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Many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy. It is not surprising that a woman may have a decline in sexual interest in the early stages of pregnancy as the nausea, vomiting and fatigue may negatively influence her libido. There may also be a fear of harming the foetus or a fear of miscarriage, especially if there has been some difficulty falling pregnant.

During the second trimester, it is common for the woman to experience a heightened sexual desire, due to increased blood flow and sense of well-being. At this stage the couple is generally better adjusted psychologically, to the idea of the pregnancy. However, many women find that sex becomes uncomfortable as their bodies get larger.

You and your partner need to keep the lines of communication open regarding your sexual relationship and possibly explore other aspects of making love such as cuddling, holding each other and discovering new positions and new ways of pleasuring.

Can sex harm the baby?
Sex cannot directly harm your baby as it is fully protected by the amniotic sac and the strong muscles of the womb (uterus). There is also a thick mucous plug that seals the mouth (cervix) of the womb which helps guard against infection. The penis does not come into contact with the foetus during sex.

What about orgasms?
Orgasms can be very different during pregnancy. Some women may become orgasmic for the first time during pregnancy due to the increased fluids in the area, making the clitoris and vagina more sensitive. Orgasms or even intercourse itself can cause the uterus to contract and the abdomen to harden due to the release of the hormone oxytocin. This is the same hormone that is responsible for your uterus contracting during labour. However, this is not usually a reason for concern in uncomplicated pregnancies and you should simply lie quietly and let the discomfort pass. This is not pre-term labour unless the cramping sensation or contractions continue for more than an hour.

Of course you should not have sex with a new partner whose sexual history is unknown to you or who may have a sexually transmitted disease, such as herpes, genital warts or HIV. The disease may be transmitted to you and your baby with potentially dangerous consequences. Such circumstances must be discussed with your doctor.

A normal pregnancy is one that's considered low-risk for complications such as miscarriage or pre-term labour. If your doctor, nurse, midwife or other pregnancy health care provider anticipates or detects certain significant complications with your pregnancy, he or she may advise against sexual intercourse.

Likely reasons would include:

• a history or threat of miscarriage
• a history of pre-term labour or signs indicating the risk of pre-term labour
• unexplained vaginal bleeding, discharge or cramping
• a leakage of the amniotic fluid
• placenta previa, a condition in which the placenta is situated down so low that it covers the cervix
• an incompetent cervix, a condition in which the cervix is weakened and dilates prematurely, raising the risk for miscarriage or premature delivery
• if you are having twins or triplets

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