Sex is safe during normal pregnancy, study shows

Sex in pregnancy is generally safe, with few complications, states a new primer for physicians to counsel patients wondering about sex in pregnancy, published in CMAJ (Canadian Medical Association Journal).The primer is based on current evidence. Potential, although uncommon, risks of sex in pregnancy include premature labour, pelvic inflammatory disease, hemorrhage in placenta previa (when the placenta covers part of the cervix) and blood clots. While restriction of intercourse is recommended for women at risk of premature labour, the evidence is contradictory and limited. In low-risk women, frequent intercourse was associated with an increased risk of premature labour only in women with lower genital tract infections. In higher risk women — carrying more than one baby, with cervical incompetence or a history of early labour — there is limited evidence to guide recommendations. “In populations at increased risk for preterm labour, there is no evidence to suggest a clear benefit from

restricted sexual activity; however, this is a simple intervention that causes no harm and may be a reasonable recommendation until better evidence emerges,” writes Dr. Clair Jones, Department of Obstetrics, Mount Sinai Hospital and University of Toronto with coauthors. In rare cases, some types of sexual activity that push air into the vagina may result in a uterine blood clot that is usually fatal. “Sex in pregnancy is normal,” write the authors. “There are very few proven contraindications and risks to intercourse in low-risk pregnancies, and therefore these patients should be reassured. In pregnancies complicated by placenta previa or an increased risk of preterm labour, the evidence to support abstinence is lacking, but it is a reasonable benign recommendation given the theoretical catastrophic consequences.” They state that there is no evidence to the theory that sex at term can induce labour but that there are no known negative outcomes for women with low-risk pregnancies. The authors conclude comfort level and readiness to engage in sexual activity should guide both sex during pregnancy as well as in the postpartum period. News from: University of Toronto   utoronto.ca ~ Sexual activity during pregnancy; Most research suggests that, during pregnancy, both sexual desire and frequency of sexual relations decrease. In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease. However, these decreases are not universal: a significant number of women report greater sexual satisfaction throughout their pregnancies. Sex during pregnancy is a low-risk behaviour except when the physician advises that sexual intercourse be avoided, because it may, in some pregnancies, lead to serious pregnancy

complications or health issues such as a high-risk for premature labour or a ruptured uterus. Such a decision may be based upon a history of difficulties in a previous childbirth. Some psychological research studies in the 1980s and ’90s contend that it is useful for pregnant women to continue to have sexual activity, specifically noting that overall sexual satisfaction was correlated with feeling happy about being pregnant, feeling more attractive in late pregnancy than before pregnancy and experiencing orgasm. Sexual activity has also been suggested as a way to prepare for induced labour; some believe the natural prostaglandin content of seminal liquid can favour the maturation process of the cervix making it more flexible, allowing for easier and faster dilation and effacement of the cervix. However, the efficacy of using sexual intercourse as an induction agent “remains uncertain”. There is substantial evidence for exposure to partner’s semen as prevention for pre-eclampsia, largely due to the absorption of several immune modulating factors present in seminal fluid. During pregnancy, the fetus is protected from penetrative thrusting by the amniotic fluid in the womb and by the woman’s cervix.Sexual intercourse after giving birth can begin when the couple are both ready. However most couples wait until after six weeks and they should consult their physician if they have any concerns. GoodNews International


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