We spend quite a bit of time talking about how to enjoy sexual experiences at various points in our lives. Here’s a topic that doesn’t get enough attention: sex during pregnancy. Women have been reaching out and asking, “Is sex during pregnancy safe?” That question is followed up with so many others. I spoke with Dr. Uchenna (UC) Ossai, a Certified Sex Counselor and Pelvic Floor Physical Therapist to get the 411 on sex safety during pregnancy.

Sex doesn’t have to change

Dr. UC says, “Sexual activities can remain the same.” If you were using toys, engaging in masturbation, or having sex with a partner before you were pregnant, these are 100% safe during pregnancy, unless you are experiencing pain or some other issue. If this is the case, please consult your doctor.

Sex may improve during pregnancy

Engaging in sexual intercourse, as mentioned above, is perfectly normal during pregnancy. “Whatever your sex life was before pregnancy doesn’t have to go away. Your sex life might even improve,” says Dr. UC. People who are pregnant have raging hormones as a new life is growing inside of them. This may spark sexual desire. It is common to want to have sex more often during pregnancy. Keep in mind that as you move into the second and third trimester, certain positions may be uncomfortable. You many need to make adjustments due to your comfort level. For some, penetrative sex may be undesirable and that is okay. It may be more desirable to engage in oral sex or mutual masturbation.

Be mindful of enhancers

One thing to consider during pregnancy is the use of enhancement gels or lubricants. Take a look at the ingredients. Dr. UC says, “Be careful with CBD lubricants, warming gels, or anything that tingles.” If you are unsure if these are safe during pregnancy, have a conversation with your doctor. Don’t be afraid to ask because you are concerned about how you will be perceived. While pregnant, it is really important that you are thinking about how to have sex safely.

What happens after pregnancy?

After pregnancy, also known as postpartum, you might focus a lot of your time on the newborn. However, we know that sexual desires do not vanish, nor should they be put on hold. During postpartum, after you have been medically cleared by your doctor, penetrative sex can be uncomfortable. If you are breastfeeding or pumping, you may experience vaginal dryness. So, what can you do? Dr. UC says, “Have a conversation with your healthcare provider regarding the appropriateness of topical estrogen cream to help improve your symptoms.” Your body is temporarily in a low estrogen state, which can lead to vulvar and vaginal dryness. Dr. UC explains, the topical estrogen can be given as a cream that is inserted into the vagina to help heal and moisturize the vaginal tissue. Another important component to sex after pregnancy is communication with your partner. Sexual communication during this time is essential to ensure that expectations are being addressed and negotiated postpartum.

Why didn’t I know about these things?

Unfortunately, many are unaware of the facts around sex during pregnancy. The same is true for accessing a Pelvic Floor Physical Therapist. You may have heard that you should do Kegel exercises to improve and strengthen your pelvic muscles before and during pregnancy. Pregnancy has a significant impact on your body, no matter the mode of your delivery. A pelvic health physical therapist can evaluate and assess your pelvic floor, spine, and core muscle function. They can help rehabilitate your body to a new and stronger place to prevent any functional limitations. After pregnancy, you might benefit from seeing a Pelvic Floor Therapist. However, many may not have access to one in their area. It is also true that access to healthcare in general is an issue for certain racial/ethnic groups or those with limited insurance coverage. In addition to access, many are unaware that a Pelvic Floor Therapist is an option. Dr. UC says that “access, knowing it’s an option, competing priorities, and medical mistrust” are the factors that impact the health-seeking behaviors of someone who could benefit from a Pelvic Floor Physical Therapist.

During pregnancy, if you are experiencing pain or incontinence (trouble with urine or fecal excretion), you may want to consider seeking Pelvic Floor Physical Therapist. Keep in mind that these conditions can be experienced before, during, or after pregnancy. The takeaway message is that you do not have to endure chronic pain or pelvic issues. Seek the care that you need. For more information about pelvic floor therapy or sex counseling, feel free to contact Dr. UC Ossai (Website: www.youseelogic.com; Email: [email protected]; Instagram: @youseelogic).

Additional Resources:

Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7(1 Pt 1):136-142. doi:10.1111/j.1743-6109.2009.01538.

Aydin M, Cayonu N, Kadihasanoglu M, Irkilata L, Atilla MK, Kendirci M. Comparison of Sexual Functions in Pregnant and Non-Pregnant Women. Urol J. 2015;12(5):2339-2344.

Yeniel AO, Petri E. Pregnancy, childbirth, and sexual function: perceptions and facts. Int Urogynecol J. 2014;25(1):5-14. doi:10.1007/s00192-013-2118-7

Leeman LM, Rogers RG. Sex after childbirth: Postpartum Sexual Function. Obstet Gynecol. 2012;119(3):647-655. doi:10.1097/AOG.0b013e3182479611

Staruch M, Kucharczyk A, Zawadzka K, Wielgos M, Szymusik I. Sexual activity during pregnancy. Neuro Endocrinol Lett. 2016;37(1):53-58.

Ashley Townes

Ashley Townes

PhD, MPH, Epidemiologist at Centers for Disease Control
Dr. Ashley Townes (she/her/hers), is a native of Cincinnati, Ohio. She attended Walnut Hills High School and the University of Cincinnati, where she received both her Bachelors and Master of Public Health degrees. She received her doctorate degree in Health Behavior and Epidemiology from Indiana University.

Dr. Townes has experience working as a Community Health Educator and Disease Intervention Specialist in Cincinnati and the surrounding areas. She has worked on several initiatives related to the dissemination of national HIV prevention and care campaign materials tailored for African Americans, Hispanic/Latinx, and transgender women of color. Dr. Townes has taught collegiate-level Human Sexuality courses, served as an Epidemiologist at the Ohio Department of Health, and currently works as an ORISE Postdoctoral Research Fellow in the Division of HIV/AIDS Prevention’s Epidemiology Branch at the Centers for Disease Control and Prevention in Atlanta, GA.

Ashley’s research background includes work on the sexual experiences of African American/Black women accessing health information and utilizing sexual health services. In 2018, she received grant funding from the Patty Brisben Foundation for Women’s Sexual Health to translate sexual health research data into educational materials. Her career interests are aimed at providing quality sexual education and working towards health equity.