In this month's issue of the Canadian Medical Association Journal doctors Claire Jones, Crystal Chan, and Dan Farine, all from the Department of Obstetrics and Gynecology at the University of Toronto, offer a review of the available medical literature regarding sex during pregnancy.
It's a refreshingly non-hysterical review, essentially telling physicians that there are very few risks associated with having sex anytime during pregnancy, and even those risks that have been identified are rare, and lack well researched probabilities. The article outlines four risks that have been identified in the research, including: preterm labor, pelvic inflammatory disease, hemorrhage, and venus air embolism. According to their review, risk of hemorrhage from intercourse is only theoretical, meaning there are no published reports of it occurring, and the likelihood of the other three things happening are extremely low (for example, the risk of a venous air embolism was documented 18 times out of 20 million pregnancies).
Even though there isn't much evidence that having sex when you're pregnant -- even if you've been labelled as having a high-risk pregnancy -- increases the risk of going into labor early, they do still toe the traditional medical answer which is that there's no reason to risk it, and doctors may want to tell people labeled high risk to avoid sex. Of course, like almost all medical texts about sex, here they conflate sex with intercourse. So when they are saying don't have sex, what they really mean is don't have vaginal intercourse. Unfortunately it's likely that most doctors make the former statement, and most patients understand it to mean no sex at all.
When people ask me questions as a sex educator about sex during pregnancy they are almost always framed as safety concerns. Is it safe to do this? Could it hurt the fetus if we do that? These are understandable questions, and they deserve knowledgeable answers, but I can't help but think that the anxiety they provoke is fueled by the way that we are encouraged to understand pregnancy as a medical event, or condition. What people who are pregnant need isn't just information about how doctors have studied them in a narrowly constructed way. They need context that goes beyond one professions understanding of what is happening to them. After all, from a historical perspective it's a relatively recent phenomenon that doctors have so much control and power over pregnancy and childbirth. And from a global perspective it isn't even true today.
Which isn't to say we need to through the obstetricians and gynecologists out with the bathwater, and reviews like the one in CMAJ remain useful and helpful pieces of a much larger picture that can help pregnant people improve their sexual health and overall health during pregnancy.
Source: Jones, C., Chan, C., and Farine, D. "Sex in Pregnancy" Canadian Medical Association JournalPublished online ahead of print January 31, 2011.
Read more:
Keeping Sex Fun While Trying to Get Pregnant
Read More - About.com's Guide to Pregnancy: Sex During Pregnancy