Sex during pregnancy: what's safe, comfortable positions and when to stop

Yes, sex during pregnancy is safe if your pregnancy is healthy and uncomplicated. KKH's obstetrics and gynaecology department says it has no harmful effects on the pregnancy or the baby, who is cushioned by the amniotic sac and the thick wall of your womb, while a mucus plug in your cervix keeps infection out. Mild cramps after orgasm are normal and don't start labour. You should avoid sex if you have a low-lying placenta (placenta praevia), your waters have broken, you're in preterm labour, or either of you has an STI or a herpes outbreak. See your doctor about any bleeding after sex. Below: how desire changes by trimester, positions that stay comfortable as your bump grows, and where to go in Singapore if something doesn't feel right.

Is sex safe for the baby?

In a healthy pregnancy, yes. KKH explains that your baby sits inside the amniotic sac, surrounded by fluid and a thick uterine wall that cushions it from movement. The mucus plug in your cervix stops infection from getting into the womb. Penetration doesn't reach the baby.

Your womb may tighten after an orgasm. KKH says these contractions are harmless in most cases and won't bring on labour. Brief cramps afterwards are normal too. See your doctor if the cramps get stronger or come more often.

If your partner is nervous, that's common, and KKH notes the worry often grows near the end of pregnancy, when some partners fear hitting the baby's head. KKH's answer is that there's no scientific evidence that sex is unsafe when a pregnancy is smooth and uncomplicated. Hearing it from your doctor at your next check-up can help.

How your sex drive changes by trimester

KKH says higher oestrogen can mean more lubrication, which some women enjoy and others find irritating. None of this is a rule. Some women want sex more, some much less, and both are normal. Our guide to common pregnancy discomforts by trimester covers the nausea, tiredness and aches that affect desire.

Comfortable positions as your bump grows

Later in pregnancy, KKH says lying on your back under your partner (the missionary position) gets difficult because of the weight on your tummy, and deep penetration can become uncomfortable. These positions keep weight off your bump:

• Side-lying spoons, with your partner behind you. KKH says this limits how deep penetration goes.
• You on top, so you control depth and keep weight off your tummy.
• On all fours, or seated on the edge of the bed.

Use pillows under your bump or between your knees, and change position whenever something aches. Sex doesn't have to mean intercourse. KKH notes that many couples hug, kiss, massage, use oral sex or masturbate instead, especially late in pregnancy.

Oral sex

Giving oral sex is safe, KKH says. Two cautions for receiving it: avoid it if your partner has cold sores, and your partner must never blow air forcefully into your vagina, because of a rare risk of an air bubble entering a blood vessel.

When to avoid sex

Your doctor will tell you if your pregnancy needs extra care. KKH advises against sex in these situations:

• Placenta praevia, where the placenta lies over the opening of your cervix: avoid penetrative sex, as it could cause bleeding.
• Your waters have broken: avoid sex, as infection could travel up to your baby.
• You're in preterm labour: avoid sex, as orgasm and chemicals in semen could increase contractions.
• Abnormal vaginal discharge, or either of you has a herpes outbreak or any sexually transmitted infection.
• Your partner has ever had genital herpes: avoid sex in the third trimester, even if he has no sores now.

If your doctor has told you to avoid sex for another reason, ask exactly what's off limits and for how long. Our 23 weeks pregnant guide lists the signs of preterm labour.

Bleeding after sex

A little spotting after sex can be normal in pregnancy, because higher oestrogen sends more blood to your cervix. KKH still says to see your obstetrician about any bleeding after sex. The doctor examines you and does an ultrasound scan to rule out serious causes such as a threatened miscarriage, preterm labour, a polyp in the birth canal or a low-lying placenta.

Where to go in Singapore if something's wrong

For most worries, call your own gynae's clinic. For urgent problems, KKH's set-up is a useful guide, and other hospitals with maternity units run similar services:

• Under 22 weeks with tummy pain or bleeding: KKH's Urgent O&G Centre, a walk-in centre at Basement 1 of the Women's Tower.
• 22 weeks or more with leaking water, bleeding or signs of labour: KKH asks you to go straight to its Delivery Suite, Level 2 of the Women's Tower.
• Under 16 weeks with light bleeding or mild pain: you can book KKH's Early Pregnancy Assessment Unit.
• Heavy bleeding or bad tummy pain at any stage: go to the Urgent O&G Centre or your nearest emergency department now.

Our signs of labour guide explains what waters breaking feels like, and our guide to choosing a gynae covers who to call between visits.

Sex after your baby is born

KKH recommends waiting until any wound has fully healed and asking your doctor at your postnatal review, which may be around six weeks after delivery, before you have sex again. Ask about contraception at the same visit, and our pelvic floor recovery guide explains why sex can feel different for a while. Our guide to sex after giving birth covers pain, low libido and contraception while breastfeeding.

Frequently asked questions

Can sex cause a miscarriage?

Not in a healthy pregnancy. KKH says sex is safe and has no harmful effects on the pregnancy or the baby. See your doctor about any bleeding, so they can check the cause.

Can the baby feel it when we have sex?

Your baby is protected by the fluid-filled amniotic sac and the thick wall of your womb, which KKH says cushion it from movement.

Can sex bring on labour?

KKH says the womb contractions after an orgasm are harmless in most cases and won't start labour. If you're already in preterm labour, avoid sex.

Is it normal to bleed after sex when pregnant?

Light spotting can happen because of extra blood flow to your cervix, but KKH says to see your obstetrician about any bleeding after sex so the cause can be checked.

Which positions are safest late in pregnancy?

Ones that keep weight off your bump: spooning on your side, you on top, on all fours or seated. Avoid deep penetration if it hurts.

When can we have sex again after the birth?

KKH suggests waiting until any wound has healed and checking with your doctor at your postnatal review, which may be around six weeks after delivery.