Sex During Pregnancy and Postpartum

by Dr. April Merritt Delaney OB/GYN

Q: Will I hit the baby if we have sex?

A: I get this question a lot. And the answer is no. In order to get to the baby, you have to go down the vagina, past the cervix and enter the uterus. The average length of the vagina is about 7.5-9 cm. The average length of the cervix is about 4-5 cm. So to get to the baby, we are talking 11.5-14 cm. HOWEVER, the cervix is closed and keeps the baby nice and protected.

This answer is usually satisfactory to most dads and moms until the third trimester. Around 35-36 weeks your doctor will start checking for cervical dilation. You may start to dilate around this time, and the baby’s head does move down. Still, sex does not hurt the baby.

But sex is definitely different during pregnancy. Positions that were comfortable in the first trimester are no longer comfortable in the third. The blood flow and pressure in the vagina increases as pregnancy progresses. You have to become more creative, more romantic and maybe move a little more slowly. This can be frustrating if you let it be. Or the creativity can be fun.

Q: Why is she not interested in me as much as before the pregnancy?

A: Pregnancy is hard on a body. Everything changes. You get curvy in places that used to be flat. You get stretch marks everywhere. You feel fat. Your breasts look great but might hurt. You have discharge and gas. You have nausea. You don’t sleep well, so you’re tired. Men, it’s not you; it’s all the changes in her body. Don’t take it personally.

Q: My wife is breastfeeding. If we have sex, will I get squirted in the eye with milk?

A: This is my favorite question I have ever been asked. My answer -“You might get squirted. Is that bad?” Sometimes nursing breasts do leak milk. Some guys get nervous. It is ok. If you want to avoid outright squirting, have sex after breast-feeding or pump before sex. Breast milk is sterile. It will not hurt you.

Q: She’s not pregnant any more, so why is she not interested in me now?

A: This is the most common question I get asked after the baby is born. Men, you have a baby. He or she is eating every 3 hours. Pooping. Crying. Burping. Peeing. Pooping. Crying. Burping. Peeing. You see the cycle? New moms are tired.

And hormones do not help. In order to breastfeed, estrogen is low so milk production is high. Estrogen plays a vital role in sex drive, vaginal lubrication, desire and orgasm. This doesn’t mean it won’t occur; it means it takes more effort.

Also, a baby just came out of the same place you are thinking about something going in. It is a scary thought for some women.

So for physical and emotional reasons, foreplay is essential. This could come in a number of different ways — dinner with candles, a glass of wine (not a bottle), a back rub, music, etc. Using a lubricant is also important (remember breastfeeding makes the vaginal tissue dry).

Sex can be wonderful after a baby but it might take more effort or planning in the first few months. But it won’t always be this way. Her sex drive, desire and lubrication will return after the breastfeeding is over.

Are you having any of these conditions? You’re OK! This is common!

*Bleeding (might be bright red spots and turn to pink or brown over a few days.) This is ok. The cervix is friable, meaning you touch it and it bleeds. That’s normal.

*Cramping or contractions. You’re ok; this is normal. Take some Tylenol and rest and drink water.

*Discharge might get heavier. You already had some and then the vagina produced more. You may even lose a mucous plug. That’s ok. Your body will make another one if it needs to.

*Kicking baby. Sometimes they are hungry after sex. But then again, you probably are too.

Call your doctor if:

*Bleeding is heavy like a period.

*Contractions that get stronger, wake you up or cause you to do labor-breathing

from the Feb/Mar 2011 issue