Sex during pregnancy: tips for comfort, safety, and more

You might hear all kinds of myths about sex during pregnancy — but here’s a simple truth: If your pregnancy is healthy, sex is safe. Some people worry that sex might harm the baby, but rest assured — your growing baby is completely unaware of what’s happening, and there’s no risk of physically “poking” any part of the baby during sex. Let’s clear up that myth right away, so you can feel more at ease.

When (or whether) you’re in the mood for sex is a whole other story. For some, nausea, fatigue, and pregnancy aches and pains can make the idea of sex feel out of the question. Others might find they’re more interested than ever. Fluctuations in sexual desire are completely normal during pregnancy. When the mood does strike, there are tips that can help make intimacy more comfortable and enjoyable.     Here, learn more about sex during pregnancy, when it’s safe (and when it’s not), and the best strategies to help you enjoy sex during pregnancy  — including tips and exercises from Hinge Health physical therapists to provide comfort, support, and pain relief.

Is it safe to have sex during pregnancy?

It’s safe to have sex when you’re pregnant, as long as you have a healthy pregnancy without complications. After sex with penetration, it’s common to notice mild cramps or light spotting — orgasm can sometimes cause cramping as well. Unless your healthcare provider tells you otherwise, you can have sex right up until your delivery date without fear of harming your baby or causing preterm labor. The muscular walls of the uterus and amniotic fluid help protect and cushion your growing baby. During pregnancy, the opening of the uterus (cervix) is also blocked by a thick piece of mucus (called a mucus plug), which keeps the uterus closed off—another reason sex doesn’t affect or harm the baby.

When to see a doctor 

 See your ob-gyn or healthcare provider if you experience any of the following:

• Severe or persistent cramping after sex.

• Vaginal bleeding heavy enough to need a pad.

• Leaking fluid before 37 weeks of pregnancy, which may be a sign of preterm labor. In this situation, sex may increase your risk of infection and other complications.

When to avoid sex in pregnancy

Sex during pregnancy might not be safe in some situations. Your ob-gyn or healthcare provider may recommend you refrain from sex, or take precautions, if you have any of the following conditions:

• Cervical changes (such as when your cervix dilates, or opens, too soon)

• History of preterm labor

• History of miscarriage, or an increased risk of miscarriage

• Placenta previa (when your placenta completely or partially covers your cervix)

• If you or your partner has a sexually transmitted infection (STI)

Physical therapy for more comfortable sex during pregnancy

Sex during pregnancy can sometimes feel different or less comfortable than usual. Changes in your body or pelvic health may play a role. “As core muscles and ligaments stretch to accommodate your growing baby, your pelvic floor muscles may become tense as they work harder to support these changes,” explains Holly Tipp, PT, DPT, a Hinge Health physical therapist. “This can lead to discomfort or pain during intercourse and changes in sexual arousal.” Although it can be common in pregnancy, pain and discomfort during sex is not something you just have to deal with, says Dr. Tipp. 

Physical therapy (PT) and exercise can help strengthen and relax pelvic floor muscles to make sex more comfortable and enjoyable when you’re pregnant. A physical therapist can guide you through safe movement, targeted exercises, and gentle stretches to ease discomfort during sex. Strengthening key muscles like your glutes and abs, while gently stretching areas that tend to tighten (such as your hips, back, and pelvic floor), can help you feel more at ease and confident during intimacy, explains Dr. Tipp. They may also suggest adjustments to your daily routine, recommend relaxation techniques, and offer tips on positioning, supports like pregnancy pillows, or using vaginal lubricant to help make sex more comfortable

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Check below for a few exercises a PT may recommend to help make sex during pregnancy more comfortable.

These exercises target specific muscles to help reduce pelvic pain and discomfort, which can make sex less painful and more comfortable during pregnancy. Learning to relax your pelvic floor and release muscle tension is also important for preparing for labor and delivery, and for reconnecting with your pelvic floor and core after birth, says Dr. Tipp.

Diaphragmatic breathing helps ease pelvic floor tension, promotes relaxation, and prepares your body for labor. Reverse Kegels teach you how to consciously relax your pelvic floor muscles, which can be especially helpful if tension or spasms are causing pain during sex. Seated back bends release tightness in your pelvic floor, inner thighs, and lower back. Cat cow gently increases mobility and flexibility in your spine and pelvic floor, helping to reduce discomfort during sex. Child’s pose helps relax your pelvic floor and lower back for greater comfort during intimacy. Butterfly stretch loosens up tight inner thigh muscles and the front of the pelvis, increasing flexibility for more comfortable positioning. Squats build lower body and pelvic floor strength and flexibility to support ease of movement and comfort during sex.

Practicing these exercises regularly can improve sexual function and increase comfort with intimacy during pregnancy.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips for sex during pregnancy

You can make sex during pregnancy more comfortable and enjoyable by experimenting with different positions, using vaginal lubricants, trying gentle stretches or warm-up exercises, and practicing relaxation techniques. Here’s how these techniques can help:

Try different positions

Positions that worked in early pregnancy may be less comfortable — and sometimes not recommended — during later stages of pregnancy. As your belly gets bigger, lying flat on your back (missionary position) could lead to symptoms like lightheadedness, dizziness, and nausea, explains Dr. Tipp. Experiment with other sexual positions to find what’s most comfortable for you. These tips work whether or not penetration is part of your sex — adapt the pace, angle, and support to what feels best:

• On top. Being the partner on top lets you steer the pace, pressure, and angle, says Dr. Tipp. It takes pressure off your belly and makes it easy to shift your hips if anything feels uncomfortable. If penetration is involved, you can also control depth.

• Side by side. Lie facing each other or with your partner behind you. Having sex while side-lying helps reduce the pressure on your belly.

• Hands and knees. This position may be more comfortable earlier in pregnancy, and less so later when your belly gets bigger. If penetration is part of your sex, it may feel deeper — go slowly and adjust angle and depth as needed, adds Dr. Tipp.

Use vaginal lubricants

Vaginal lubricants can help reduce dryness and make intimacy more comfortable. You can use them as needed — just before or during sex — by applying them to the outside (vulva) and inside the vagina.

“There’s nothing wrong or shameful about using a vaginal lubricant — it can help make sex more comfortable and enjoyable,” says Dr. Tipp. Water-based lubricants or vaginal moisturizers are usually the best options to relieve dryness. Most water-based and silicone-based lubricants are safe to use during pregnancy. Avoid oil-based, spermicidal, or harsh-chemical-containing products, as they can cause irritation, increase infection risk, or damage condoms. Check with your healthcare provider to make sure it’s a safe option for you.

‘Warm up’ for sex

Gentle exercises that help open up the hips and promote relaxation of the pelvic floor may help make sex more comfortable and pleasurable. You can try simple moves (like the ones above), such as child’s pose, inner thigh stretching, and squats.

Practice relaxation techniques

Taking time to relax can make intimacy more comfortable and enjoyable. Deep breathing, progressive muscle relaxation, or mindfulness exercises can help ease tension in your body, including your pelvic floor muscles. Even a few minutes of intentional relaxation before sex may help increase comfort, lower stress, and help you focus on feeling connected with your partner.

Will my sex drive change during pregnancy?

It might — and that’s completely normal. Some people find they want sex more often during pregnancy, and even experience more powerful orgasms. For others, pregnancy-related symptoms or body changes may decrease libido. Your sex drive may also change from day to day or trimester to trimester. Early on, you might be too tired or nauseous to have sex. For some people, sex drive may come back mid-pregnancy, and then wane again toward the end.

Can sex help trigger labor?

No, research shows that vaginal intercourse does not induce labor in a healthy pregnancy, even if you’re full term. This is an old wives’ tale — sex won’t start labor unless your body is already ready. However, if your healthcare provider considers you to be at high risk for preterm labor, they may recommend you refrain from sexual intercourse during the pregnancy or just in the later stages. Sex during pregnancy can lead to cramps or contractions right after sex and during orgasm. If you have severe, persistent cramping after sex, or vaginal bleeding that is heavy enough to need a pad, contact your health care provider.

Is it safe to have oral sex or anal sex during pregnancy?

Oral sex and anal sex can be safe during pregnancy with certain precautions. You can enjoy oral sex as long as you and your partner don’t have an active herpes lesion on your mouth or genitals. Your partner should not blow air into your vagina. While very rare, this can potentially lead to an air embolism, which is when a bubble of air enters the bloodstream and could cause complications for you or your baby.

With anal sex, be careful not to spread bacteria from the rectum to the vagina. Anal sex also carries a higher risk of contracting STIs, so consider using a condom and lubricant for extra protection.

PT tip: Be open with your partner

An important part of intimacy is communication. Tell your partner what feels good and what doesn’t. Try changing positions or using more lubricant if something doesn’t feel right. “If sex is too painful and you don’t want to continue, it’s okay to stop,” says Dr. Tipp. Let your partner know you might need extra time to relax your pelvic floor, and explore other ways you can stay close and connected.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Carbone, L., De Vivo, V., Saccone, G., D’Antonio, F., Mercorio, A., Raffone, A., Arduino, B., D’Alessandro, P., Sarno, L., Conforti, A., Maruotti, G. M., Alviggi, C., & Zullo, F. (2019). Sexual Intercourse for Induction of Spontaneous Onset of Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. The Journal of Sexual Medicine, 16(11), 1787–1795. doi:10.1016/j.jsxm.2019.08.002

2. Is Sex Safe During Pregnancy? (2021, August). American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/sex-and-pregnancy/

3. Is it safe to have sex during pregnancy? (2021, February). Www.acog.org. https://www.acog.org/womens-health/experts-and-stories/ask-acog/is-it-safe-to-have-sex-during-pregnancy

4. NHS. (2020, December 2). Sex in pregnancy. Nhs.uk. https://www.nhs.uk/pregnancy/keeping-well/sex/

5. Oral and Anal Sex During Pregnancy.  (2017, July) American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/oral-and-anal-sex-during-pregnancy/

6. Sex during pregnancy. (2022). Journal of Midwifery & Women’s Health. doi:10.1111/jmwh.13351

7. Sex during pregnancy. (n.d.). Www.marchofdimes.org. https://www.marchofdimes.org/find-support/topics/pregnancy/sex-during-pregnancy