Expert Advice: Is Sex Safe During Pregnancy?

Pregnancy raises many questions about what women can do safely, especially regarding sex.

Some couples worry that having sex might harm the baby or lead to problems. Others think that all sexual activity should stop once a woman is pregnant.

But doctors say pregnancy itself is not a reason to stop having sex.

The American College of Obstetricians and Gynaecologists (ACOG) says most sexual activities are safe for women with healthy pregnancies. They explain that the amniotic sac and strong uterus muscles protect the baby.

Still, this advice does not apply to every pregnancy. Some complications can make sex unsafe, and a woman may need to avoid it based on her doctor’s advice.

To give more details about sex during pregnancy and the precautions women should take, PREMIUM TIMES spoke with Halimat Jimoh, a nurse and midwife. She discussed when sex might be unsafe, the risks of sexually transmitted infections (STIs), and why precautions are necessary even during oral sex.

When Sex May Not Be Advisable

Ms Jimoh explained that during a normal pregnancy, the baby is safe inside the uterus, surrounded by amniotic fluid and the cervix.

However, she noted that some pregnancy issues can change the advice for a woman.

These issues can include unexplained vaginal bleeding, placenta previa, leaking amniotic fluid, certain cervical conditions, and concerns about early labor.

This means that pregnancy should not be seen as a blanket reason to stop having sex. Instead, a woman’s unique situation and any complications should decide what is safe.

“Pregnancy itself is not a reason to stop having sex; it is certain pregnancy complications or medical concerns that may make avoiding sex necessary,” she said.

Oral Sex Is Generally Safe, But Not Risk-Free

While vaginal sex usually gets the most attention, oral sex is another form of sexual activity that couples may wonder about.

Ms Jimoh said oral sex is generally safe during a normal pregnancy, but some precautions are needed.

One precaution is that a partner should not blow air directly into the vagina.

Although rare, blowing air into the vagina can cause an air embolism, which is a dangerous condition where an air bubble enters a blood vessel and blocks blood flow.

Moreover, oral sex does not remove the risk of STIs. The National Health Service (NHS) states that infections like herpes, gonorrhea, syphilis, chlamydia, HIV, and hepatitis can spread through oral sex. The risk is higher if either partner has sores or cuts around the mouth, genitals, or anus.

This means that not having vaginal sex does not make oral sex completely safe. For pregnant women, an STI from sexual contact can have effects beyond just the mother.

Pregnancy Does Not Protect Women from STIs

According to Ms Jimoh, being pregnant does not stop a woman from getting an STI.

An infection during pregnancy can harm the mother and may also affect the baby, depending on the infection. Syphilis is one example.

The World Health Organisation (WHO) estimates that about eight million adults aged 15 to 49 contracted syphilis in 2022.

The WHO says untreated or poorly treated syphilis during pregnancy can lead to serious birth issues in 50 to 80 percent of cases, depending on the infection stage.

The infection can pass from mother to baby through the placenta and might cause stillbirth, early death, premature birth, low birth weight, or congenital syphilis.

WHO also stresses that early testing and treatment during pregnancy can prevent these problems. Ms Jimoh advises pregnant women not to wait until after delivery to seek care for a suspected STI.

“Many STIs can be treated or effectively managed, and early testing, diagnosis, and appropriate treatment during pregnancy can help protect both the mother and baby,” she said.

Herpes Requires Particular Attention

One infection that needs special attention during pregnancy is genital herpes. This is important because of the risk of passing it to the baby during childbirth.

Ms Jimoh explained that genital herpes can be transmitted from mother to baby during delivery.

The risk is higher if a woman gets genital herpes for the first time late in pregnancy since she may not have built enough antibodies to protect her baby.

The Centres for Disease Control and Prevention (CDC) estimates that the chance of passing herpes to a newborn is between 30 and 50 percent when a woman gets genital herpes close to delivery.

This is much higher than the risk of less than one percent for women with recurrent herpes or those who got the infection early in pregnancy.

The CDC advises pregnant women with genital herpes to inform their healthcare providers. Antiviral drugs may be prescribed near the end of pregnancy to lower the risk of an outbreak during delivery. A cesarean delivery may be suggested if there are genital lesions or symptoms when labor starts.

When Should Sexual Activity Be Avoided?

Sores are not the only reason a pregnant woman might need to pause sexual activity.

Ms Jimoh says women with unexplained vaginal bleeding, leaking amniotic fluid, known or suspected STI exposure, unexplained sores, unusual discharge, pain, or fever should see a doctor.

Women already advised to avoid sex due to pregnancy complications should not assume oral sex is safe.

Instead, Ms Jimoh says they should ask their healthcare provider what types of sexual activity are suitable for their condition.

Vaginal bleeding during pregnancy should not be dismissed as normal after sex.

For pregnant women, regular antenatal care, early testing, and prompt medical help for unusual symptoms can help spot and manage risks early.

The message, Ms Jimoh stressed, is not that pregnant women must stop being sexually active, but that they should understand their individual circumstances and seek professional advice when complications, warning signs, or infection concerns arise.