex or very limited sex. Your water has broken . Sexual intercourse after your water breaks may increase your risk of infection. This can complicate birth and even be dangerous.

. Sexual intercourse after your water breaks may increase your risk of infection. This can complicate birth and even be dangerous. You’re expecting triplets or a high-order pregnancy . When the uterus is stretched beyond normal expectations—like with triplets—orgasm may increase the risk of preterm labor.

. When the uterus is stretched beyond normal expectations—like with triplets—orgasm may increase the risk of preterm labor. You’re at high risk for preterm labor for other reasons. Just because you’ve had a preterm birth in the past doesn’t mean you will have another, and doesn’t mean you should abstain from sex “just in case.” However, there are some situations where some sexual limitations may be wise.

Another concern about sex is the introduction of bacteria. Some bacterial infections can increase the risk of preterm labor, and sexual intercourse does introduce bacteria to the reproductive system.

However, intercourse is associated with a risk of preterm labor only in cases where a woman has had numerous sexual partners before pregnancy. This is more likely due to an undiagnosed underlying infection—one that was present before conception—and has very little to do with sex during pregnancy itself.

There’s some disagreement in the medical community about which situations warrant sexual abstinence and which don’t.﻿﻿

Don’t put yourself on sex arrest if your doctor doesn’t think it’s necessary. Before you abstain, ask your doctor.

Sexual Limitations

If your doctor does recommend sexual restrictions during your pregnancy, be sure to ask clarifying questions. If you’re feeling embarrassed, write your question down on paper and bring it to your appointment. That may be slightly easier than asking out loud.

Also, find out how long restrictions apply. For example, if you experience bleeding early in pregnancy, your doctor likely doesn’t intend for you to abstain from sex for the rest of your pregnancy. The restrictions may only extend until you stop bleeding, or until some other specific time marker.

Alternatives to Intercourse

If vaginal intercourse isn’t allowed, find out about other forms of intercourse and sexual activity. For example, orgasm may be okay as long as there is no vaginal penetration.

Masturbation : Absolutely, masturbation is safe during a normal pregnancy. In some situations, your doctor may approve masturbation and only restrict vaginal sexual intercourse.

: Absolutely, masturbation is safe during a normal pregnancy. In some situations, your doctor may approve masturbation and only restrict vaginal sexual intercourse. Sex toys : These are safe during pregnancy. "Vibrators are fine. No harm [will come] to fetus or baby," says Dr. Krychman, who also wrote the book 100 Questions & Answers About Women's Sexual Wellness and Vitality. Dr. Krychman recommends using proper technique, hygiene, and lubrication when using sex toys—good advice whether you’re pregnant or not.

: These are safe during pregnancy. "Vibrators are fine. No harm [will come] to fetus or baby," says Dr. Krychman, who also wrote the book 100 Questions & Answers About Women's Sexual Wellness and Vitality. Dr. Krychman recommends using proper technique, hygiene, and lubrication when using sex toys—good advice whether you’re pregnant or not. Physical intimacy: If limitations are recommended, remember that you can explore non-sexual touch like cuddling, hugging, massage, gentle kissing, and light caressing.

Pregnancy Sex, Trimester by Trimester

While sex and orgasm can be more pleasurable when you’re expecting, other discomforts of pregnancy can get in the way. Don’t be surprised if you feel turned on and turned off at the same time.

First Trimester

During the first trimester, morning sickness and fatigue can put a damper on sexual activity. However, this doesn’t mean you won’t want sex. You’ll still be experiencing that increase in blood flow and sensitivity in your pelvis and breasts. You just may also be feeling sick.

Second Trimester

The best sex in pregnancy will likely come during your second trimester. This is perhaps because morning sickness and fatigue hit hardest during the first trimester, and it isn’t until the third trimester that the size of the baby starts to get in the way of sex and leads to physical discomfort.

Third Trimester

In the third trimester of pregnancy, your enlarged abdomen can get in the way of sexual intercourse. It’s still possible to have sex even with your belly bump, but you may need to get creative with sexual positions. Also, the third trimester comes with back pain and difficulty sleeping, which can lower your energy levels and sexual desire.

Orgasm during the third trimester may also be frustrating.

You may find it more difficult to reach orgasm, and if you do, it may be less satisfying. This is partially due to the increased size of your uterus. The contractions may feel less satisfying.

Your Body During Orgasm

Understanding what an orgasm is and what happens during one may help reduce your fears and anxiety surrounding orgasm and pregnancy. Sexual excitement can start with a thought, an image, or a casual touch.

Your heart starts to beat a little faster. You may blush, not just in your cheeks, but also in other areas of your body like your chest and neck. Blood flow increases to your genitals, and the area becomes swollen and more sensitive to touch.

The Bartholin's glands—which sit just to the right and left of your vaginal opening—secrete arousal fluids that lubricate the vagina and labia. The clitoris contains over 8,000 sensory nerve endings. It pulls back under its hood slightly, as it also becomes swollen and more sensitive to the touch. Also, as sexual arousal increases, your muscles generally start to tense all over your body. The vaginal opening tightens as well.

The generalized muscle tension and sensitivity build as sexual stimulation continues. When (and if) an orgasm occurs, the muscles of the vagina, anus, and uterus contract rhythmically. These involuntary contractions are part of what creates the physical sensation of release that comes with an orgasm.

As all this is happening, your body releases a cocktail of hormones, including a hearty dose of oxytocin and endorphins. Oxytocin is sometimes called the "love hormone." It promotes bonding and also reduces pain. Endorphins are also feel-good hormones that reduce pain.

Contractions After Orgasm

Orgasms can sometimes cause mild cramping after sex and, later in pregnancy, trigger Braxton Hicks contractions. But those post-orgasm contractions do not trigger premature labor or miscarriage unless you are specifically at risk for preterm labor.

Post-sex uterine contractions may feel like a new experience, especially if you never had cramps after sex in the past or did not notice uterine contractions after sex when you weren’t pregnant (few women do).

Uterine contractions are a normal and harmless part of orgasm, whether or not you are pregnant. You just notice them more now because of your enlarged uterus and your increased attention to your pregnant body.

Evaluating Cramps

"Uterine contraction may occur after orgasm," says Dr. Krychman. "These are irregular, have low intensity, and resolve quickly. Uterine contraction is a result of hormonal changes that occur with orgasm."

To differentiate between Braxton Hicks contractions and true labor contractions, "be on the lookout for increasing intensity of contractions, and those that become regular," says Dr. Krychman. Labor contractions will come at regular intervals and intensify over time.

Harmless contractions will become less intense, gradually fade away, and may stop or slow down if you walk around or change positions. If you're unsure, call your doctor.

Orgasm Intensity

For many women, pregnancy increases sexual pleasure. In fact, some women experience orgasm for the first time when they are pregnant. There are a few reasons for this boost in sexual pleasure.

Increased blood flow to the pelvic region: Sexual excitement involves an increase in blood flow to the pelvic area of your body. Pregnancy also leads to a similar increase.

Sexual excitement involves an increase in blood flow to the pelvic area of your body. Pregnancy also leads to a similar increase. A sensation of fullness in the pelvic area : The increased blood flow also means there is slight swelling of the labia, clitoris, and vagina. This can also lead to arousal.

: The increased blood flow also means there is slight swelling of the labia, clitoris, and vagina. This can also lead to arousal. Increased sensitivity to touch : The blood flow, plus the swelling, plus higher levels of hormones can lead to an increased sensitivity to touch. This can make reaching orgasm easier and can even lead to multiple orgasms in some women.

: The blood flow, plus the swelling, plus higher levels of hormones can lead to an increased sensitivity to touch. This can make reaching orgasm easier and can even lead to multiple orgasms in some women. Increased breast size and sensitivity: During pregnancy, your breasts get ready to start breastfeeding. This preparation includes an increase in breast size, increased blood flow to the breasts, and the very beginnings of breast milk production. Your breasts may be more sensitive to the touch, and during sexual excitement and orgasm, a few drops of milk may leak from the nipples.

Sex Dreams

According to the American Academy of Sleep Medicine, about 8% of adult dreams contain sexual content.﻿﻿ Sexual dreams occur in both men and women. Men and women may experience actual orgasm during a sex dream about 4% of the time.

During pregnancy, women are more likely to have sexually charged dreams and more likely to experience orgasm during those dreams. Some will have their first-ever sex dream when they’re expecting.

Sex dreams are most likely to occur during the second trimester.

This all goes back to the increased blood flow to the pelvic region. Your body is physiologically turned on even during your sleep.

Also, you’re more likely to have sex dreams if you’re not having much sex when you’re awake. If anxiety or fear of sex is keeping you from masturbating or from being with your partner, your body may take care of things itself while you sleep.

If your doctor has told you not to have sex, and you have an orgasm in your sleep, try not to worry. If you begin to experience intense and regular contractions or other signs of preterm labor, contact your doctor. But it’s extremely unlikely an orgasm in your sleep will trigger labor.

Triggering Labor

Folk wisdom says that sex will bring on childbirth if your due date is close or you’re overdue. There is some science to drive this common belief—for one, the concentration of prostaglandins in cervical mucus is 10 to 50 times higher after sexual intercourse. Prostaglandins are hormones that stimulate uterine contractions, among other things.

But despite this increase in labor-friendly hormones, research has not found that sex can trigger labor if the cervix isn’t already ripe and ready.

A randomized controlled study assigned pregnant women who were due to give birth in two weeks to either have vaginal intercourse at least twice a week or to remain sexually abstinent.﻿﻿ The rate of spontaneous labor was the same for both groups.

In other words, sex did not bring on labor faster. In fact, not only is sex unlikely to lead to preterm delivery, at least one older study found that sexual intercourse late in pregnancy was associated with a decreased risk of early childbirth.

This is actually a comforting thought for those afraid to have sex during pregnancy. If sex hasn’t been found to put people into labor who are due to have their baby, think about how much less likely is it for sexual intercourse or orgasm to bring on labor in a woman whose body isn’t even close to ready.

Orgasm During Childbirth

You may have heard that some women experience orgasm during childbirth. This is not a myth. This isn’t a topic with much research, and it’s unclear just how many women experience orgasm during childbirth.

Physiologically, there’s an explanation. The pressure and vaginal stimulation of the baby’s head going down the birth canal may stimulate nerves that trigger sexual pleasure. This sense of fullness of the baby moving through the vaginal canal may result in decreased labor pain for some women, a mixture of pain and pleasure for others, and a moment of pure sexual pleasure for a lucky few.

Orgasm during childbirth isn’t a goal or something to aim for.

Don’t feel bad if it doesn’t happen for you. It likely has more to do with a person’s unique physiology than anything you have control over.

On the other side of the coin, you also shouldn’t feel ashamed or embarrassed if you do experience orgasm during childbirth. It’s completely normal. Consider yourself lucky.

A Word From Verywell

Don’t be afraid to ask questions about sex during pregnancy. Your health care providers are there to help. Sexual needs are as important as any other primal needs of the body and mind.