OBGYN | Gynecologist | Chicago | OB GYN Blog

By Denise Mann
WebMD Feature
Reviewed by Louise Chang, MD

women’s minds, especially when they are dealing with nausea, vomiting, and overwhelming fatigue. Other women, however, may crave sex in pregnancy. And men, too, are split into different camps regarding sex during pregnancy. Some men may find nothing sexier than a pregnant woman, but other men may be too afraid of hurting the baby or their pregnant partner to enjoy sex.
But desire aside, is sex during pregnancy even safe?

The good news — or bad news, depending on how you look at it — is that “sex during pregnancy is extremely safe for most women with uncomplicated, low-risk pregnancies,” says Dayna Salasche, MD, an associate professor of obstetrics/gynecology at Northwestern University Feinberg School of Medicine and an obstetrician at Northwestern Specialists for Women, both in Chicago. “Some people feel like they enjoy sex during pregnancy more and others enjoy it less,” she tells WebMD.
Trimester by Trimester Guide to Sex During Pregnancy

During the first trimester, many women report no great desire for sex because they feel tired and nauseous, but during the second trimester, “they are feeling better, there is more lubrication, and they have engorgement in the genital area,” says Monica Foreman, MD, an obstetrician at Montefiore Medical Center in the Bronx, N.Y. This makes sex more appealing and potentially more satisfying. What‟s more, most women are still fairly comfortable during second trimester because their stomach is not overly rounded yet. This is not quite true during third trimester. As the stomach grows and fatigue returns with a vengeance, sex may seem less attractive — not to mention physically difficult during the final weeks of pregnancy.

If the dad-to-be is nervous about having sex with his increasingly pregnant partner, “we tell them that their baby is well protected. It is an egg surrounded by a pillow and another pillow and that there is no way they will hurt the baby, and that usually makes them feel much better,” Salasche says.
Whether or not having sex close to your due date during third trimester can bring on labor is an old wives‟ tale, but having an orgasm causes the release of prostaglandins, which can theoretically cause contractions.
“At 40 weeks, this can‟t hurt,” Foreman says.
Sexual Positions During Pregnancy
“As she grows, the traditional man-on-top position is more uncomfortable for pregnant women,” Foreman says. Other, more comfortable sexual positions during pregnancy may include intercourse from behind or side-to-side (spooning).
And “at some point, a pregnant woman should not be flat on her back because the growing uterus can compress major blood vessels,” Salasche says. This can cause pelvic pressure and pain. This phenomenon typically occurs during the third trimester. Lying flat on her back can also cause “supine
hypotensive syndrome,” which results in a change in heart rate and blood pressure that can lead to dizziness and other symptoms or signs.

One sexual act to avoid during pregnancy is blowing during oral sex, Foreman adds. “If oral sex is performed on the pregnant woman while blowing air into the vagina, the woman can develop an air embolus, which can travel to the lung and have potentially fatal consequences.”
Reasons to Avoid Sex in Pregnancy Sex during pregnancy may not be safe for women with a history of repeated miscarriages, preterm labor, bleeding, or an incompetent cervix (a condition in which the cervix effaces and dilates without contractions in the second or early third trimester, when the baby‟s weight puts increasing pressure on it), she says.

That’s not all. Women with placenta previa (a condition where the placenta is covering the cervix) are at risk of hemorrhaging if they have sex during pregnancy. Women with premature rupture of membranes (PROM), which occurs when the sac containing the developing baby and the amniotic fluid bursts or develops a hole before labor, should also avoid sex during pregnancy, Salasche says.
“If there are not any contraindications, a woman can have intercourse throughout her whole pregnancy,” Foreman says.

Other red flags that sex during pregnancy may not be wise may occur after intercourse. “If you have bleeding or foul-smelling discharge after sex during pregnancy, tell your doctor right away,” she says. Discharge may be a sign of an infection that can travel upward to the uterus, and bleeding may be a sign of a problem in general.

Pregnant women should also be aware that if their partner has an STD, they still need to use a barrier method of contraception, such as a condom, to protect themselves.
“Most people think, „I am pregnant, I don‟t need contraception,„ but you still need a barrier method for protection against STDs,” says Manju Monga, MD, the Berel Held Professor and the division director of maternal-fetal medicine at the University of Texas Health Sciences Center in Houston.
Let’s Talk About Sex During Pregnancy

“We discuss intercourse in the general prenatal discussion because a lot of women feel uncomfortable bringing into up,” Foreman says. “We tell them what is and isn‟t OK.”
“I do bring up sex during pregnancy when it is contraindicated,” says Monga, who sees mainly high-risk patients. “Physicians who see low-risk pregnant patients on a day-to-day basis discuss sex at the first prenatal visit, but I tend to see women later in their pregnancy, when they develop complications.”
The bottom line when it comes to sex during pregnancy is “to have fun, listen to your body, and be open with your partner,” Salache says.

Offering a wealth of medical expertise, Ashley Alloway has worked with the founding doctors of the Northwestern Specialists for Women since May of 2007. Before joining NSW, she worked at the Obstetric and Gynecologic Specialists of Northwestern, where she provided both routine obstetrical and gynecological care to women of all ages and regularly participated in rounds at the hospital. Ashley was the first Physician Assistant to be hired by both practices and since then - recognizing the integral role of the PA in providing comprehensive patient care - both physician groups have expanded their medical teams to include another Physician Assistant.
Prior to this, Ashley served as a Physician Assistant in the Department of Obstetrics and Gynecology in the Women’s Center at the University of Chicago, a resident run outpatient clinic. Here, teaching was a top priority and she gained invaluable experience dealing with both routine and more complex ob and gyne cases, in addition to providing comprehensive treatment to undeserved patients.
Ashley received her undergraduate degree in biological sciences from the University of Kansas and completed her Physician Assistant graduate degree from Midwestern University in 2004.  She is a Board Certified Physician Assistant, enabling her to practice medicine with physician supervision and to provide a broad range of diagnostic and therapeutic services to patients.

Dr. Venkatachalam graduated from the University of Pennsylvania with a BA in Biology and French Literature. She received her Masters in Public Health from the George Washington University in Washington D.C., specializing in Epidemiology and Biostatistics. After earning her MD from the University of Tennessee, Memphis, she completed her residency in obstetrics and gynecology at New York University. Dr. Venkatachalam is a Junior Fellow of the American College of Obstetrics and Gynecology and a member of the Association of Professors of Obstetrics and Gynecology. She has spent time abroad providing prenatal care in developing countries. She is fluent in Spanish and proficient in French. Prior to joining Obstetric and Gynecologic Specialists of Northwestern in 2007, she served on faculty at Emory University, acting as a residency coordinator in addition to providing outstanding patient care. She is currently a Clinical Instructor of Obstetrics and Gynecology at Northwestern University’s affiliate medical school, The Feinberg School of Medicine. 

While interested in all aspects of general obstetrics and gynecology, Dr. Venkatachalam’s particular obstetrical interest is in high risk pregnancies, particularly those complicated by diabetes, hypertensive, cardiac, and hematological disorders, and has presented research at the regional and national levels. She is also adept at minimally invasive surgery, particularly in new modalities to treat abnormal uterine bleeding, fibroids, and providing permanent sterilization.  

Dr. Dayna Salasche received her B.S. at the University of Illinois in Psychology. She graduated from medical school at Rush University Medical College in Chicago. She completed her residency in Obstetrics and Gynecology at Lutheran General Hospital, where she also served as Chief Resident.  Dr. Salasche is also a Fellow of the American College of Obstetrician Gynecologists. In addition to being on staff at Prentice Women’s hospital, she is also a clinical instructor of Obstetrics and Gynecology at Northwestern University’s affiliate medical school, The Feinberg School of Medicine. 

Dr. Salasche is interested in all aspects of both Obstetrics and Gynecology including advanced maternal age and multiple gestations. She is particularly interested in the evaluation and treatment of women who have abnormal pap smears, and issues of recurrent chronic vaginitis. Dr. Salasche is also an expert at laparoscopic surgery.

Dr. Kimberly McMahon received her undergraduate degree in biomedical engineering from Tulane University. She then received her master’s degree is in physiology and medical degree from the University of Louisville.. She completed her residency in Obstetrics and Gynecology at Northwestern Memorial Hospital. She is a member of The American Association of Gynecologic Laparoscopists and a Fellow of The American College of Obstetrician Gynecologists. She is a clinical instructor of Obstetrics and Gynecology at Northwestern University’s affiliate medical school, The Feinberg School of Medicine. While focusing on all aspects of general obstetrics and gynecology, Dr. McMahon’s special interests include adolescent gynecology and colposcopy. Additionally, she is published in the area of multiple gestations and preterm labor. 
Dr. McMahon has received national recognition in laparoscopic surgery and continues to focus on laparoscopic hysterectomy and minimally invasive surgery.

With 12 years of experience practicing Obstetrics and Gynecology, Dr. Bonnie E. Wise brings to the team at Northwestern Specialists for Women (NSW) a wealth of expertise diagnosing, treating and educating patients on all facets of women’s health and wellness. With a natural gift of relating to women of all ages, combined with a passion for patient care throughout all stages of a women’s life, Dr. Wise’s  ultimate goal is to help women truly understand their bodies and improve the overall quality of life with exciting and cutting-edge treatment options.  Prior to forming NSW, Dr. Wise was a member of the Obstetrics and Gynecologic Specialists of Northwestern and has served as a Clinical Instructor of Obstetrics and Gynecology at Northwestern University’s affiliate medical school, The Feinberg School of Medicine since 1997.
Dr. Wise specializes in both low and high risk pregnancies, which includes women of advanced maternal age, twins and pregnant athletes. She is also recognized for her expertise in the diagnosis and treatment of urinary incontinence, where she offers cutting-edge outpatient procedures for the diagnosis and treatment of stress incontinence.  Other gynecological interests include the treatment of uterine fibroids with minimally invasive surgeries including laparoscopic hysterectomy and hysteroscopic resection of uterine fibroids and polyps, as well as endometrial ablation for heavy vaginal bleeding. Dr. Wise is also committed to promoting preventative healthcare through counseling in the areas of premenstrual syndrome, STD’s, preconception, infertility, menopause and hormonal changes.
Dr. Wise received a B.A from Boston University, attended The Chicago Medical School and completed her residency at the University of Illinois and Michael Reese Hospitals. She is a Fellow of The American College of Obstetrics and Gynecology, The American Medical Association, The Chicago Medical Society, The American Association of Gynecologic Laparoscopists and was awarded “Top Doctor” in Chicago by her peer group.
In her spare time, Dr. Wise is an avid runner and athlete. Her other sources of inspiration are her husband and her two beautiful children.