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Sex during pregnancy

Do not automatically assume that sex during pregnancy is wrong. CAN I have sex when I’m pregnant? This is a common question that I get from my patients, particularly couples who are having their first child.

Most of them wonder if it is safe to continue having sex, even up to the third trimester. There are also other couples who have real cause for concern if their pregnancy has some challenges, such as bleeding in early pregnancy or a history of miscarriage. Usually, it is the husband who prompts his wife to bring up the subject, and she will shyly or sheepishly ask me about it. While I can understand their embarrassment, I find it ironic that sex should be considered such a taboo subject during pregnancy. After all, the miracle of pregnancy starts with the act of sex (medical interventions like IVF notwithstanding)!

The apprehension towards sex in pregnancy may stem partly from the belief that pregnant women have to be treated like fragile flowers in bloom; not to be handled roughly or put through strenuous activities like work or?sex. Is this true? Let’s take a look.

Some good lovin

Sex is a normal and healthy activity for couples to express their intimacy and love for one another. However, your hormonal changes during pregnancy can affect how you feel about making love. During the first trimester, you may be too tired and nauseated from morning sickness. But you may find yourself experiencing sexual desire in the second trimester, especially as you discover how beautiful the pregnant body can be. Then, your desire may or may not fluctuate during the third trimester.

The important thing is to understand your body and share your feelings with your partner. Do not automatically assume that sex during pregnancy is wrong – it can actually be more enjoyable for you and your partner. This is because you will be experiencing more vaginal lubrication, and your genital area will be engorged, helping you enjoy orgasms and even multi-orgasms! You do not have to worry about using birth control, and if you have been trying to get pregnant for awhile, you can finally enjoy sex as a truly pleasurable activity instead of as a “duty”.

I sometimes encourage couples to have sex, especially for pregnancies that are postdates. Most couples are pleasantly surprised to hear that sex may help to induce labour because seminal fluids contain prostaglandins (hormones) that can cause contractions of the uterus.

Is it safe?

Of course, the question that troubles couples is whether sex will harm their unborn baby. The answer is that it will not. Sex is safe during pregnancy, except in rare cases where there are possible complications for the pregnancy. I will discuss that in the next section. These are some of the most common fears that couples have about sex.

Will sex hurt the baby? No, your growing baby will not be harmed because he/she is well protected by the amniotic fluid and your uterus. So even pressure against your abdomen during vigorous sex will not affect your baby.

Will sex cause an early miscarriage? No. Miscarriages in the first trimester are usually related to chromosomal abnormalities or other problems in the foetus, and these are not associated with what you do (or don’t do).

Are orgasms dangerous? No. They may cause uterine contractions, but they will not cause premature labour or delivery. However, you may feel an achiness or cramps after sex, which is caused by stimulation of the cervix. You may also find a few spots of blood because the cervix is well- supplied with blood in pregnancy. The cramping or bleeding should go away if you rest in bed for a few hours. If the symptoms do not go away and become worse, call your gynaecologist.

Can I have oral sex? Yes, as long as you and your partner are comfortable with it. However, make sure your partner does not blow air into your vagina, because a burst of air may block a blood vessel, which is life-threatening for you and your baby.

When sex is not ok

There are times when I will advise my patients to abstain from sex. One instance is if you have a history of premature birth or labour with previous pregnancies. During sex, the prostaglandins from your partner’s semen could cause contractions and risk premature labour again. Another condition is called placenta previa, where your placenta partly or completely covers your cervical opening. Sex is not recommended because it could lead to bleeding and premature labour. An ultrasound during your usual prenatal checkups will reveal this condition.

Sex is also not advisable if you have unexplained vaginal bleeding, cervical incompetence (your cervix opens prematurely), if your water bag has broken, and if you are carrying two or more babies. Finally, sex is a definite no-no if you or your partner have an active sexually transmitted disease. Even if you are not the one with the STD, you should not risk getting it from your partner because you may not be able to get safe treatment for it, as some antibiotics cannot be used during pregnancy.

The STD could cause an infection in your vagina or uterus and create a danger of premature labour or illness in your unborn baby. If your partner has cold sores from the herpes virus, you should avoid skin-to-skin contact because the herpes virus could spread to you and your baby. The HIV virus can also be passed from mother to baby.

Enjoy it!

When I talk to my patients about this topic, the husbands usually get more “excited” because I encourage them to be a bit more creative in bed! This is to help the couple find positions that are most comfortable for them. Some safe positions are next to, or on top of your partner. It is up to you and your partner to discuss what works. You may not feel like having sex because your body feels awkward and uncomfortable as you get bigger. But here’s a surprise – your partner may find you more desirable during pregnancy!

However, this doesn’t mean that you should submit to intercourse if you don’t feel like it. Explain your feelings to your partner and discuss what he can do to help you experience sexuality and intimacy. Hugging, cuddling, having massages, having relaxing baths together or even just touching each other are just as important as the act of intercourse. Communication and creativity are the two key words to having a fulfilling sex life during pregnancy.

And remember to talk with your doctor about this as well. My patients are very open to discussing sex with me because I make them feel comfortable. So be comfortable with your doctor and don’t be afraid to ask the question “Can we?”

The Star Newspaper, Sunday September 2, 2007

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