Orgasm and Sex When You're Expecting

Everything You Were Too Embarrassed to Ask About Orgasm, Sex, and Pregnancy

Pregnant Hispanic woman and husband feeling baby kick
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Are you worried that sex or orgasm may harm your baby or threaten your pregnancy? You’re not alone. One in four women report fear of sex during pregnancy. Many men also are afraid of harming their pregnant partner or the unborn child with sexual intercourse.

Here’s the good news: for the vast majority of women, sex and orgasm are not only safe during pregnancy—but healthy ways to reduce stress and promote emotional well-being.

Important Conversations

Research has shown that sexual intercourse and orgasm do not cause or increase the risk of negative outcomes for the baby or the mother. In a normal and healthy pregnancy, orgasm doesn’t increase the risk of miscarriage or preterm labor. Sexual activity may even have positive health benefits for the pregnancy, by boosting feel-good hormones like oxytocin and increasing the amount of blood flow (and oxygen) to the uterus.

Despite the fact that everyone—you, your doctor, the baggers at the supermarket, everyone—knows that sex is how most people get pregnant, many are still afraid to talk about sex and pregnancy.

You may have questions you’d like to ask your midwife or doctor, but feel too embarrassed. And your doctor may be hesitant to bring the subject up.

“Everyone is uncomfortable about sex,” explains Dr. Michael Krychman, executive director of the Southern California Center for Sexual Health and Survivorship Medicine.

“[There is a] conspiracy of silence. Doctors don’t ask, patients don’t tell. It’s important for both sides to discuss it openly.” 

Your Body During Orgasm

Understanding what an orgasm is and what happens during one may help reduce your fears and anxiety surrounding orgasm and pregnancy, and help you understand the connection between orgasm, pregnancy, and childbirth.

Sexual excitement can be started by a thought, an image, or a casual touch. Your heart starts to beat a little faster. You may blush, not just in your cheeks, but also in other areas of your body like your chest and neck. Blood flow increases to your genitals, and the area becomes swollen and more sensitive to touch.

The Bartholin's glands—which sit just to the right and left of your vaginal opening—secrete arousal fluids that lubricate the vagina and labia. The clitoris—which sits just above the urethra—contains over 8,000 sensory nerve endings. It pulls back under its hood slightly, as it also becomes swollen and more sensitive to the touch. Also, as sexual arousal increases, your muscles generally start to tense all over your body. The vaginal opening tightens as well.   

The generalized muscle tension and sensitivity build as sexual stimulation continues. When (and if) an orgasm occurs, the muscles of the vagina, anus, and uterus contract rhythmically. These involuntary contractions are part of what creates the physical sensation of “release” that comes with an orgasm.     

As all this is happening, your body releases a cocktail of hormones, including a hearty dose of oxytocin and endorphins.

Oxytocin is the “love” hormone and promotes bonding. It also reduces pain. Endorphins are also feel-good hormones that reduce pain.

In fact, research has found that orgasm and vaginal stimulation can more than double a woman’s ability to tolerate pain. This may be important for childbirth, as the pressure of the baby going through the vaginal canal surprisingly reduces some of the pain of labor.

Is Sex and Orgasm Safe?

Yes, in a healthy, normal pregnancy, sex and orgasm are safe. They aren’t only safe but, also, are beneficial for the mother, her developing baby, and the relationship she has with her partner.

Sex and orgasm during a healthy pregnancy have not been found to increase the risk of miscarriage, preterm labor, or other pregnancy complications.

One reason people worry that sex may be harmful to a pregnancy are the orgasmic contractions. They can sometimes cause mild cramping after sex and, later in pregnancy, trigger Braxton Hicks contractions. (Braxton Hicks contractions are uterine contractions that occur during the second half of pregnancy and help prepare the uterus for childbirth and “real” labor contractions. But they are not labor contractions.)

Could those post-orgasm contractions trigger premature labor or a miscarriage? Research says no. You do not need to worry about the mild cramps or contractions that occur after orgasm if you’re not specifically at risk for preterm labor.

The post-sex uterine contractions may feel like a new experience, especially if you never had cramps after sex in the past and never noticed uterine contractions after sex when you weren’t pregnant (few ever do.)

However, as you read above, uterine contractions are a normal part of orgasm. They are harmless when you’re not pregnant, and still harmless when you are. You just notice them more now because of your enlarged uterus and your increased attention to your pregnant body. 

In fact, not only is sex unlikely to lead to preterm delivery, some studies have found that sexual intercourse late in pregnancy was associated with a decreased risk of early childbirth.

Besides triggering Braxton Hicks contractions, another reason why it was once thought that sexual intercourse might trigger preterm labor was the introduction of bacteria. It is true that some bacterial infections can increase the risk of preterm labor, and sexual intercourse does introduce bacteria to the reproductive system.

However, research hasn’t found this to be a problem either. Only in cases where a woman has had numerous sexual partners before pregnancy was sexual intercourse possibly associated with a risk of preterm labor. This is more likely due to an undiagnosed underlying infection—one that was present before the woman even got pregnant—and has very little to do with sex during pregnancy itself. 

When It's Not Safe

There are some specific situations when sexual intercourse or orgasm may be risky during pregnancy.

Your doctor may recommend not having sex if...

  • You’re experiencing unusual bleeding. Spotting during pregnancy can be normal, and some light spotting after sex can also be normal. This can occur from the cervix getting hit during deep thrusting. However, bleeding during pregnancy may be a worrisome sign. In early pregnancy, bleeding could signal the start of a miscarriage. Talk to your doctor. She may recommend abstaining from sexual intercourse for a short period of time.
  • The placenta has grown over the wrong area of the uterine wall. Known as placenta previa, this is when the placenta attaches itself low on the uterine wall and fully or partially covers the cervix. Sex may be risky in this situation.
  • You have been diagnosed with incompetent cervix. This is when the cervix doesn’t remain strong and closed, as it should. The pressure of the baby’s head pressing on the cervix causes it to open prematurely, sometimes leading to second-trimester pregnancy loss. A surgical procedure known as cerclage may be done to hold the cervix closed. Most doctors suggest no sex or very limited sex.
  • Your water has broken. Sexual intercourse after your water breaks may increase your risk of an infection. This can complicate the birth and even be dangerous.
  • You’re expecting triplets or a high-order pregnancy. When the uterus is stretched beyond normal expectations—like with triplets—orgasm may increase the risk of preterm labor.
  • You’re at high risk for preterm labor for other reasons. Just because you’ve had a preterm birth in the past doesn’t mean you will have another, and doesn’t mean you should abstain from sex “just in case.” However, there are some situations where some sexual limitations may be wise.

There’s some disagreement in the medical community about which situations warrant sexual abstinence and which don’t. Don’t put yourself on “sex-arrest” if your doctor doesn’t think it’s necessary.  Before you abstain, ask your doctor.

Can It Cause Miscarriage?

Early miscarriage—defined as pregnancy loss that occurs before 12 weeks—is usually caused by a hormonal imbalance or a chromosomal defect in the embryo. Sex and orgasm do not cause miscarriage nor increase the risk of losing your baby in early pregnancy.

Some worry that the baby might get “shaken out” of the uterus by sexual motion, or worry that orgasm will “squeeze” the embryo off the uterine wall. This isn’t true.

Second-trimester pregnancy loss—occurring after 12 weeks—may be due to incompetent cervix. Occurring in about 1 in 100 pregnancies, sex may put your pregnancy at risk if you have this pregnancy complication. Talk to your doctor if you’re concerned.

Evaluating Your Cramps

It is normal to experience mild cramping and Braxton Hicks contractions after sex or orgasm, and these are nothing to worry about.

“Uterine contraction may occur after orgasm,” explains Dr. Krychman. “These are irregular and have low intensity and resolve. Uterine contraction is a normative response to sexual orgasm. It’s a result of hormonal changes that occur with orgasm such as oxytocin.” 

However, what if the cramps you have after sex are more than just mildly discomforting? How can you tell the difference between Braxton Hicks contractions and early labor contractions?

“Women should be on the lookout for increasing intensity of contractions, and those that become regular in duration and interval,” explained Dr. Krychman.

Labor contractions will come at regular intervals and intensify over time. Harmless contractions will become less intense, gradually fade away, and may stop or slow down if you walk around or change positions.

Of course, if you’re unsure, call your doctor.

Triggering Labor

There’s a pretty commonly shared bit of folk wisdom that sex will bring on childbirth if your due date is close or you’re overdue. Unfortunately for those who want to trigger labor with sex, research has not found this to be true.

There is some science to drive this common belief—for one, the concentration of prostaglandins in cervical mucus is 10 to 50 times higher after sexual intercourse. Prostaglandins are hormones that stimulate uterine contractions, among other things.

Despite this increase in labor-friendly hormones, research has not found that sex can trigger labor to begin if the cervix isn’t already ripe and ready.

A randomized controlled study assigned pregnant women who were due to give birth in two weeks to either have vaginal intercourse at least twice a week or to remain sexually abstinent. The rate of spontaneous labor was the same for both groups. In other words, sex did not bring on labor faster.

This is actually a comforting thought for those afraid to have sex during pregnancy. If sex hasn’t been found to put people into labor who are due to have their baby, how much less likely is it for sexual intercourse or orgasm to bring on labor in a woman whose body isn’t even close to ready?

Orgasm Intensity

Good thing sex and orgasm are safe during pregnancy because for many women pregnancy increases sexual pleasure. In fact, some women experience orgasm for the first time when they are pregnant.

There are a few reasons for this boost in sexual pleasure:

Increased blood flow to the pelvic region: As you read above in the section on how orgasm works you know that sexual excitement involves an increase in blood flow to the pelvic area of your body. It also happens to be that pregnancy leads to an increase in blood flow to your sexual organs. Whether due to pregnancy or sexual arousal, that increase in blood flow is going to have you feeling frisky.

A sensation of fullness in the pelvic area: The increased blood flow also means there is slight swelling of the labia, clitoris, and vagina. This can have you feeling “in the mood” even if you’re not really doing anything sexually exciting.

Increased sensitivity to touch: The blood flow, plus the swelling, plus higher levels of hormones can lead to an increased sensitivity to touch. This can make reaching orgasm easier and can even lead to multiple orgasms, in some women.

Increased breast size and sensitivity: Your breasts get ready to start breastfeeding before the baby even arrives. Part of this preparation includes an increase in breast size, increased blood flow to the breasts, and the very beginnings of breast milk production. Your breasts may be more sensitive to the touch, and during sexual excitement and orgasm, a few drops of milk may leak from the nipples.

Differences Between Trimesters

While sex and orgasm can be more pleasurable when you’re expecting, the other discomforts of pregnancy can get in the way. Don’t be surprised if you’re feeling turned on and turned off, all at once.

During the first trimester, morning sickness and fatigue can put a damper on sexual activity. However, this doesn’t mean you won’t want sex. You’ll still be experiencing that increase in blood flow and sensitivity in your pelvis and breasts. You just may also be feeling sick.

In the third trimester of pregnancy, your enlarged uterus can get in the way of sexual intercourse. It’s still possible to have sex even with your belly bump, but you may need to get creative with sexual positions. Also, the third trimester comes with a host of physical discomforts, back pain, and difficulty sleeping at night. This can mess with your energy to have sex.

Orgasm during the third trimester may also be frustrating. You may find it more difficult to reach orgasm, and if you do, it may be less satisfying. This is partially due to the increased size of your uterus. The contractions may feel less satisfying.

The best sex in pregnancy will likely come during your second trimester.

Studies have found that women are more likely to experience orgasm, increased lubrication, and increased sexual desire during the second trimester when compared to the first and third. This is perhaps because morning sickness and fatigue hit hardest during the first trimester, and it isn’t until the third trimester that the size of the baby starts to get in the way of sex and leads to physical discomfort.

People refer to the second trimester of pregnancy as the honeymoon phase of pregnancy. They typically are talking about the fact that you get the most benefits and the least discomforts of pregnancy during this trimester. However, when you consider that honeymoons are associated with sex, it may also truly be the honeymoon period of pregnancy. Enjoy it while it lasts.

Sex Dreams

According to the American Academy of Sleep Medicine, about 8 percent of adult dreams contain sexual content. Sexual dreams occur in both men and women. Men and women may experience actual orgasm during a sex dream about 4 percent of the time.

During pregnancy, women are more likely to have sexually charged dreams and more likely to experience orgasm during those dreams. Some will have their first ever sex dream when they’re expecting. The sex dreams are most likely to occur during the second trimester.

Why the increase in sex dreams? Again, it all goes back to the increased blood flow to the pelvic region. Your body is physiologically turned on even during your sleep.

Also, you’re more likely to have sex dreams if you’re not having much sex when you’re awake. If anxiety or fear of sex is keeping you from masturbating or from being with your partner, your body may take care of things itself while you sleep.

What if your doctor has told you not to have sex, and you have an orgasm in your sleep? You probably have nothing to worry about. Of course, if you begin to experience intense and regular contractions or other signs of preterm labor, contact your doctor. But it’s extremely unlikely an orgasm in your sleep will trigger labor.

Orgasm During Childbirth

You may have heard that some women experience orgasm during childbirth. This is not a myth. This isn’t a topic with much research, and it’s unclear just how many women experience orgasm during childbirth.

Physiologically, there’s an explanation. The pressure and vaginal stimulation of the baby’s head going down the birth canal may stimulate nerves that trigger sexual pleasure. This sense of fullness of the baby moving through the vaginal canal may result in decreased labor pain for some women, a mixture of pain and pleasure for others, and a moment of pure sexual pleasure for a lucky few.

Orgasm during childbirth isn’t a goal or something to aim for; don’t feel bad if it doesn’t happen for you. It’s likely got more to do with a person’s unique physiology than something anyone has control over.

On the other side of the coin, you also shouldn’t feel ashamed or embarrassed if you do experience orgasm during childbirth. It’s completely normal. Consider yourself lucky if you strike this childbirth pot of gold.

Masturbation

Absolutely, masturbation is safe during a normal pregnancy.

In fact, in some situations, even if you’re on some sex restrictions due to pregnancy complications, your doctor may approve masturbation and only restrict vaginal sexual intercourse.

This is something to clarify and ask about if your doctor tells you not to have sex. If you’re feeling too embarrassed to ask your doctor directly, write your question down on paper and bring it to your appointment. That may be slightly easier than asking out loud. 

Vibrators and Sex Toys

“Yes,” says Dr. Krychman, who also wrote the books Sexual Spark and 100 Questions & Answers About Women's Sexual Wellness and Vitality. “Vibrators are fine. No harm [will come] to fetus or baby.”

Dr. Krychman does recommend using proper technique, hygiene, and lubrication when using sex toys, good advice whether you’re pregnant or not.  

Sexual Limitations

If your doctor does recommend sexual restrictions during your pregnancy, be sure to ask clarifying questions. Your doctor may or may not be specific when giving you the advice.

  • If vaginal intercourse isn’t allowed, are other forms of intercourse (anal, oral) okay?
  • Is masturbation okay?
  • Is orgasm okay, without vaginal penetration?

Also, be sure to ask for how long the restrictions apply.

For example, if you experience bleeding early in pregnancy, your doctor likely doesn’t intend for you to abstain from sex for the rest of your pregnancy. The restrictions may only extend until you stop bleeding, or until some other specific time marker.

A Word From Verywell

Don’t be afraid to ask questions. If you’re too embarrassed, write your questions down. Sexual needs are as important as any other primal needs of the body and mind.

Also, if limitations are recommended, remember that sex being off-limits doesn’t mean you can’t be physically intimate. You can explore non-sexual touch with your partner like cuddling, hugging, massage, gentle kissing, and light caressing. 

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