Sex and the pregnant woman

By BRIGITTE ROZARIO

There are many myths about a pregnant woman and sex. Some people think having sex will harm the baby. Others wonder if the baby can actually see the penis!

Obstetrician and gynaecologist Datuk Dr Nor Ashikin Mokhtar of the Primanora Medical Centre answers some common questions about sex and the pregnant woman.

Can a woman have sex throughout the whole pregnancy?

Why not? A healthy woman with a healthy pregnancy can have sex through the whole pregnancy.

I know the joke about the pregnant woman carrying twins and when she has sex, one child says to the other, 'Shhh! Daddy's coming!'

But the truth is the baby can't see. They're so well cushioned. They're in an amniotic bag. They're floating. So, they can't see and they can't feel anything.

They might be aware that mummy's happy and if mummy's happy then baby is happy.

Are there any situations where it is unsafe for her to have sex?

She should not have sex under certain conditions. If she has a history of repeated miscarriages, particularly so in the first trimester, then she's advised to refrain from it. If she thinks her partner or husband has some underlying sexually-transmitted disease (STD) then she should not have sex with him. Or, if she herself has some STDs or if she is bleeding because of a miscarriage or a low-lying placenta, then she should not have sex. Or if she has a history of premature labour, premature contractions, then she is also advised not to have sex.

If she has weakness of the cervix, she is also advised against having sex because then it could start contractions.

How will she know if she has any of these conditions?

Her obstetrician will have her medical history on record, unless it is something she's not told the doctor. In which case, if she doesn't tell, the doctor will not know.

The doctor can pick up whether she has a low-lying placenta or having a miscarriage now.

Are there certain sex positions she should not attempt?

As she grows there are some sex positions she shouldn't be in because of her anatomy. I don't think he can get on top of her if she's too big!

Then you have to be more creative – doing the back way or sideways. They have to be creative. Maybe getting a copy of the Kamasutra might help.

The woman will know if she's too big and she's not comfortable in certain positions.

Does a woman's sexual desire change during pregnancy?

Her desire for sex might not be the same because she gets so tired and towards the end the couple might be too preoccupied with thinking when is the baby coming and all that excitement, and they might not enjoy sex.
 

For women and men, sex is different. For men, they see and they want to have sex. But for women it's more personal. I always tell my patients and even their husbands, for women the greatest sex organ is the one between the ears, not between the legs.

This is where the emotions and general wellbeing all have an effect on her desire and her willingness to participate in sex. At that stage also, understanding the awkwardness of her condition, I think she will appreciate more caressing and hugging and kissing than trying to penetrate her, if the position is not appropriate.

As no two women are the same, similarly their sex drives during pregnancy are also not the same. Some women just breeze through pregnancy, like nothing happened. Others will be vomiting and dragging themselves around because it's so nauseating and surely sex will be the last thing on their minds.

Likewise if she has got problems during the pregnancy, if she's bleeding then there will be no sex desire. The general wellbeing of the mother and the baby does influence her sex drive.

But if she's is generally a healthy woman, she can have sex throughout the pregnancy, again depending on how she feels and her mood.

During early pregnancy, her breasts will be tender and that's when it's 'See, no touch'. But in late pregnancy (30 weeks and above), I do advice the mothers and husbands that if they want the baby to come out, then go home and have sex. Because in the man's seminal fluid there is prostaglandins which has an effect on the neck of the womb and ripening it.

When can the mother resume sexual relations after having her baby?

It depends on where she is and her cultural and religious beliefs and her upbringing. The uterus would have gone back to normal size by about six weeks.

I would say, if you want to resume sexual relations, then technically when she's not bleeding anymore. That's usually after six weeks for a natural delivery; for a caesarean, about six weeks to two months.

Last words of advice for couples on having sex during pregnancy?

First of all, you have to understand the pregnancy changes that the wife is going through so as not to feel that you're now taking second place in the family perspective. A lot of it is about talking it out and communicating about how best you can support each other rather than thinking she doesn't care about you anymore.

The most important thing for the woman is that you know your body better than anybody else and if there's the slightest thing that's telling you that something's not quite right then you need to seek a medical opinion from your doctor.