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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Let's talk about SEX!

Sexual intercourse and the expression of sexuality during pregnancy, differs from one couple to another and tends to change over time, as your pregnancy progresses. Sexual practices during pregnancy are dependent on a number of factors; your previous beliefs about sex, your partner's previous beliefs, and the physical and emotional changes that are occurring throughout the course of your pregnancy.

While some women find love-making to be highly arousing during pregnancy; due to increased vaginal lubrication, engorgement of the genital area, the lack of birth control, or the return to sex as pleasure as opposed to procreation; others may find it unenjoyable; due to fear of hurting the baby, nausea, fatigue, awkwardness or feeling over-engorged.
 
It is important for couples to discuss their feelings surrounding sex and sexuality, in order to have a mutually fulfilling sex life and sense of intimacy during pregnancy. Some women feel large, uncomfortable and unattractive, while their male counterparts may find the pregnant body to be very erotic and desirable. It is normal for all couples to experience differences in sex during pregnancy. This may require differences in the language of love-making- show and tell your partner what produces pleasure, and what causes pain or discomfort. Both partners should explain their feelings about how pregnancy is affecting their sexuality.

Is it safe to have sex during pregnancy?

You can safely have sex throughout your pregnancy, even right up until the birth, if you and your partner are both comfortable and you are experiencing an uncomplicated, low-risk pregnancy. This includes orgasms. While orgasm, nipple stimulation and the prostaglandins in semen, may cause mild uterine contractions, these are usually temporary and harmless.

Sex is a wonderful way of allowing couples to remain intimate during pregnancy and helps to tone-up the pelvic muscles for birth. It is also relaxing, which is a bonus for both you and your baby.

Many parents worry, that they may hurt their unborn child. Even if your partner is on top; the strong muscles of the uterus protect your baby, the amniotic fluid has a cushioning effect that prevents any trauma, and the thick plug of mucous that seals the cervix, safeguards against infection. Orgasms, a first for many women during pregnancy, will not stimulate miscarriage or early labour in a normal, low-risk pregnancy. Your baby may thrash about, because they enjoy hearing the increased beating of your heart; not because they are experiencing any pain or know what's happening.

There are few reasons why you might need to abstain from sexual intercourse at certain times during your pregnancy or under certain circumstances. These include unexplained bleeding, preterm labour, cervical insufficiency, a dilated cervix and sexually transmitted diseases (STD's). Intercourse is best avoided if placenta previa exists (where the placenta covers the cervix) or if your waters have broken, as this increases the risk for infection.

If you have a history of premature labour, you may chose to abstain during the later stages of your pregnancy; while a tendency to miscarriage may have you avoiding intercourse during the first trimester. If you are in a high risk category, speak to your health care provider about whether or not sex is safe for you. If you have been told to abstain; clarify if this refers to penetration, orgasm, or both, and whether it is temporary or applies to the entire pregnancy. Always report any unusual symptoms following intercourse to your doctor; such as bleeding, pain, abnormal discharge, or lasting contractions.

What positions are best?

Be creative and experiment with different positions. Although many people tend to prefer the missionary position during pregnancy, a growing abdomen will make this exceedingly more difficult. It is also not recommended that an expectant mother lies on her back, after the 4th month of pregnancy (16 weeks gestation). Try positions that allow for manual stimulation of the clitoris, that increase your chances of becoming multi-orgasmic. Some examples include:

* Woman on top- this position works well throughout pregnancy, especially near the end of pregnancy. It allows the woman to control the depth of the penetration, as well as most of the movement.

* Spooning- Many women find this position to be particularly relaxing. The man lies behind the woman, so that his penis goes between her thighs and he enters her from behind. By lying side-by-side, no pressure is placed on the abdomen. This position allows for shallow penetration and can be used throughout pregnancy.

* Hands & knees- This is another great position for pregnant women because of the lack of direct pressure on the abdomen. However, it may prove difficult at the end of pregnancy if your belly is resting on the bed and you are unable to hold it up high enough, to still allow for penetration.

* Side lying- Lay on your side with your partner facing you and pull up one leg, to allow room for your partner. In the last part of pregnancy, this may get tiring after awhile.

As a couple, experiment with positions that work for you. Use your imaginations, try it and if it doesn't work, stop.

If either of you do not feel like having sex, this is particularly important. Explain to your partner what is going on and how they can help you feel more sexual. This is very personal and may differ from one couple to another. For example, take relaxing baths, have romantic dinners, cuddle, massage one another, kiss, engage in mutual masturbation, etc.

Libido

You can generally expect a down-up-down pattern in desire during the course of the 3 trimesters. During the first 3 months, your libido may be at an all time low; due to sore breasts, nausea, vomiting and fatigue. Some couples also have psychological issues. If you have previously lost a baby and are scared that sex could trigger another miscarriage, get your doctor to assess your risks. If you do decide to abstain during this time, explore other ways to feel close as a couple.

As your hormones stabilize during the second trimester; you are likely to feel less sick, more energized and less anxious. There is also more lubrication and engorgement in the genital area, making sex more appealing and potentially more satisfying. Most women are still quiet comfortable during the second trimester because their stomachs are not fully rounded yet.

With the birth looming your libido might dip, with sex becoming increasingly more physically challenging and women possibly feeling uncomfortable about their bodies. It is important to share these concerns with your partner, so that they know that you have gone off sex and not off them. This will give your partner an opportunity to express his feelings too. Becoming a parent is stressful and it is not uncommon for men to have erectile difficulties.

Cramps after intercourse:

Cramping after climaxing is normal and is experienced by most pregnant women, especially in the third trimester. This is because orgasms cause your uterus to contract. During orgasm, the hormone oxytocin is released. In the past, the issue of female orgasm during pregnancy, was a controversial one, since oxytocin is also responsible for triggering labour contractions. It is now known, that orgasm will not lead to preterm labour in women with healthy pregnancies, and they cannot cause your cervix to dilate. These cramps are the same muscle contractions that you experienced during orgasms before pregnancy. They are merely more intense because of your growing uterus and the release of oxytocin. These contractions can last anywhere from 30-60 minutes.

Sex restrictions:

From 16 weeks gestation, a woman should not be flat on her back because the growing uterus can compress major blood vessels, resulting in pelvic pressure and pain. Lying flat on your back can also possibly cause supine hypotensive syndrome, which results in changes in heart rate and blood pressure.

Oral stimulation of the female genitalia is safe throughout pregnancy provided that your partner does not blow air into your vagina. This could force air into your blood stream and cause an embolism, which could obstruct a blood vessel and prove to be potentially fatal to both mother and baby. Similarly, the insertion of foreign objects into the vagina, should not be part of sex play during pregnancy. Douching should never be done during pregnancy.

Intercourse should be avoided if the amniotic fluid is leaking, has ruptured, or there is a suspicion that it may be leaking.

If you are high risk for preterm labour, orgasm and intercourse should be avoided until your doctor tells you it is safe. Nipple stimulation should also be avoided in these circumstances.

If your partner has oral herpes, it is not safe for him to give you oral sex during this time. During the third trimester, you should abstain from oral sex completely, if your partner has ever had oral herpes, irrespective of whether he is symptomatic or not.

If you are having a healthy pregnancy, it is generally safe to use a vibrator. Make sure that it is clean and be extra careful not to penetrate too forcefully. If you have placenta previa, using a sex toy or having intercourse, could traumatize the placenta and cause heavy bleeding. This may jeopardize your pregnancy. If you are at risk for premature labour, having an orgasm could cause contractions and is therefore not safe in these circumstances. If your water has broken and you insert a sex toy, there's a risk of infection to your baby.

If you were having anal sex pre-pregnancy and would like to continue to do so, it probably is safe, with a few exceptions. It is common for women to suffer from hemorrhoids during pregnancy and these tend to get larger as pregnancy progresses. Having anal sex when you have bleeding hemorrhoids, can cause you to lose a considerable amount of blood, which can endanger both you and your baby. If you have placenta previa, anal sex can cause trauma to the placenta, resulting in bleeding that poses a significant risk to the pregnancy. In all circumstances, you should never go from anal to vaginal sex without cleaning up first and changing condoms, if you are using one. Failure to do so, places you at risk of developing bacterial vaginitis, and there is some concern that this infection may cause preterm labour or your waters to break too early.

If you have any questions about specific sexual activities, talk to your doctor about what's safe during pregnancy.

Warning signs:

Although these signs are rare, they could indicate that you are experiencing preterm labour or miscarriage. Contact your health care provider immediately if you have:

* very painful contractions

* uterine cramps lasting longer than 1 hour

* unusual or heavy vaginal bleeding

Sex….in a nutshell

Good, lasting sexual relationships; require practice, patience, understanding and love. This is equally true during pregnancy, when your relationship is affected by several emotional and physical changes. Never allow the frequency or infrequency of intercourse to affect other aspects of your relationship. It is the quality not the quantity of love-making that is important. For example, if you suffer from morning sickness at certain times of the day, keep your schedules flexible, and put the good times to use. Don't pressure yourself to feel sexy if you are feeling queasy, rather wait for the symptoms to subside because morning sickness can be aggravated by emotional stress. Similarly, if you are suffering from fatigue, make love in the morning or on weekend afternoons if possible, followed by a nap.

Recognize any strains that expectant parenthood may be placing on your relationship. Some expectant couples find it hard to adjust to the idea that they will no longer be just lovers, or husband and wife, but mother and father too. This may be compounded by thoughts about the responsibilities and lifestyle changes, as well as the financial and emotional costs of bringing up a baby. Some men feel a sense of subconscious hostility or jealousy towards their expectant wife, because she is now the centre of attention; or because they feel she is doing all the suffering (especially if the pregnancy is a difficult one), for the baby they both want and will both enjoy. Keep the lines of communications open and discuss any feelings that may arise-preferably not in the bedroom. If any problem seems to big to handle alone, seek professional help.

Physically, acknowledge any changes in the intensity of sexual desire that one or both of you may be feeling. There are many physical changes that affect physical desire and sexual pleasure for both partners. Learn to minimize the negative interference of some factors, use others to enhance your sexual pleasure, and simply learn to live with and love the rest.

Remember that big is beautiful and expected during pregnancy. As your shape changes, experiment with different sexual positions, to make love-making more comfortable and enjoyable. The engorgement of a woman's genitals can affect the sexual experience for both partners. Increased blood flow to the pelvic area, due to hormonal changes during pregnancy, may bring about a heightened sexual response in some women. Others may find that they have a sense of residual fullness that persists after intercourse, with the sensation that they haven't quiet made it. This may make intercourse less satisfying and is more common in the later stages of pregnancy. For men, a women's engorged genitals may increase their sexual pleasure (if they feel pleasantly and snugly caressed); or decrease it (if the fit is too tight and they lose their erection).

During the later stages of pregnancy, a woman begins to produce colostrum, which may leak from the breasts during sexual stimulation. If either partner finds this disconcerting, refrain from breast play. Breast tenderness, especially during the first trimester, should be communicated to your partner; rather than suffering and resenting his touch in silence. The enlargement and continued sensitivity of the breasts during pregnancy, enhances sex for some couples.

Changes in the volume, consistency, taste and odor of vaginal secretions, can impact on sexual relations. Increased vaginal secretions can enhance sexual pleasure if a woman's vagina has always been dry or narrow; but can hinder a man's ability to climax if the vaginal canal is excessively wet and slippery. Extra foreplay may be helpful in this regard. The changes in scent and taste may make oral foreplay unpleasant. This can be remedied by massaging scented creams into the thighs and pubic area (but not the vagina).

Occasionally, deep penetration can cause bleeding, particularly during later pregnancy when the cervix begins to ripen for delivery. If your practitioner assures you that there are no complications, abstinence is not required; simply avoid deep penetration.

Although sex may be different from what you have experienced before, in most cases it is completely safe. Studies show that couples who are sexually active during pregnancy have lower rates of premature labour than those who abstain. Contractions experienced after orgasm, are not a sign of labour and pose no danger in a normal pregnancy. However, orgasms, that are particularly intense that may be triggered by masturbation, may be prohibited in high risk pregnancies. Foetal reactions, such as slowed movements, followed by squirming and kicking and increased heartbeat after orgasm, are a result of hormonal and uterine activity. Your baby can't see what you are doing, has no idea what is happening and will have no recollections of it. Instead, they are likely to enjoy the gentle rocking of the uterine contractions during orgasm. Some couples are also frightened of hurting their baby. If deep penetration becomes uncomfortable towards the end of pregnancy, avoid it.

Intercourse during a normal, healthy pregnancy has several benefits on both a physical and emotional level. It ensures an increasing sense of intimacy between you and your partner, it can help you get into shape, it helps prepare the pelvic muscles for delivery and is relaxing for everyone concerned, including your baby.

References

Murkoff, H.E., Eisenberg, A. & Hathaway, S.E. (2002). What to expect when you're expecting. Pocket Books: UK.

http://www.askamum.co.uk

http://www.webmd.com

http://www.about.com

http://www.ivillage.com

http://www.babycentre.com

http://www.pregnancy-info.net

http://www.askdrsears.com