Does pregnancy affect the sexual function of couples?

Sexual function is an important part of each human being’s personality and in the general couple relationship, with an obvious impact on quality of life and safe sexual performance during pregnancy is important for couples. 

Pregnancy is one of the most serious periods in women’s lives. Sexuality is an important part of health and well-being. The World Health Organization (WHO) defines sexual health as a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

Sexuality is a taboo subject in many countries across the world, including Uganda.  It is this negativity that greatly affects the quality of life and may often be responsible for psychopathological disturbances among couples. Thus, most people usually are unwilling to talk about their sexual problems and often, sexual dysfunction goes less than recognized and treated. 

Pregnancy is a condition that leads to an adverse effect on the quality of the sexual relationship between the couples. Safe sexual function during pregnancy is one of the keystones for couples to go forward from partners to parents. Research shows there is an association between pregnancy and sexual dysfunction. Physiologic changes during pregnancy affect the body’s hormonal milieu as well as a woman’s sexual desires, responses, and practices. Typically, women’s sexual interest and coital frequency declines in the first trimester of pregnancy show variable patterns in the second trimester and decreases sharply in the third trimester

Many women have some level of apprehension about sexual intercourse during pregnancy, which may include fear of harming the fetus or potential for miscarriage or fetal demise, which can often precipitate avoidance of sexual activity during pregnancy. The worry about complications during pregnancy as a result of sexual activity and the discomfort of pregnancy can affect the satisfaction of both men and women. 

Theoretically, sexual intercourse may stimulate contractions due to stimulation of the lower uterine segment, endogenous release of oxytocin from orgasm, direct action of prostaglandins in semen, or increased exposure to infectious agents. A few studies associating coital and orgasmic frequency with negative effects to the fetus have suffered from small sample size and incomplete control for confounders, including maternal history of preterm delivery or risk factors. However, larger studies performed in women during all stages of pregnancy have observed no overall association between pregnancy complications such as vaginal bleeding, premature rupture of membranes, preterm birth, low birth weight, or perinatal mortality and coital frequency. 

Evidence currently is insufficient to justify recommending against sexual intercourse during pregnancy. Overwhelmingly, studies of sexual activity in pregnancy have been unable to demonstrate an increased risk of preterm labor, delivery, or infectious complications in the absence of acquired sexually transmitted infections. 

It is therefore perfectly safe to have sex during pregnancy unless your healthcare provider has told you not to due to some reasons.

The author is; Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist working with Aga Khan University as the CPD Coordinator & is the Heroes in Health Award Winner-Midwife of the year 2021