Is Sex During Pregnancy Safe? Despite common fears, most women worry about engaging in sexual activity while pregnant.

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Is it Actually Safe to Have Sex During Pregnancy? Explained by a Urologist

sex during pregnancy is it safe and what do you need to know I'm Dr Reena Malik urologist and pelvic surgeon and today we're going to talk all about why people are scared to have sex during pregnancy and how to have sex during pregnancy safely when we look at data about sex during pregnancy there's obviously an issue with education across the board only about 15 to 30% of people actually get any education about sex during pregnancy and only 29% of women actually ra ra the issue of Sex and the majority of them are raising it themselves their doctors are not bringing it up and most people actually want to know more about sex during pregnancy So today we're going to talk all about it so in 2017 they did what's called a systematic review looking at what people thought about sex during pregnancy and they looked at 34 studies from a variety of low to Middle income countries majority there was one study in the United States but ultimately what did people feel about sex and there was obviously positive but also negative beliefs the most common belief was that it could hurt the fetus about a third of people felt like having sex in some way shape or form could hurt the baby about 177% thought it could result in miscarriage 15% thought it could result in bleeding 12% thought that it could lead to pre-term labor and in the positives there was only 9% of people who thought that it made labor easier so what is the truth ultimately when you look at how often people people are having sex during pregnancy there is generally a decline from pre-pregnancy so when people are having sex 6 to 21 times a month that goes down to about 3 to 10 times a month in the first trimester then it goes from 2 to seven times in the second trimester a month and then from 1 to five times in the third trimester but when you look at the averages it shows a little bit difference right so prior to pregnancy it's about seven times a month the first trimester it goes down to about four and a half times a month and then it goes to seven times in the second trimester and then drops again in the third trimester to one to two times so ultimately what we're seeing is that very often there is a decline in the frequency of sex and oftentimes there's also a decline in desire during that time often because there's a lot of nausea the body is changing and so there is some negative body image thoughts and then ultimately that tends to improve by the second trimester where liido tends to increase and then during the third trimester the size of the growing fetus can become very large and make it a little bit more difficult to have sex in certain positions which can also lead to um some decline in sexual activity but despite this we know that 50 to 75% of couples are still having sex in the last trimester and 30% are still having sex in the last month and even if they're abstaining from sex they're still having oral sex about 30% of the time other types of sex or manual stimulation and so there's still some activities of sexual stimulation and potentially orgasm that happen in that last trimester now these concerns where do they come from why are we worried about having sex during pregnancy well let's debunk some of these myths first is the thought that you might hurt the baby so one is really important to understand the anatomy the baby itself is very well protected it's in a sack of fluid called the amniotic fluid and the amniotic membrane which keeps it protected from the outside world obviously sometimes there is a bit of pain with sex during pregnancy and this is because during pregnancy there's a lot more blood flow to the genitals and so sometimes the cervix can be sensitive and hence there can be some pain or spotting and that doesn't necessarily mean you're harming the baby a lot of people worry that they're going to give the baby dimples or they're going to the baby's going to know what's happening or they're going to hit the baby uh with their phus but they've actually done ultrasound studies where they've looked at uh the phus penetrating using ultrasound they've seen that it doesn't get anywhere near the cervix or specifically it doesn't penetrate the cervix so you're not in any danger of harming the baby uh also what they describe it as is you know yeah like will the baby feel some movement sure it's going to feel like the uterus is moving a little bit but the uterus moves all the time so it's no different than if the mom were to go for a jog or exercise versus having inter of course so rest assured you can't hurt the baby number two is can you cause pre-term labor now there's three reasons why people think that having sex can lead to pre-term labor and there's theoretical reasons but then in actuality the data has not shown that in healthy lowrisk pregnancies these reasons actually pan out so the first is prostaglandins so prostag gandin are important during pregnancy and during labor because one they can increase the onset of Labor they can cause cervical ripening and they can cause uterine contractions and there's two ways where prostaglandins come into play during sex one is that semen contains prostaglandins and so the thought is that semen which is released onto the cervix can then cause cervical ripening and lead to pre-term labor ultimately the seman issue they've actually looked at this in some studies looking at the Bishop score which is a score they use to determine um the onset of Labor and the timing of delivery and essentially they found that there was no effect of the prostate Landin and semen leading to a change in the time to delivery and similarly they looked at this in a variety of studies and a whole different types of ways and they found that does not cause an issue labor now the other thing is that the female body makes oxytocin after orgasm and oxytocin is a substance that is specifically utilized to expedite uterine contractions so the thought is that are these orgasms or potentially other types of stimulation like nipple stimulation which can lead to lot of oxytocin release leading to pre-term labor now the interesting thing here is right how do you control for this not every orgasm is the same in a woman not every orgasm is as Intense or not all the nipple stimulation leads to as intense of a release of oxytocin so ultimately as long as you are having pleasurable good feelings during sex and you're not having painful contractions It Is by all means very very safe to go ahead and have sex play with the nipples do all the things that cause pleasure because you're still a sexual being even when you are pregnant and lastly the thought is that actually trauma to the cervix or the pelvic floor organs from thrusting or penetration can lead to harm but they've looked at multitude of studies looking at sex and pre-term labor with like over 30,000 patients and they have not found any risk of inducing pre-term labor due to vaginal penetrative sex so rest assured again you will not harm the baby now I will talk about at the end of this some issues that you need to be thoughtful of if you fall into these categories about talking to your obstetrician about sex with these certain conditions and number three will it cause infections no it will not cause infections however just like when you're not pregnant you still need to use barrier protection if one of you may have infections from sexually transmitted diseases because that can then cause other complications particular if you have vaginal or genital infections that can induce the risk of pre-term Labor so it's important again to use condoms or other barrier protections if you're having sex with a partner that has a sexually transmitted infection or may have one um so it does not always necessary if you're in a monogamous relationship and you are both sure that you have no evidence of sexually transmitted infections but don't forget just because you can't get pregnant doesn't mean that you can't get sexually transmitted infections at number four will it cause miscarriage so no very you know miscarriage is common unfortunately but miscarriage does doesn't come from having sex it comes because there is an abnormality in the developing fetus that causes it to miscarry and it is not due to anything you did your partner did uh you worked out too hard you had sex too hard whatever those are not the reasons that miscarriages happen rest assured if you're in that unfortunate circumstance to have gone through a miscarriage in the past is not something you did is not from sex and you cannot induce a miscarriage through sex okay now let's talk about how to make sex more comfortable during pregnancy so in fact very often there is an increase in blood flow to the genitals during pregnancy which can make things a bit more sensitive uh in addition there can be nipple tenderness there can be a growing abdomen that's because of the baby and so these things can pose a little bit of challenges in terms of sensitivity go with your partner's responses if they like something um obviously go ahead but obviously tread lightly if they say they're sensitive U make sure you're sort of checking in and communicating throughout the sexual cter to make sure they're comfortable now after about 20 weeks we don't want moms to be lying flat on their backs so if you're going to have sex in the missionary position you may consider using a pillow to prop up the mom um or try other positions like sideline positions or rear entry positions that may be more comfortable as you know the the baby gets a little larger and becomes a little bit more difficult to navigate now the question is when should you worry about sex well ultimately you may worry about sex if you notice that you're having a significant amount of bleeding if you're noticing some uterine contractions or prolonged pain if you notice any water leaking like amniotic fluid those are all concerns that you need to talk to your doctor about or if you have certain conditions this can be if you've had a history of a pre-term birth with a short cervix now not everyone who's had a pre-term birth in the past needs to abstain from sex so this is an important discussion to have with your doctor uh and if they don't bring it up please bring it up yourself if you've had a circle clge now that's a typically a procedure that's done if you have what's called cervical incompetence and and they you risk having a pre-term labor this is important to understand if you're doing this as a preventative measure or a rescue measure because that may change again how long you need to abstain from sex for usually there is a period of time where you can't have sex and they call this pelvic rest so talk to your doctor about exactly what pelvic rest means does it mean that I can't have penetrative sex can I have orgasms can I have oral sex can I have manual penetration um again talk to your doctor about all these very specific things because the data is sort of very mixed and there's not a lot of data on all of these specific types of sex or specific types of pleasure and orgasm and so again talk to your doctor and they can make a full assessment of you based on your history your particular uh anxieties about sex and what they think about your future um how your pregnancy is progressing and all those things if you've had pre-term pre-labor rupture of membranes there's usually a reason to stop having having sex at some point placenta Privia or placental abruption those are all issues where you need to discuss very specifically about when it's okay to have sex and when it's not the couple things that are usually not an issue is if you've had a history of uh C-section usually it's fine to have sex and if you have twin gestation some some sources say you shouldn't but generally the evidence says that it's safe to have sex with twin gestations and probably multiple gestations as well but again talk your obstetrician all right I hope you guys found this helpful I uh I made this video because I was asked on an interview if sex during pregnancy was safe and I looked at the interview like of course it is and realized that this is a question that most people uh don't know the answer to and so I wanted to share this information with you I hope you found it helpful and as always want to take care of yourself because you're worth it

Dr.

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