Let’s talk about sex, baby, let’s talk about you and me…Remember that song? Really, let’s talk about it. Sex is always a big question when pregnancy is involved.

As a sex-positive parent, person, and doula, I always find interesting the topics of sex education, stigmas, and myths. Doctors can answer questions about sex, but honestly, how many women in their second trimester would be willing to share details of what goes on in their bedrooms?

So, let’s tackle the questions you may have on sex during pregnancy and after birth.

Can you have sex while pregnant?

This is a valid question and perhaps one of the first a woman asks upon discovering she’s pregnant. There’s a lot of information out there, but to be honest, the answer is fairly simple: You can have sex if you want to as long as your doctor hasn’t indicated otherwise (for example, by recommending a pelvic rest period).

Sex drive during pregnancy

Will you even want sex during pregnancy? Let’s tackle the sex drive question. Due to hormone fluctuations and increased blood flow, the first trimester may also change your sex drive. A decrease in your libido may be due to the nausea, stress, and extreme fatigue that often characterize the first trimester.

I know some of you are reading this and thinking, “But I want sex all the time!” Others may be having the opposite reaction, going, “Sex? Ew!” I’m here to tell you both reactions or something in the middle are totally normal. Sex drive varies from pregnancy to pregnancy, and it’s all varying degrees of normal.

Just like your sex drive can fluctuate, so can your partner’s. I don’t think we talk enough about this. Many partners fear harming the mom or the baby when engaging in sexual activities, so they avoid it. However, some see that pregnancy glow and feel friskier than usual. Again, we’re going to have varying degrees of normal.

At the end of the day, if you and your partner are having issues or different sexual needs and desires, it’s okay to consult a therapist, specifically a sex therapist.

Best sex positions during pregnancy

Sex positions will strongly depend on body and belly size and what’s comfortable for you. That said, there’s a top three list of comfortable and safe sex positions, which help take pressure off the back and belly and make everything enjoyable for the parties involved.

1. Sideways: This is a great intercourse position for comfort and ease, whether you choose to be face to face or spoon. It allows you to be off your back, which is important after 20 weeks, and it doesn’t put any pressure on your belly.
2. Hands and knees: It seems hard to do with a belly, but this is a good position that removes any pressure or the burden of bodyweight on either person and permits easy access. A pillow propped under the belly and/or knees will provide a shield and lots of comfort.
3. Cowgirl: This may be harder after the second trimester depending on body types and navigation, but it is nevertheless a great go-to position.

Painful sex during pregnancy?

The question of discomfort is pertinent in all trimesters. Painful sex during pregnancy is not unusual. Your uterus is lower than normal due to growing a baby, your hormones are raging, and you have increased blood flow, which can increase sensitivity.

It’s important to mention that anxiety can have a huge effect on abdominal discomfort after intercourse. Staying calm, breathing deeply, and doing proper aftercare are good ways to alleviate anxiety.

Is it normal to bleed after sex during pregnancy?

Light bleeding after sex while pregnant can be normal, especially during the first trimester. Of course, there are times when spotting isn’t normal and would indicate the need for medical attention.

Here are a few reasons to seek medical attention:

• Heavy, menstrual-like flow
• Spotting that lasts for a long time and/or increases
• Spotting accompanied by back cramps, fever, or headaches

These could stem from simple issues such as vaginal tearing, infection, or cervical irritation/bruising. In the third trimester, anything stronger than spotting could be a sign of serious conditions such as placenta previa or placenta abruption.

Sex during each trimester

First trimester sex

Between the nausea and the exhaustion, you may not feel much like sex in the first trimester, and that’s totally okay. We have already talked about the varying sex drives. There’s also the added bonus of not worrying about birth control anymore.

You’re already pregnant. Enjoy what you can as much as you can if you desire so. Unless your doctor has said otherwise, there are no sex-related worries during the first trimester.

Second trimester sex

Sex is still safe during the second trimester. However, there are some things to be more mindful of, such as choosing your sex positions and keeping an eye out for bleeding that’s more than spotting coupled with other symptoms. During this trimester, your partner may be more concerned about harming the baby as you grow bigger, so reassuring them that sex is safe and providing various options is a good way to ease anxiety.

Third trimester sex

One concern you may have is leaking breasts. What you’re leaking is colostrum, and sexual stimulation can sometimes cause this to happen. It’s totally normal and a sign that your body is preparing for the production of milk. Some people even collect it in syringes and keep it for the baby. You can find milk syringes and colostrum collectors on Amazon.

The other top concern many people have during the third trimester is the possibility of sex triggering labor. Sex has been used as a way to induce labor because some research has suggested that the prostaglandins in semen and oxytocin, the hormone released by a woman’s body during orgasm, could speed things along.

However, the research isn’t particularly concrete, so the safest thing is to have sex in the recommended positions, practice keeping the anxiety and stress down after sex, and monitor bleeding, cramping, and pain as needed. Always consult with your doctor if you have any concerns.

Sex after baby

Is there a right time for sex after pregnancy?

The question of when sex is okay after birth is common. Your body is healing, which takes time, and healing journeys are personal. With that said, always wait for your doctor to clear you.

Having sex before getting the green light from your doctor can lead to issues such as an infection or another pregnancy in quick succession. The infection risk comes from your cervix not having closed up all the way and bacteria getting in. Pregnancy occurs because your hormones are still fluctuating and birth control can’t be established until about week six.

As part of standard postpartum care, week six is also around the time when most doctors schedule a postpartum check to examine you and make sure you have healed. Everyone’s delivery story is different, so look to your doctor to clear you as opposed to following googled advice. Desires can be hard to resist, but healing is an essential part of the postpartum period, and you should allow your body to have its rest.

Is sex after baby painful?

Postpartum sex, especially the first time you have it after delivery, will definitely bring some discomfort and possibly pain. This can be totally normal. It’s important to be able to tell what’s normal and what requires seeking medical help.

Pain during sexual intercourse after birth can be from:

• Vaginal dryness: This can be the result of low estrogen as its levels don’t return to normal for two months after birth. Water-based lubricants are great helpers in this case, as is a greater focus on foreplay to increase arousal.
• Tearing: If the birth was accompanied by tearing (either natural or due to an episiotomy), it would be totally normal to experience some pain.
• Pelvic floor issues: This is a major postpartum concern that no one seems to address. Pelvic floor issues affect a large number of women. Ways to accelerate healing include Kegels, giving the pelvic floor more time to adjust and recover, and seeing a pelvic floor therapist. Seeking extra help from a specialist can increase your postpartum healing in general, not just in terms of sex.
• Extreme pain due to other serious factors: In this case, you should definitely reach out to your doctor. Many women suffer in silence, thinking that extreme pain for long periods after or during sex is normal. It’s truly not, and there is no shame in checking to see what’s wrong and getting help for you and your partner.

What if I still don’t want sex after the doctor has cleared us?

Whether due to pain or sex drive issues, there will be some who aren’t ready to return to sex after having a baby. Libido problems are normal after delivery and dealing with this is a personal postpartum experience. Your body is healing, but so is your mind.

Between navigating the (possible) baby blues, adjusting to having your first baby, or having a new baby with siblings around, you will need plenty of time, so make sure you give it to yourself. If you and your partner struggle with sex missing from your daily life, reach out to a therapist and/or a sex therapist to help you find other ways to connect and be intimate.

Conclusion

Sex during pregnancy can be safe, empowering, and fun. Don’t be afraid to get a little adventurous and, if necessary, utilize resources such as sex therapists. There’s no question that sex while pregnant can be different, but it doesn’t have to be a miserable experience.