The Sexuality of Pregnancy & Birth

An excerpt from The Rhythms of Women’s Desire: How Female Sexuality Unfolds at Every Stage of Life by Elizabeth Davis, Hunter House Publishers, 2013

The First Trimester | The Second TrimesterThe Third Trimester
Birth as a Sexual Event

Chapter Four: The Sexuality of Pregnancy and Birth (abridged)


Increased circulation in pelvic tissues as a means for uterine growth can lead to pelvic engorgement, similar to that in premenstrual or ovulatory phases of the cycle. This may cause the mother to wonder what’s hit her, and whether her desire for deep and forceful penetration is really safe. There is no doubt that orgasm causes uterine contractions, but to a degree so minor as to have no serious impact on placental circulation.

If there is a history of miscarriage or episodes of bleeding in the current pregnancy, sexual activity should probably be curtailed, at least for the first trimester. Barring these exceptions, sex brings physiological benefits of increased pelvic circulation, release of tension, and internal muscle toning particularly helpful in preparation for birth. Many couples describe their sexual encounters in pregnancy as re-bonding experiences, akin to those in the initial phase of their relationship. No wonder, for both partners are assuming new roles, and are discovering aspects of one another heretofore unknown.

A mother’s level of desire in the first trimester may also have something to do with the sex of the child she is carrying. At about six to eight weeks, when the baby’s brain is developing, male fetuses are exposed to an enormous dose of testosterone, the level of which is four times that of infancy and childhood.1 This undoubtedly has some impact on the mother, quite possibly increasing her libido. By the same token, it may be that a mother’s ability to recognize the sex of her unborn has a hormonal basis, since surges of testosterone continue to occur in male fetuses at regular intervals during gestation.

For more on the sexuality of pregnancy: The Rhythms of Women’s Desire: How Female Sexuality Unfolds at Every Stage of Life, by Elizabeth Davis, Hunter House Publishers, 2013. Find it on Amazon.


Throughout pregnancy, oxytocin levels continue to rise. Oxytocin initiates Braxton-Hicks contractions, which tone the uterus and prepare it for labor. In large amounts, oxytocin has also been shown to cause mood elevation and alleviate depression–perhaps this accounts for feelings of joy and well being often experienced at this stage of pregnancy. Take ample amounts of oxytocin, mix with high levels of estrogen, blend with vaginal engorgement, and no wonder many mothers in their second trimester find themselves sexually insatiable, surprising both themselves and their partners.

Let’s take a closer look at male reactions to sex in pregnancy. If there is concern about jeopardizing the pregnancy during the first trimester, feeling the baby move in the second may further compound this fear.

A surprising number of males struggle with conflicting images of Madonna/Whore, the Mother versus the Lover, unable to blend the two and hence uncertain of how to relate to their pregnant partner sexually. That a mother might also be blatantly lustful and erotic is a powerful merger of two culturally disparate aspects of femininity.

Some mothers feel this too and may manifest it either by avoiding sex or by wanting to focus exclusively on the baby. Resulting problems may be considerable; disrupted intimacy in a rapidly changing relationship will breed estrangement and mistrust unless lines of communication are kept open. In my practice, I remind my clients of the sexual nature of birth, and use it as a reference point to encourage them to stay open to their partners as much as possible. Labor is, after all, an intensely physical experience; the estimated caloric output of the first birth is equivalent to that of a 50-mile hike! And it involves the same kind of emotional surrender as spontaneous orgasm.

An important aside here about physical and sexual abuse: more and more of us are becoming aware of forgotten or repressed experiences now that support is available. For some, the emotional vulnerability of pregnancy may trigger recollections for the first time that are doubly difficult to handle if parents or other relatives are implicated. The accompanying sorrows and fears may interfere with the mother’s primary relationship. But wherever possible, it is better to bring these to the surface while pregnant than to have them arise and interfere with labor or mothering. Precisely because pregnancy is such a labile state, I recommend hypnotherapy, as it can be especially useful for reactivating and healing the past.


By overview, the first trimester is initiation into pregnancy; the second, integration and equilibrium; and the third, completion and transition to labor and parenting. Sexuality is often disrupted at this stage by the physical discomforts of extra weight. Sleep may be sporadic, especially if heartburn is a problem, and urination becomes frequent again as the baby moves low. None of this is particularly conducive to amour, but a midday rendezvous can help. These inconveniences promote readiness to give up pregnancy and get on with labor, simultaneously preparing a mother for the challenges of caring for her newborn.

Emotionally these are trying times, with mixed feelings in relationship. Sometimes a mother wants to cling to her partner and hold back time, aware that the baby will soon be out in the world (or in the middle of the bed) and nothing will ever be the same again. Sometimes she wants the privacy just to be with the baby, trying to get to know it as well as she can before it is born, so that sex seems extraneous, or more for her partner than for herself. Especially when she is thinking of the challenges ahead and her ongoing need for support, she may be demanding, moody, or fearful.

But in the last week or so, a drop in progesterone often leads to loss of water weight, and a feeling of lightness and well-being. Substances called prostaglandins, found in the brain as well as seminal and menstrual fluids, may also be responsible for labor’s onset. Or it may be the fetus that is responsible; it too releases prostaglandins as its brain matures. Prostaglandins soften the cervix and cause uterine contractions.

This is why many care providers now encourage intercourse at term, especially if the baby is overdue. Seminal fluid is extremely high in prostaglandins and thus may help trigger labor. (A substitute may be found in evening primrose oil, reputed to have a similar effect when rubbed gently on the


Is birth really a sexual event? How can this be, when it’s reputed to be so painful?

Let’s consider these questions one at a time. Birth as a sexual event—-however can we doubt it? After all, it is an intensely physical experience centered in the vagina. In fact, the entire pelvic area is highly stimulated in labor: not just the vagina, but the clitoris, rectum, anus, the supporting tissues and musculature. We can compare the sensations of labor contractions to those of strong menstrual cramps, but with one important difference—contractions come in waves, they build up steadily instead of taking hold abruptly. Those who have learned to cope with menstrual cramps by relaxing and letting go have a distinct advantage in labor. And here is where the parallels to sexual intercourse begin. Particularly when sex is very passionate and forceful, there may be moments of pain or cramping discomfort with deep thrusting and intense pelvic movement. Relaxation, rhythmic breathing, and a change of position help us ease through these sensations without losing momentum, as we would if we tightened up or shut down emotionally. Especially with orgasm, the ability to surrender and diffuse sensation throughout the body is critical.

Deep relaxation, surrender, letting go: when midwives are asked to disclose the secret of giving birth with relative ease, these are the words we choose. More than metaphors for coping, these responses are based on physiological imperatives, as we will see in the forthcoming section. We will also look closely at how environment affects the spontaneity of the birth process.

For more read The Rhythms of Women’s Desire: How Female Sexuality Unfolds at Every Stage of Life by Elizabeth Davis, Hunter House Publishers, 2013. Find it on Amazon.