While sex during pregnancy is generally safe — and sometimes quite satisfying — there are certain circumstances when it may be advised to avoid having sex. Open communication with your partner and your healthcare provider is essential for ensuring safety and addressing any concerns or limitations. Among the more enjoyable changes pregnancy brings to many women is a heightened sex drive and strong orgasms. But common misconceptions can affect how often pregnant women have sex.

A 2024 review in Public Health Reviews revealed fluctuations in sexual desire across trimesters were influenced by things like concerns about the baby’s safety and the way their bodies were changing.

Nausea and fatigue can dampen your libido in the first trimester, but it often returns in the second trimester as morning sickness subsides and energy levels increase. You can fend off exhaustion, and its effects on your libido, by giving yourself permission to take a break when you need rest.

Breast tenderness and concerns about weight gain can also contribute to a decrease in your sex drive. Share your concerns with your partner so they can work with you on it.

As your body changes throughout pregnancy, getting the most enjoyment from sex may call for changes to your usual routine, and that’s okay.

Sex During Pregnancy Is Safe

Vaginal sex (involving the penis, fingers, or a vibrator), oral sex, manual stimulation (using hands), and anal sex are all safe to have during pregnancy. Unless advised otherwise by your healthcare provider due to specific medical reasons, you can typically enjoy these activities without concern during your pregnancy.

If the pregnancy is progressing normally, sex is in no way harmful to the baby, says Faina Gelman-Nisanov, MD, a gynecologist with Maiden Lane Medical in New York City. Your baby is well protected within your uterus. Amniotic fluid cushions the baby, and a thick mucus plug seals the cervix tight to guard against infection, according to the Mayo Clinic.

And according to the American College of Obstetricians and Gynecologists, uterine muscles also help protect the baby.

Although an orgasm may cause uterine contractions, they’re not labor contractions. Sex during pregnancy, particularly in the third trimester, may cause cramps or contractions during orgasm due to the release of a hormone called oxytocin, as well as from hormones called prostaglandins that are present in male semen. Typically, these cramps resolve within 1 to 2 hours.

Learn More About Mucus Plugs

Working With Your Changing Body

As your pregnancy proceeds and your belly grows bigger, you may need to try different sex positions to see what feels comfortable for you. Trying different positions and openly expressing what works for you and what doesn’t can enhance your comfort and intimacy along the way.

“I recommend avoiding the missionary position for long periods of time, especially into the second and third trimester,” Dr. Gelman-Nisanov advises. “A pregnant woman is more likely to have comfort with positioning herself on top of her partner, or with her partner behind her.” Some options include:

Lying on your side
Being on top
Getting on your hands and knees for rear entry
Sitting on your partner’s lap
Oral sex

Research also shows that a positive body image can help you have more and better sex. In a 2021 study of more than 500 participants, researchers saw that a positive body image improved couples’ sex lives.

Also, remember that partnered sex isn’t the only way women can experience pleasure during pregnancy. Sex toys like vibrators are safe to use as long as your doctor hasn’t told you to avoid sex for a medical reason, Gelman-Nisanov says. She notes that they should be cleaned appropriately before and after use and stored in a clean, dry place.

Benefits of Having Sex During Pregnancy

There are many benefits to having sex while pregnant, including:

Increased Desire and Stronger Orgasms Sex may be on your mind a lot during the second trimester because of an increase in blood flow to the vagina and higher hormone levels, explains Gelman-Nisanov. The vagina becomes engorged and vaginal lubrication increases. As a result, your desire to have sex rises and orgasms become stronger.
Improved Mood and Health Orgasms release endorphins, promoting feelings of happiness and relaxation. They can help with headaches and other pain, heart health, self-confidence, sleep, and stress.
Strengthened Emotional Bond Maintaining a healthy sex life during pregnancy fosters a closer emotional connection with your partner, which is especially valuable during a period of significant change.
Increased Physical Activity Engaging in sexual activity can burn calories, aiding in both partners’ fitness and activity levels.

How to Play It Safe

Your doctor may tell you not to have sex while pregnant if:

You’re at risk for a miscarriage.
You’re at risk for preterm labor, or giving birth before 37 weeks.
You have placenta previa, in which the placenta is covering the cervical opening.
You’re experiencing vaginal bleeding. Spotting is normal, but severe or persistent cramping or heavy bleeding warrants immediate medical attention from an ob-gyn. Spotting after vaginal sex is common due to minor cervix blood vessel irritation, lasting up to 48 hours, but heavy bleeding requiring a pad warrants contacting your healthcare provider.
You have a short cervix, which increases risk of miscarriage or preterm labor, or if the cervix has opened.

If your partner has a history of sexually transmitted infections (STIs) or if there’s even a possibility of STI or HIV exposure when you’re having sex, always use a condom. HIV can be transmitted to the baby, and some other STIs can be transmitted to the baby during delivery.

While oral sex during pregnancy is generally considered safe, remember that your partner should never blow air into the vagina, because this could cause an air embolism (in which a blood vessel becomes blocked by air bubbles), which could become life-threatening, per the Cleveland Clinic.

While anal sex is safe, Gelman-Nisanov says it should be limited if the pregnant woman has hemorrhoids. Also, if you have anal sex and then want to have vaginal sex, just make sure to clean the body part or vibrator that was in your anus. That way, you can avoid spreading bacteria from the rectum to the vagina.

Expect pregnancy to bring waves of changes — physical, emotional, and sexual. By listening to your body and recognizing your needs, you will be better able to enjoy the unique pleasures of this special time in your life.

Editorial Sources and Fact-Checking

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Sources

Fernández-Carrasco, FJ et al. Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners: Systematic Review. Public Health Reviews. January 19, 2024.
Is Sex Safe During Pregnancy? American Pregnancy Association.
Is It Safe to Have Sex During Pregnancy? American College of Obstetricians and Gynecologists. February 2021.
Sex During Pregnancy. Journal of Midwifery & Women’s Health. November–December 2022.
Sex During Pregnancy: What’s OK, What’s Not. Mayo Clinic. July 22, 2022.
Gumusay M et al. Investigation of Sexual Function and Body Image of Pregnant Women and Sexual Function of Their Partners. Sexual and Relationship Therapy. 2021.
Daescu AMC et al. The Paradox of Sexual Dysfunction Observed During Pregnancy. Healthcare. July 2023.
Orgasm. Cleveland Clinic. May 9, 2022.
Sexually Transmitted Infections, Pregnancy, and Breastfeeding. Office on Women’s Health. February 22, 2021.
Vaginal Gas. Cleveland Clinic. September 20, 2022.