A reader submitted the following question:

"Is it OK to have sex if you're pregnant? Especially during the later months?"

You're not alone in wondering about this. In fact, survey studies have found that 25-50% of pregnant women and 25% of their partners are concerned that sex could potentially hurt or "traumatize" a developing fetus [1]. Such concerns have the effect of causing many pregnant couples to have sex less often than they'd like and/or to have sex that is less satisfying than usual because they are anxious or worried. Fortunately, research suggests that these concerns are largely unfounded.

First, it is not true that the fetus will necessarily be harmed or birth complications will result if expectant parents engage in vaginal intercourse. Research suggests that frequent sexual activity during pregnancy is unlikely to be cause problems in low-risk pregnancies [2]. To the contrary, some research suggests that sex--specifically in the later months of a pregnancy--could potentially even have a protective effect against premature birth [3].

Second, couples don't necessarily have to limit sex to certain stages of a pregnancy. A review of 59 studies concerning heterosexual couple's sexual activity patterns during pregnancy found that sexual activity levels do not typically change during the first trimester, they become highly variable during the second, and they drop substantially during the third [1]. Most couples have intercourse up until about the seventh month, and about one-third have sex up until the ninth month. Only about 10% of women abstain from intercourse entirely after learning of a pregnancy.

It makes sense that sexual activity tends to decline over the course of a pregnancy, given that women typically report less enjoyment from sex in the later months. For instance, whereas 75-84% of women report enjoying intercourse during the second trimester, this number drops to 40-41% by the third trimester [1]. This decrease in satisfaction could potentially stem from a large number of factors, from pain during intercourse to nausea and morning sickness to difficulty finding a comfortable position to changes in perceived attractiveness to changes in level of sexual desire.

In order to increase sexual enjoyment during pregnancy, the most common recommendation from physicians and sex therapists is to experiment with different sexual positions. Many women find that being on top or having sex side-by-side is more comfortable during pregnancy. Of course, some pregnant women prefer activities other than vaginal intercourse, such as clitoral stimulation, breast and nipple stimulation, or oral sex (although air should not be blown into the vagina so as to reduce the risk of developing an embolism. While this outcome is very rare, it has the potential to be life-threatening [2]).

With all of that said, research suggests that most people tend to be more worried about this subject than they should be. As long as the partners are healthy and the pregnancy is not high-risk, having sex throughout a pregnancy is generally considered to be safe. However, should you have concerns about your specific situation, don't hesitate to talk to your doctor.

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[1] vod Sydow, K. (1999). Sexuality during pregnancy and after childbirth: A metacontent analysis of 59 studies. Journal of Psychosomatic Research, 47, 27-49.

[2] Jones, C., Chan, C., & Farine, D. (2011). Sex in pregnancy. Canadian Medical Association Journal, 183(7), 815-818.

[3] Sayle, A E., Savitz, D.A., Thorp Jr, J.M., Hertz-Picciotto, I., & Wilcox, A.J. (2001). Sexual activity during late pregnancy and risk of preterm delivery. Obstetrics & Gynecology, 97(2), 283-289.

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