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A frequent concern we have during pregnancy is whether it is safe to have sex. Many of us worry that sexual activity, particularly vaginal penetration, may cause a miscarriage or precipitate labor.


Generally speaking, if care is taken to follow sensible guidelines, it is usually safe to have sex during most of pregnancy. There are medical exceptions to this; each woman should discuss sexual activity during pregnancy with her doctor to make sure that there are no specific restrictions applying to her pregnancy. With the above in mind, these are some general, common sense guidelines for sex during pregnancy:


Avoid rough or forceful penetrative thrusting in any position during pregnancy! Gently does it.


Never blow air into a pregnant woman’s vagina during love play. The vagina’s blood vessels expand during pregnancy and air blown into the vagina can enter the cardiovascular system, causing an embolism to form which could travel to the lungs or heart with potentially fatal results for both the expectant mother and her fetus. (This tragic outcome can also occur when air is blown into the vaginal canal of a woman who is not pregnant, but the risk increases exponentially with pregnancy).


Keep weight off your uterus during sex.



Some positions that allow for vaginal penetration while keeping weight off the uterus include:


 Vaginal penetration from behind with the pregnant partner’s weight comfortably resting on her knees and elbows.


The penetrating partner sits in a chair in chair while the pregnant partner straddles them, with her feet comfortably on the floor (the chair should not be too high).


The pregnant partner brings her buttocks to the edge of the bed and comfortably lifts her legs, relaxing them in the air or draping them around penetrating partner’s hips.


Both partners lie on their side with the pregnant partner in front in a spooning position.


The penetrating partner lies on their back while the pregnant partner straddles them.


The pregnant partner lies on her back while the penetrating partner lies on their side, weight resting on their elbow and hip.


The penetrating partner stands and supports the pregnant partner by holding their buttocks while the pregnant partner puts her arms around her partners shoulders and holds the standing partners' hips with her.


Use your love and creativity to invent more!


Women also go through profound hormonal changes during pregnancy that can affect our physical and emotional state:


Our breasts swell with milk, and may start leaking fluid and become sore or tender.


We may become bloated and have a sore back, experience sudden periods of exhaustion, and have hormonal fluctuations that cause us to feel emotions intensely.


Our backs and feet ache from carrying extra weight. Sometimes we also gain weight while eating to feed two.


 All these symptoms affect our sexual being. Some women find that during certain phases of their pregnancy they crave sex intensely, while during other phases they experience almost total disinterest. Both are natural and normal states that we need to accept and honor.


Keep in mind that we are complex. Tremendous demands are placed upon a woman's body during the nine months of gestation, and we need to lavish extra excellent care on ourselves during this special time. Lots of support, understanding and assurance from partners and friends can make a big difference, too.


Massage is particularly helpful in easing that sore back and legs, those aching feet, the result of carrying the extra weight of pregnancy. Sensual massage may be a great alternative to sex during some portions of our pregnancy, and a truly necessary prelude to sex during others.


If you haven't got a partner, massage yourself! What a fabulous time to invest in an effective vibrator. Use it for body massage and orgasm!


Birth is an astonishing phenomenon in which the tiny mouth of the cervix dilates hundreds of times its normal size (to about 10 centimeters!) and the vaginal canal expands vastly to allow a 6 to 12 pound baby to be delivered from the uterus.  

This whole process of birth has many potential effects on a woman’s sexuality, and if she's co-parenting, not a few on her partner's.

Adjusting to the new responsibilities and demands of parenthood.

This can be joyous but VERY tiring. While you are taking care of baby, remember to take care of you. Too often women are encouraged to become entirely “baby centered” during this time when they, too, need consideration and care. Pay attention to the messages your body sends you about your needs, and don’t neglect them.  


The most frequently shared issue interfering with sex after birth experienced by both partners is exhaustion! Both partners are up at night and engrossed in the strenuous demands of infant caretaking 24/7. Who has the time or energy for sex?!  But don’t let this whole experience hit you like a run-away train and cause you to lose perspective on your relationship; connecting with each other is very important during this time. You’re in this together. 


Make time for yourself and your partnership. Massage is a great help for relaxing tired muscles, and for staying in intimate contact with your partner.


Other effects of birth that can impact sexuality include


Healing from a vaginal incision to widen the birth canal (episiotomy).
This takes time. If you have stitches, they will probably disintegrate, but you may still be too sore for vaginal sexual activity for a while. Be patient and prudent.  

Stretching and weakening of the pubococcygeal (PC) muscles.
This can occur during pregnancy and especially during birth. PC and vaginal muscle exercises are in order. See Pelvic Exercises to strengthen your muscles and heal this condition.


Prolonged bleeding after labor.
Some light bleeding and discharge often continues after labor. This averages four weeks. If you bleed excessively, or if your discharge doesn’t taper off after four weeks, let your doctor know right away. 

Hormonal fluctuations.
Normally these will settle down, first to some extent as birth recedes, and then completely after you stop nursing.

Mood swings.

These tend to be related to hormonal fluctuations. If you experience depression, consult your doctor about taking a medication that will not adversely affect breastfeeding.


Postpartum depression.
Postpartum depression is a serious, lingering form of depression that sometimes occurs after birth. Apart from undermining your sex drive, It can very adversely affect the wellness of both mother and child, and should never be neglected. A combination of medication and counseling is usually recommended to help the individual experiencing it cope with its impact.  
Counseling is often extended to the whole family as well. 

Lack of bladder control
"Since birthing I leak all the time." Yep. Alot of us do. This commonly relates to the weakening of the pubococcygeal (PC) muscles. It's time to exercise these muscles regularly to regain control!

Breast soreness, leaking and tenderness while nursing.

A good support bra, a moisturizer for sore breasts and nipples, and keeping too much milk from building up in the breasts through nursing and if necessary a breast pump, will help alleviate these symptoms. Still, this may be a time when erotic breast-play needs to stop or be moderated according to your sensitivity.


Potentially adjusting your body image to wider hips, fuller breasts, and a wider waist.

Your body may change and expand after pregnancy. Let your esteem expand with it - you mouthwatering, womanly Goddess, you! You're more beautiful than ever. 


Childbirth Has Affected Vaginal Sex

Q. I had a baby about six months ago. After about two months my man and I began making love again, but penile penetration doesn’t feel the same. I don’t seem to feel his penis as well as before. The quality of contact is not the same. It’s almost as if my vaginal muscles aren’t responding.

I did have a small episiotomy, but I don’t think that’s the culprit, or at least not all of it. The small area of scar tissue does seem a bit less sensitive, but it’s my whole vaginal canal that seems different.

Is this unusual after childbirth, and does it pass?

~ Serita

A. This is a fairly common experience after childbirth. It may mean that the muscles of your vaginal canal were stretched during pregnancy and childbirth and need to be toned to regain their elasticity. Muscles may also tear during birth, and need to heal.

Not only is this important for sexual health, but these muscles help protect you from uterine prolapse, a dangerous condition when the pelvic muscles grow too weak to hold the uterus in place and it drops into the vaginal canal, and can even hang out of it.

See your gynecologist/OBGYN specialist and ask them to look at your vaginal muscle tone. A good doctor will hopefully be able to see lax tone or torn muscle, although unfortunately many are deficient in this regard because they are not trained in medical school to be aware of this key area of sexual and reproductive health.

Also ask them to look for any muscle tearing. This can be indicated by redness or bruise-like discoloration, and may be felt as a persistent soreness or ache. A combination of specific exercises and rest is usually recommended for this.

The principal therapy for lax pelvic muscles is – you guessed it – pelvic exercises. Go to our Pelvic Exercises Section and use these exercises to restore your vaginal muscle tone. Then keep it up for life, to maintain your sexual health and pleasure!

As for your episiotomy scar (scar tissue left from an incision made to make the vaginal opening larger during birth) you must access its affect. You mention less sensitivity in this area - does it have significant repercussions on your ability to enjoy vaginal-penile sex? If so, try massaging the tissue with moisturizer regularly. If the scar tissue really is a pronounced obstruction to your pleasure and other techniques don't alleviate this, you can speak to your doctor about an operation to remove the scar tissue.

Work those pelvic muscles, Serita. You may come out of this feeling more toned and aware of your body than ever.



Photos and Image: "Namibie Himba 0703a" by Yves Picq http://veton.picq.fr - Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons Others: Wikipedia Commons

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