Sex and Pregnancy - Public Information Resource

Sex and Pregnancy - Public Information Resource

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Facts about sex during pregnancy including suitable sex positions for pregnant women, pregnancy myths, STD complications and support groups.

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Sex and Pregnancy

Suitable Sexual Positions Safe to Use During Pregnancy
Pregnancy Myths
Pregnancy and STDs:
AIDS/HIV
CHLAMYDIA
GONORRHEA
HERPES
SYPHILIS

Further Advice

Other Related Sexual Health Topics:
Birth Control
Safe Sex
STD Facts and Prevention

Safe Sex & Pregnancy:
Suitable Sexual Positions Safe to Use During Pregnancy

Spoon Position

This position puts no pressure on the woman's abdomen and is suitable for the most advanced stages of pregnancy.

How To Do

The woman lies comfortably on her side and the man enters her from behind fitting his body closely to hers
The man can cuddle up close and caress her breasts while kissing her shoulders and the nape of her neck

Leapfrog Position

This position is ideal when the woman starts to feel uncomfortable with the man's weight pressing down on he. It also protects her belly from over-enthusiastic thrusting.

How To Do

The woman kneels on the bed with legs spread wide falling forwards as the man enters her from behind
The man can then caress her back and control the depth of thrust

Woman-On-Top/Astride Position

This is a good position for the middle months of pregnancy when other positions have become uncomfortable.

How To Do

The woman sits astride the man's lap and supports herself with her arms
The woman moves up and down on top of him

Click here for more details about these positions, including photos and techniques.

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Safe Sex & Pregnancy:
Pregnancy Myths

Is it possible to get pregnant from anal sex?

It is not technically possible to get pregnant from anal sex as there is no way for the semen to get from the rectal tract to the vaginal tract.

Anal sex is still not a very good method of birth control as semen leaking from the anus after intercourse may drip across the perineum (the short stretch of skin separating vulva and anus) and cause what is known as a 'splash' conception.

8% of couples of who use anal sex as a method of birth control have pregnancies each year.

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Safe Sex & Pregnancy:
Pregnancy & STD's

Pregnant couple (IMage Credit: Another Sex Tutorial)

AIDS/HIV & Pregnancy

Aids can be transmitted from Mother to infant :

Intrauterine (during pregnancy)
Peripartum (during birth)
Breast feeding

Facts

During pregnancy or at birth women can transmit HIV to their fetuses
Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies
It can also be spread to babies through the breast milk of infected mothers

What Do Do

Treating pregnant mothers with anti-HIV drugs is very effective in limiting transmission to infants, but some transmission still occurs.

The risk of transmission further diminishes with a Cesarean section.

If the drug AZT is taken during pregnancy, the chance of transmitting HIV to the baby is reduced significantly.

If AZT treatment of mothers is combined with cesarean sectioning to deliver infants, infection rates can be reduced to 1 percent.

Aids and Babies

Babies born to mothers infected with HIV may or may not be infected with the virus, but all share their mothers' antibodies to HIV for several months. If these babies lack symptoms, a definitive diagnosis of HIV infection using standard antibody tests cannot be made until after 15 months of age, when babies are unlikely to still carry their mothers' antibodies and will have produced their own, if they are infected. New technologies are being used to detect HIV infection in infants (3 to 15 months). A number of blood tests are being used to detect the virus in babies younger than 3 months.

Need more information about AIDS/HIV & Pregnancy? Visit the Sexually Transmitted Disease Resource Center

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CHLAMYDIA & Pregnancy

Chlamydia infection can cause Pelvic inflammatory Disease
9% of women with PID will have a life-threatening tubal pregnancy
Tubal pregnancy is the leading cause of first-trimester, pregnancy-related deaths in American women

IN NEWBORNS

Chlamydia infection during pregnancy can result in neonatal conjunctivitis (eye infection) usually within the first ten days). Symptoms include:

a progressively worsening cough
congestion
eye discharge
pneumonia (usually with three to 6 weeks)
swollen eyelids

Both conditions can be treated successfully with antibiotics. Because of the risks to the newborn routine testing of pregnant women for chlamydial infection is recommended.

Need more information about Chlamydia & Pregnancy? Visit the Sexually Transmitted Disease Resource Center

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GONORRHEA & Pregnancy

Gonorrhea is passed from mother to child as the child passes through the birth canal during delivery, causing eye infections.

Need more information about Gonorrhea & Pregnancy? Visit the Sexually Transmitted Disease Resource Center

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SYPHILIS & Pregnancy

An infected pregnant woman can pass the Syphilis bacterium to her unborn baby, which can result in it being born with serious mental and physical problems.

An untreated pregnant woman with active syphilis will pass the infection to her unborn child. Of 25% of stillbirth or neonatal death, 40 to 70% will have syphilis-infected babies. A fetal death taking place after a 20-week gestation or if the fetus weighs more than 500gms with an untreated mother at delivery is classified as a syphilitic stillbirth. Hepatitis screening should be done as well.

Babies with congenital syphilis can have symptoms at birth, but symptoms can develop 2 weeks to 3 months later and include:

anemia
fever
rashes
skin sores
swollen liver and spleen
various deformities
weak/hoarse crying sounds
yellowish skin (jaundice)

The moist sores of congenital syphilis are infectious.

When infected infants become older children and teenagers, late-stage syphilis symptoms may occur, including damage to:

bones
brain
eyes
ears
teeth

The rise in infant syphilis death has become a public health concern that warrants attention.

Need more information about Syphilis & Pregnancy? Visit the Sexually Transmitted Disease Resource Center

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HERPES & Pregnancy

20-25% of pregnant women have genital herpes
Many women find that their outbreaks tend to increase as the pregnancy progresses, probably because of the immune suppression that takes place to prevent the mother's body from rejecting the fetus

Many women who have their first outbreak of genital herpes during pregnancy do not actually have a new infection, instead, the outbreak is the first symptomatic recurrence of a long-standing infection

Between 10 - 14% of women with genital herpes have an active lesion at delivery (the odds are higher for women who acquire herpes during pregnancy, and lower for women who have had herpes for more than six years)

There is a high risk of transmission if the mother has an active outbreak because the likelihood of viral shedding during an outbreak is high

There is a small risk of transmission from asymptomatic shedding (when the virus reactivates without causing any symptoms)

Newly infected people (whether pregnant or not) have a higher rate of asymptomatic shedding for roughly a year following a primary episode, and this higher rate of asymptomatic shedding, plus the lack of antibodies, create the greater risk for babies whose mothers are infected in the last trimester

Recurrent genital herpes presents only a minimal risk in pregnancy, though it may interfere with the woman's enjoyment of pregnancy

If a woman has active herpes at time of delivery, a Cesarean section is usually performed

Maternal illness following a cesarean is approximately 28%, compared with 1.6% following a vaginal delivery

Most women with genital herpes can experience a safe pregnancy and normal vaginal childbirth

Women with a history of genital herpes before becoming pregnant have a low risk of transmitting the virus to their baby because of antibodies circulating in her blood which should protect the baby during pregnancy and delivery

There are two situations in which the developing fetus may be at risk:

A severe first episode during the first trimester (12 weeks) of pregnancy, which can lead to miscarriage.
A first episode in the last trimester of pregnancy, when there is a large amount of virus present and insufficient time for the mother to produce antibodies to protect the unborn baby

Mothers who acquire genital herpes in the last few weeks of pregnancy are at the highest risk of transmitting the virus and if the infection is a true primary (no previous antibodies to either HSV-1 or HSV-2), and she becomes HSV positive at the end of pregnancy, the risk of transmission can be as high as 50%. The risk is also high if she has prior infection with HSV-1 but not HSV-2 t and is infected with herpes in the last few weeks of pregnancy. This is rare but it may account for almost 50% of all cases of neonatal herpes.

Care during pregnancy with Herpes

Inform your doctor/obstetrician:

If you or your partner has genital herpes
When the male partner has genital herpes and the woman has no evidence of infection

You may need to consider:

A blood test to establish if the woman has HSV antibodies
The use of condoms after conception through to birth
Your partner taking oral antiviral medication for the duration of the pregnancy to suppress genital herpes outbreaks
Avoiding oral sex for the duration of the pregnancy if the woman's partner has a history of facial herpes or cold sores
Exploring alternatives to intercourse, such as touching, kissing, fantasizing, massage

As the last stage of pregnancy approaches:

Regular checks should be made
The woman and her doctor can discuss the possibility of a Caesarian delivery
The use of antiviral drugs can be considered
While the risk from the scalp monitor may be quite small, a cautious approach would be for a pregnant woman to ask that it not be used unless there is a compelling medical reason (an alternative is the external monitor, which tracks the baby's heartbeat through the mother's abdomen)
The pregnant woman should observe normal guidelines for healthy pregnancy
Good nutrition and rest are even more important at this time.

During Birth and After Birth with Herpes

If a woman has primary herpes at any point in the pregnancy, there is the possibility of the virus crossing the placenta and infecting the baby in the uterus (about 5% of cases)
Transmission of the virus to the fetus causes neonatal herpes, a potentially fatal condition
The spread of herpes to newborns is rare (less than 0.1% of babies get neonatal herpes)
In about 90% of cases, neonatal herpes is transmitted when an infant comes into contact with HSV- 1 or 2 in the birth canal during delivery.
Newborns may be infected by mothers who first get herpes just before giving birth because there has not been enough time to build up natural protection (immunity) and when the virus is active during delivery, the baby is at risk
Babies born prematurely may be at a slightly increased risk, even if the mother has a long-standing infection as the transfer of maternal antibodies to the fetus begins at about 28 weeks of pregnancy and continues until birth
The use of a fetal scalp monitor (scalp electrodes) used to monitor the baby's heartbeat during childbirth makes tiny punctures in the baby's scalp, which may serve as portals of entry for herpes virus
HSV can also be spread to the baby if someone kisses the baby with an active cold sore
In instances HSV can be spread by touch
By the time a baby is around six months old, his/ her immune system is better able to cope with exposure to the virus

If you have an outbreak of genital herpes, be sure to wash your hands before touching the baby. No extreme precautions are necessary. There is no risk in:

breast feeding
having the baby in bed with you
holding the baby

An infant with herpes can become very ill causing:

eye or throat infections
damage to the central nervous system
mental retardation
death

Symptoms can include:

blisters on the body
lethargy
poor feeding
irritability
fever

If any of the above occur take him/her to your pediatrician immediately, instead of waiting to see whether the situation will improve.

Need more information about Herpes & Pregnancy? Visit the Sexually Transmitted Disease Resource Center

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Safe Sex & Pregnancy:
Further Advice

Contact your local health care practitioner, the Family Planning Association or a local Family Planning Clinic. Visit our support page for a clinic in your area.

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Information on a new antiviral Herpes Treatment that works in one application.

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