Apprehensive Mom

Friday, July 26, 2013

Question

Dear Patrick: After trying for a whole year, we finally got pregnant! I am so excited. But I want to wait a few more weeks before I tell anybody else so the risk of miscarriage is a little lower. (I have lost two previous pregnancies.) Because of these very sad experiences, I was anxious about being sexually active and so I asked my gynecologist if it was okay to keep having intercourse with my husband. He replied, “You shouldn't worry about that, dear. You'll be far too busy getting ready to be a new mother.” Then he patted me on the head. (Yes, he really did.) And that was the end of our appointment.

I don't know which part of this experience upset me more—the condescension or the bad information. Why would my doctor tell me not to worry about having sex? I want to keep on having sex, if I can! If I didn't like having sex with my husband how would I have gotten pregnant in the first place? I do want to get ready to take care of our baby, but my husband is also concerned about this. And what is he supposed to do while I knit booties? Take a mistress?

Can you please tell me whether I should worry about having sex or not. How long can I continue to have intercourse before the baby arrives? Is there any chance that having an orgasm would increase my risk of miscarriage? I want to do anything I can to keep this baby and have a healthy child.--

Answer

You don't say why you had two miscarriages. (And you may not know why; it's often impossible to figure out what went wrong.) So I can't tell if these problems are likely to affect this pregnancy, or not. The current medical opinion is that sex during a normal pregnancy is safe. But the only person who can tell you whether you are having a normal pregnancy or not is your doctor. So it's very important to have a care provider you trust, someone who doesn't condescend to you or act shocked at the idea that a pregnant woman might have an active libido. Keep in mind that you don't necessarily have to count on a medical doctor for your primary care. Sometimes women feel more confidence in a physician-assistant, nurse practitioner, midwife, or even a doolah (a person trained to be a pregnant woman's caretaker). Much depends on what your insurance will cover. Start asking friends for referrals to a caring, updated doctor who is a good communicator.

            Pregnancy is not a single event. It's a series of physical changes, for you and the baby. As your hormones fluctuate and your body gets bigger, you may find that all physical appetites are affected. Some women suffer from nausea and a sharper sense of smell that makes the ordinary world a gauntlet of stenches. This may be a perpetual state or last only as long as it takes to throw up. Sometimes nausea persists through the entire pregnancy; other women have problems with it only during certain trimesters. You and your partner can start now by reading about pregnancy and developing good communication about mutual expectations, hopes, dreams, and limitations. It's important to keep your alliance in good working order. Few things test a marriage (or any other partnership) more than the nonexistent sleep schedule of a newborn.

            It's impossible to predict what you will want or be able to do sexually while you make a baby. Your libido might increase sharply; it could be blocked. Sometimes it fluctuates depending on what's happening and how far along you are. Sometimes there's a desire for sex, but you may be so big that it's hard to find a comfortable position. You may find that you need extra reassurance about being attractive to your partner. And he may find that his libido is affected as well. It's very important that neither partner feel deprived. IF your sex life already includes a variety of positions and techniques, that's a definite plus. Sometimes intercourse is too difficult, but you may be able to use hands or mouths or full-body contact to achieve release. Just be aware that if you create deprivation or distance during pregnancy, it can be hard to reconcile once the baby arrives, and you have all the challenges of sleep deprivation and care for an infant. Just as you need reassurance that your husband still sees you as a beautiful and desirable woman, he needs to know that you still want and need him as your lover, not just as an assistant who can be sent to the store when the diapers run out. Sex may feel very different. The stimulation you need to have an orgasm might change. Your fantasies might change, too. Just try to roll with it and look at it all as an adventure.

            Here are some of the physical problems that can cause a physician to recommend a moratorium on preggers sex: the threat of miscarriage; a history of pre-term labor (delivering a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions); unexplained vaginal bleeding, discharge, or cramping; leaking amniotic fluid; placenta previa, a condition in which the placenta covers the cervix or opening of the uterus; a weak cervix that opens prematurely, which increases the risk for too-early delivery; or multiple births (twins, triplets, etc.).

            Some women worry about sex during pregnancy because they have heard the term “contractions” applied both to orgasm and to delivering a child. The relatively mild flutterings of orgasm are of a different order than the hard, gripping contractions that are also called labor pains. So you don't need to worry about orgasms hurting the baby if you are both doing well. Oral sex is still on the menu. Your whole pelvic area will be developing new blood vessels to support the child, but there is no truth to the myth that breathing on a pregnant woman's genitals will cause a heart attack because air bubbles will get into her bloodstream. It is never a good idea to aim a high-pressure stream of air at somebody else's pelvis. I'm talking about the kind of air pressure you get from a hose that blows up tires, or some other mechanical device. You also should not put your mouth against the other person's body and blow air as hard as you can, if only because it will make you dizzy, look stupid, and feel icky. But a mild puff of air intended to create a gentle, teasing sensation is safe. From time to time, I hear rumors that this or that sexual position is not safe during pregnancy. Any comfortable position is okay to use. I've even heard that pregnant women should only have anal sex so their partner's penis won't touch the baby. This NEVER happens. No human penis is long enough to perform such acrobatics. For one thing, the cervix is in the way. And there is a thick plug of mucus that protects the growing child from infection. So you don't have to switch orifices unless you already know that's something you like.

            If, after sex, you notice severe contractions or pain that does not let up, or you have significant leakage of clear fluid or blood, call your doctor at once. Always keep your doctor's number (and your partner's name and contact info) on your person at all times. That way, if there is an emergency, medical personnel will be able to take better care of you.

            Congratulations and best wishes! I hope you continue to do well, as individuals and as a family.

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