Is Sex Safe During Pregnancy? Bleeding After Sex and When to Avoid It

Is sex safe during pregnancy?

Yes, in a healthy pregnancy. ACOG says most sexual activity is safe for women having healthy pregnancies, including intercourse and penetration with fingers or sex toys, because the amniotic sac and the strong muscles of the uterus protect the fetus. ACOG's guide for partners says that unless the ob-gyn has said otherwise, you can have sex throughout pregnancy.

If you have a pregnancy complication, or questions about what is safe for you, ACOG says to talk with your ob-gyn. In the UK, Aneurin Bevan University Health Board in NHS Wales gives the same rule: you can have sex safely during pregnancy unless your doctor or midwife advises otherwise.

Can sex hurt the baby or cause a miscarriage?

Sex does not hurt the baby in a healthy pregnancy. ACOG says the amniotic sac and the muscles of the uterus protect the fetus, and NHS Wales says a penis or sex toy cannot reach beyond the vagina or harm the baby.

Oluwatosin Goje, an ob-gyn at Cleveland Clinic, says there is no evidence that having sex in early pregnancy increases the risk of miscarriage. If you have pain or bleeding in the first weeks, though, Dr. Goje recommends holding off on vaginal sex until a provider has examined you, which is usually at the first appointment around 10 weeks.

Is bleeding after sex normal when pregnant?

Light spotting after sex is common in pregnancy, and ACOG still asks you to tell your ob-gyn about any bleeding. ACOG says the cervix may bleed more easily in pregnancy because more blood vessels are developing there, and that spotting or light bleeding after intercourse is not uncommon. ACOG also says cramps or spotting after penetrative sex are normal, and that orgasm can cause cramps.

Dr. Goje of Cleveland Clinic says spotting after sex is often the result of increased blood flow to the cervix and vagina and is not a sign of miscarriage, and that it is always a good idea to check in with your provider about it. ACOG says to call your ob-gyn if cramping is severe and persistent, or if bleeding is heavy like a normal period. More on light bleeding at each stage is in spotting during pregnancy.

Later in pregnancy, bleeding can come from the placenta. ACOG says bleeding later in pregnancy can be more serious, and that placenta previa, where the placenta partly or completely covers the cervix, may cause bleeding that often comes without pain. Ireland's health service, the HSE, lists bleeding after sex among the signs of placenta previa.

When should you avoid sex during pregnancy?

Your doctor or midwife may tell you to avoid sex if you have certain complications. Cleveland Clinic lists placenta previa, a history of premature labor (giving birth before 37 weeks), changes in the cervix such as early dilation, and sexually transmitted infections, where it advises no unprotected sex until you have been treated and retested.

Cleveland Clinic also says to hold off on sex and talk to your ob-gyn if fluid is leaking from your vagina, because your waters may have broken too soon and sex could increase your risk of infection.

The HSE says the position of the placenta is recorded at the anatomy scan at 18 to 22 weeks, and that for 9 in 10 women with a low-lying placenta, it moves up in the womb by the third trimester and does not affect the birth. If you do have placenta previa, the HSE says you may need to avoid sex to prevent more bleeding.

NHS Wales says using condoms in pregnancy helps protect you and your baby from STIs, that many STIs have no symptoms at all, and that testing for them, including with a vaginal swab, is safe in pregnancy and will not harm your baby.

Is sex safe in the third trimester?

Yes, unless your ob-gyn has told you otherwise: ACOG says you can have sex throughout pregnancy. ACOG also says desire can shift across the trimesters: you may feel too nauseated and tired in the first, your sex drive may come back in the second, and it is normal for desire to wane again in the third.

ACOG suggests trying different positions as your belly grows. Dr. Goje of Cleveland Clinic advises against lying on your back for long periods, especially in the second and third trimesters, when the weight of the belly can press on important blood vessels; she suggests side-by-side or spooning, being on top, penetration from behind, or standing, with pillows for support. Why lying flat matters later in pregnancy is explained in sleeping position in pregnancy.

Can sex start labor?

There is no definitive research showing that sex can start labor, according to Cleveland Clinic, and research does not show any increase in spontaneous labor after sex. Cleveland Clinic also says sex won't lead to preterm labor as long as your ob-gyn has not told you to avoid it because of a medical condition.

When should you call your doctor or midwife?

• You have any bleeding, even light spotting after sex. ACOG asks you to contact your ob-gyn about any bleeding in pregnancy, and to call if it is heavy, like a normal period, or if cramping is severe and does not stop.
• Fluid gushes or trickles from your vagina. Cleveland Clinic says this can be a sign that your waters have broken too soon.
• Before 37 weeks, you have regular or frequent tightenings of the uterus, often painless (four times in 20 minutes, or eight times in an hour for more than an hour), pressure in your pelvis or lower belly, a constant low, dull backache, mild cramps, or a change in your discharge (more of it, or watery, mucus-like or bloody). ACOG lists these as signs of preterm labor.
• Early in pregnancy, bleeding comes with pain in your belly, pelvis or shoulder. ACOG says these can be signs of an ectopic pregnancy and to call your ob-gyn right away.
• Sex is painful. Cleveland Clinic says to talk to your provider to find the cause.
• You notice possible signs of an STI, such as unusual discharge, pain when peeing, or sores or blisters around your genitals. NHS Wales says to speak to your midwife straight away.