In pregnancies with no risk factors, the woman and couple can continue sexual activ­ity and orgasm as desired until the onset of labor (C. Jones et al., 2011). A woman’s sexual interest and responsiveness will likely change throughout the course of her preg­nancy. Nausea, breast tenderness, and fatigue can inhibit sexual interest during the first 3 months. A resurgence of sexual desire and arousal occurs for some women in the sec­ond trimester, with increased vasocongestion of the genitals during pregnancy heighten­ing sexual desire and response. However, most research shows a progressive decline in sexual interest and activity over the 9 months of pregnancy (Bogren, 1991). Some of the most common reasons women give for decreasing sexual activity during pregnancy include physical discomfort, feelings of physical unattractiveness, and fear of injuring the unborn child (Colino, 1991).

The partner’s feelings also affect the sexual relationship during pregnancy. Reac­tions to the woman’s changing body and to the need for adjustment in the couple’s sexual repertoire can vary from increased excitement to inhibition for the partner.

During pregnancy a couple will need to modify intercourse positions. The side-by­side, woman-above, and rear-entry positions are generally more comfortable than the man-above position as pregnancy progresses. Oral and manual genital stimulation as well as total body touching and holding can continue as usual. In fact, pregnancy is a time when a couple can explore and develop these dimensions of lovemaking more fully; even if intercourse is not desired, intimacy, eroticism, and sexual satisfaction can continue. Open communication, accurate information, mutual support, and flexibility in sexual frequency and activities can help maintain and strengthen the bond between the partners.