Sex in pregnancy is generally considered safe, unless your doctor or midwife has told you otherwise. It cannot hurt the baby, who is ensconced in your uterus and surrounded by amniotic fluid, and it can be an enjoyable way to stay connected with your partner. As the midwife Holliday Tyson said while speaking about whether sex triggers labour in an Ontario antenatal class in 2015: You can have sex whenever you want when you're pregnant; you're a grownup. There are just a few situations in which you shouldn't do it while pregnant or may be advised not to by your medical team. Let's start with the most common.

You're just not up for it.

Sex changes in pregnancy, and it can feel different in every trimester. For many women, pregnancy is not a consistently sexy time. Your body is constantly changing. Your symptoms may include pain, morning sickness, heartburn, constipation, and other uncomfortable feelings, and your lingerie probably stopped fitting after the first trimester. Hormonal changes can cause vaginal dryness or sore breasts, both of which make sex uncomfortable. From your second trimester, you might experience Braxton-Hicks contractions for up to thirty minutes after sex. Losing your libido is completely normal in these circumstances.

However, some women do really enjoy sex in pregnancy. There is increased blood flow to the pelvic area and vagina, which can improve your experience. Hormonal changes can also increase your interest in sex. So, the message is, as long as you're not at risk of catching STIs or HIV from a partner and your healthcare team hasn’t told you to avoid sex, do what feels right for you.

You've had vaginal pain or bleeding.

It can be normal to experience some cramping and spotting after sex while pregnant, especially in the first trimester. However, just to be safe, any pain or vaginal bleeding you experience for any reason should be reported to your doctor or midwife. You will almost certainly be told to avoid sex if you experience heavy bleeding, especially if you also have a low-lying placenta.

Your partner has active or a history of oral herpes, tends to blow into your vagina during oral sex, or might have an STI or HIV.

A partner with active or a history of oral herpes can pass on an infection that could harm the baby or affect your labour and delivery.

Even a partner without oral herpes should never blow into your vagina during oral sex. Rarely, this can cause an air embolism, which can be life threatening for you and your baby.

If you or your partner do not have the same sexual partner throughout your pregnancy or you are not sure whether your partner has been tested for STIs or HIV, it is essential that you do not have unprotected sex of any kind.

Your cervix is damaged or weak (cervical incompetence or cervical insufficiency).

An incompetent or damaged cervix is usually diagnosed with an ultrasound or pelvic examination. A cervix is deemed incompetent when it shortens or opens in the second or early third trimester, without any other signs of labour happening. As problems with your cervix put you at higher risk for miscarriage and premature labour, your healthcare team will likely tell you to avoid sex.

Your waters have broken or you have leaked amniotic fluid.

Sex after your waters have broken can increase your risk of infection. If you have leaked amniotic fluid but are not sure whether your waters have broken, it’s important to get this checked out by a doctor or midwife before having sex. Amniotic fluid is sometimes difficult to distinguish from urine or vaginal discharge. It may help you to remember that amniotic fluid does not smell. It is usually thin and clear, sometimes with a hint of pink, brown, or green.

You are nearing the end of a pregnancy with twins or triplets.

Most multiple pregnancies end in premature births. As your healthcare team will usually want to keep your babies in the womb for as long as possible, you may be advised to avoid sex.

You are ripe for labour (close to your due date or overdue).

Returning to midwife Holliday Tyson’s explanation, some research shows that sex can trigger labour if you are close to your due date or overdue (though, understandably, intimate encounters can be a hard thing to study). Around this time, you may actually want to try sex to get things started naturally. The prostaglandins in semen are thought to make the cervix more favourable to labour. Alternatively, you could continue to wait for the baby to come when they want to or choose another potential induction method (Prince Harry writes in his memoir Spare that the late Queen told Meghan Markle that a bumpy car ride does the trick!). It’s entirely up to you.

For more information on having a healthy pregnancy, start Unii’s Pregnancy Journey with Dr. Shree Datta.

When should I avoid sex in pregnancy?