Sexual liberation has hardly made a dent in our understanding of sexuality during pregnancy. Most of us are unclear even about the basics: Is it really all right to be sexually active? How active? For how long? What about orgasms? Is it normal to feel sexual at some times and turned off at others?

Misperceptions abound, and perinatal professionals are often too busy to discuss such personal matters in much depth (especially if we don't approach them directly with our questions). As a result, it is easy to blindly accept the age-old assumptions about which positions are safe and what should and should not be done. Discussions about sexual feelings, needs, and preferences, which can be difficult at any time, may cease abruptly during pregnancy. Even passion can become taboo.

Sexuality During Pregnancy

Although sexual routines change during pregnancy, there is no reason to curtail them altogether. Indeed, lovemaking can offer greater enjoyment and satisfaction in the prenatal months than before. Achieving new heights, however, will take patience, clear communication, and a willingness to experiment with different ways of enhancing each other's pleasure.

The fires of love burn capriciously over the thirty-eight or so weeks of pregnancy. Typically, each trimester brings changes of its own.

First Trimester and Lovemaking Routines

While adjusting to pregnancy, your partner may have morning sickness (not necessarily limited to the morning hours), increased tenderness in her breasts, mood swings, fatigue, and irritability. Self-conscious about her appearance and preoccupied with her body's changes, she may lose touch with her sensuality, and her interest in intercourse may wane.

During the first three months of pregnancy, you may start missing the familiar intimacy of your relationship and feel apprehensive about losing your partner's affection. If your usual lovemaking routines have shifted and your sexual advances are at times brushed off, you may also feel unappreciated or rejected, and begin pulling back. Try not to overreact. Remember, this disruption has been caused by factors beyond the control of either of you, and it is only temporary. Your partner will soon regain her energy, her longing to be close to you, and her desire for lovemaking.

Another phenomenon associated with the first trimester is "spotting," or slight vaginal bleeding, which can arouse concerns about possible miscarriage. Among couples who do have a miscarriage, some feel guilty, believing that intercourse brought it on. Sexual activity, however, does not increase the risk of miscarriage. Your prenatal care provider should be able to reassure you that sex does not terminate a pregnancy.

Second Trimester and Sexual Desire

Your partner may approach the second trimester with a heightened sexual desire. As the physiological discomforts of the first three months begin to subside, she will start easing into her "new" body and settling into the pregnancy. Now she can regard her new shape and the kicking baby as affirmations of her femininity. Elevated levels of progesterone and estrogen surge through her bloodstream, increasing both her energy and her enthusiasm for intimacy.

Ironically, you may approach the middle months of pregnancy with a diminished desire for sex. Your decreased sex drive may spring from concern about your partner's comfort, or from a preoccupation with the looming responsibilities of fatherhood. Or you may be reluctant to initiate sex for fear of being rebuffed.

On a more subtle level, your diminished sex drive may be related to the changes occurring in your partner's body. You may think, "There isn't enough room inside for the kid and me," or maybe, "There is too much room." The baby's movement during lovemaking can also be disquieting. You may feel intruded upon, as if someone were watching, or that you are intruding upon the baby. The truth is, babies move reflexively in response to sound or motion. They neither meddle in our lovemaking nor feel distressed by it.

An additional factor that can contribute to this second trimester decreased sex drive is a history of miscarriage, premature labor, placenta previa, or other pregnancy complications. If your partner has been through such difficulties before, she (and you) may worry that penetration will hurt the baby or interfere with the pregnancy. In most cases concerns of this sort, while understandable, are not substantiated.

There are exceptions, however. If your partner has had a miscarriage due to an incompetent cervix, intercourse should be discontinued so as not to further weaken the cervix. In the event of placenta previa or other complications, sex without penetration may be the best way to keep lovemaking alive.

Vigorous intercourse during the second trimester can at times cause a small amount of bleeding from the newly softened and engorged blood vessels within the cervix. In most instances, healing is rapid. For preventive purposes, try sexual positions that discourage deep penetration. Spotting after intercourse may also result from cervicitis, or inflammation of the cervix -- a condition that can be treated medically. Prenatal care providers generally encourage couples with no history of miscarriage and no signs of spotting to relax and enjoy lovemaking.

In addition, quasi-scientific or religious claims can play a role in the second-trimester downshifting of sexuality. You may have heard, for example, that frequent intercourse and female orgasm deprive the fetus of oxygen, or that intercourse with a pregnant woman is unsanitary and unnatural. Neither assertion is true.

Third Trimester and Sexual Activity

During the last three months of pregnancy, many women become less sexually active. Some limit their lovemaking because they think they're supposed to, or that their partners are not interested. Some refrain out of fear that the fetus will become infected, or that orgasm will initiate premature labor. Others simply feel constrained by the physical discomforts and reduced mobility typical of the approach to term. However, none of these factors needs to stand in the way of a pleasure-filled trimester and a grand erotic finale to pregnancy.

Your care provider may advise you and your partner to restrict intercourse between weeks twenty-four and thirty-two to prevent preterm labor. The early halting of intercourse is justified in the event of bleeding or a documented risk of prematurity, or if the membranes have ruptured. In the absence of these conditions, restrictions may be unjustified and impede your bonding with each other.

What are the chances of transmitting infection to the fetus through intercourse? Research indicates that penetration in late pregnancy does not pose a problem before the membranes have ruptured. Healthy couples are no more likely to develop infections during pregnancy than they are at other times.

As for orgasm, there is no need to worry. In uncomplicated pregnancies, orgasm before term does not trigger labor. Orgasm at term, when the cycle of pregnancy is complete, can occasionally kick off labor-activating contractions (that are far more manageable than those set off by castor oil, Pitocin, or other common labor inducers). Some practitioners actually recommend intercourse or non-penetrating orgasm in late pregnancy.

Lovemaking at term has many proven benefits and goes a long way toward preparing the mother for birth. Sucking on her nipples and stimulating her genitals can activate slow contractions. Prostaglandin, a component of semen, can naturally soften her cervix, paving the way to an easier labor. Elevations in maternal heart rate that sometimes accompany orgasm have no adverse effect on the fetus. Nor has any correlation been found between incidence of orgasm and prematurity.

Similarly, third-trimester aches, pains, and lack of agility need not put a damper on lovemaking. Positional adjustments and inventive approaches are easy to incorporate into any sexual repertoire.

Sustained Lovemaking Throughout Pregnancy

Partners who pleasure each other sexually throughout pregnancy deepen their bond and move into labor and birth more harmoniously. To sustain lovemaking, find creative ways to accommodate your partner's changing shape and shifting center of balance.

Accommodating the need for variety in your lovemaking may at first seem awkward or anxiety provoking. Try to see each new encounter as a ready-made opportunity to add pleasure, excitement, and a new dimension to your relationship. Take things slowly. If you or your partner is not enjoying a new position or activity, go back to one you are comfortable with; then, if you would like, try something else. Impromptu sensuality is one of life's bountiful feasts.

Wise lovers know that lovemaking is not synonymous with sexual intercourse. They express their passion through kissing and fondling (making out), oral-genital sex (fellatio and cunnilingus), mutual masturbation, bathing together, sexually intimate conversation, and sharing erotic memories and sexual fantasies. They indulge their partners with facial massage, perineal massage, foot rubs, and thigh, belly, breast, and buttock massages with vitamin E-rich oils that keep the skin elastic. Wise lovers and their partners take turns massaging each other, as well.

Lovemaking without penetration can be especially meaningful to a woman who has become hypersensitive or averse to intercourse, due perhaps to previous molestation or abuse. It can also be a tender gift to a woman recovering from an invasive obstetric procedure or from childbirth itself.

Quality Sex Rather Than Quantity

In addition, wise lovers understand that focusing on the frequency of sex will only create more tension. Rather than get caught up in the mathematics of intercourse, they emphasize closeness, tenderness, reassurance, reliability, and availability. They know that when it comes to communicating love, quantity is far less important than quality.

As you, too, become a wiser lover and begin to modify your lovemaking, keep communicating. Talk about your changing sex life, all the while letting your partner know that you find her attractive and desirable. Otherwise, she may interpret your silence as a sign that you don't find her appealing or that you are not interested in the pregnancy or in fathering. The repercussions of such misunderstandings can too easily carry over into the months of early parenting.

As a wise lover, you are sure to recognize that, contrary to popular opinion, sexuality need not wane as pregnancy progresses. The truth is, many women feel more sexually vibrant and feminine now than ever before. Similarly, men often find their pregnant wives attractive in new ways.

Keeping Enthusiasm Alive

How can you keep your enthusiasm alive? By checking in with yourself from time to time.

Personal, time is essential for nourishing neglected parts of ourselves and for refreshing our relationships. Whereas running on empty gets us nowhere fast, doing something pleasurable every day refuels us, for it gives us opportunities to release tension, express ourselves, make contact with others, and step outside ourselves to reframe our situation.

It is important, however, to distinguish between taking time to yourself and running away from hurts and frustrations. Fleeing is a saving grace in physically dangerous situations; but in response to uncomfortable feelings or relationship problems, it only complicates matters. During the delicate months of pregnancy, in particular, your emotional departure is certain to feel like abandonment to your partner and children.

Sexual Stress and Tension During Pregnancy

Although we like to envision pregnancy and childbirth as trouble-free milestones in a relationship, couples often report more stress during these months than ever before, or after. In fact, extramarital affairs, abuse, and neglect can increase significantly during this emotionally vulnerable time. So tune in to your relationship, monitor your uncomfortable feelings, and talk them through frequently. Rather than viewing each conflict or disagreement as a problem, see it as an opportunity to understand each other better and draw closer together in preparation for parenting your newborn.

Reprinted with permission of the publisher,
New World Library, www.newworldlibrary.com
©2001. All Rights Reserved.

This article was excerpted from the book:

Fathering Right from the Start: Straight Talk About Pregnancy, Birth and Beyond
by Jack Heinowitz, Ph.D.

Becoming a father is a life-changing event, and not an easy one. The new feelings, emotions, and reactions surfacing every day can be confusing and overwhelming, summoning new dads to resolve old issues. Fathering Right from the Start guides men through this life passage, helping them navigate difficult times and participate meaningfully in parenting. Complete with exercises, checklists, and firsthand accounts by fathers from all walks of life, this indispensable book carries the seeds for a new tradition of men's involvement in the emotional, cultural, and physical structure of the family.

Info/Order this book.

About The Author

Jack Heinowitz is the father of three children (now adults). He is a leading expert in new parenthood and men's issues, having taught and counseled individuals, couples, and families for more than 30 years. He holds Master's degrees in Elementary School Teaching and Counseling and a PhD in Psychology. Jack is a popular speaker and offers workshops to expectant and new parents and to health professionals. He is the author of the Pregnant Fathers series and co-director of Parents As Partners Associates in San Diego with his wife, Ellen Eichler, LCSW.