Document Type : Original Article
As shown by increasing evidence, sexual health
issues significantly affect quality of life (
A total of 86% to 100% of all couples are sexually
active during pregnancy, but others usually
report a decreased frequency of intercourse and sexual desire, particularly from the female (
As pregnancy progresses, more restrictions on
sexual function are imposed due to increased abdominal size, fear of harming the baby, and other
factors that are mentioned in different studies (
Anxiety and inadequate knowledge, fear of
bleeding or miscarriage, and infection of female
genitalia are noted as the main concerns for avoiding
sex during pregnancy (
Emotional distress caused by sexual dysfunction
could also affect self-esteem and the relationship.
It has been said that the sexual experience
for a woman could be under the pressure
of cultures or traditional context in the living
environment of the pregnant woman and her
This study was designed to evaluate the frequency and perception of sexual intercourse during pregnancy in a group of Iranian couples.
This cross-sectional study was conducted in two academic clinics in Tehran, Iran during 2008. One hundred fifty five pregnant women were recruited by the simple sampling method. The exclusion criteria were as follows: any underlying disease (diabetes mellitus, hypertension, other systemic diseases), history of pelvic surgery (due to uterine anomaly, ovarian cysts, appendicitis, etc.), history of gynecologic and obstetric complications (bleeding during pregnancy, intra uterine growth retardation), previous history of abortion or sterility, and past history of preterm labor.
A checklist was administrated in the labor room that included demographic data, partus, and their views on sexuality during pregnancy. The frequency of sexual activity in each trimester, vaginal intercourse, coitus position, orgasm, breast stimulation, condom usage, gestational age, delivery method, need for induction, preterm labor (before 37 weeks), premature rupture of the membranes, APGAR, and fetal outcome were also recorded.
The Ethical Committee of Shahed University of Medical Sciences approved this study and informed consent was taken from all participants. Data were entered into SPSS version 16 software and analyzed with the t and chi-square tests.
We recruited 155 pregnant women to participate in the study. Of participants, 69 (44.5%) believed that intercourse was dangerous late in pregnancy, 44 (28.4%) thought it was dangerous during all trimesters, 18 (11.6%) said that their husbands believed it to be harmful, 16 (10.3%) believed it to be safe, and 8 (5.2%) had no information about their opinion.
In total, 124 women (80%) were sexually active
during pregnancy. These couples had a lower
mean age (p=0.02) than the non-sexually active
The frequency of intercourse was highest in
the first trimester (36.8% had intercourse once a
week), than in the second trimester (32.9% had
intercourse once a month), and third trimester
(49.7% reported no sexual intercourse;
Mean (± SD) of some variables between those with and without sexual activity during pregnancy
|Sexual activity Variable||First trimester||Second trimester||Third trimester|
|26.4 ± 4.2||26.4 ± 3.6||27 ± 3.8||25.84 ± 3.6||27.27 ± 4.3||26.2 ± 3.5|
|28.3 ± 4.4||29.6 ± 3.8||29.4 ± 4.08||29.2 ± 3.8||29.3 ± 4.01||29.3 ± 3.9|
|4.7 ± 3.5||4.8 ± 3.7||4.6 ± 3.36||5.04 ± 3.9||5.2 ± 4.07||4.7 ± 3.5|
|31.6 ± 5.5||32.5 ± 4.8||30.6 ± 5.9||32.1 ± 4.8||31 ± 5||32.8 ± 6.6|
Frequency of intercourse in each trimester
|Frequency||No. (%)||No. (%)||No. (%)|
|7 (4.5)||2 (1.3)||1 (0.6)|
|155 (100)||155 (100)||155 (100)|
The most prevalent etiology for the decreased times for intercourse in the first trimester was fear of abortion (39.45%), in the second trimester it was declining libido (26.28%), and in the third trimester it was fear of membrane rupture (19.3%).
No significant relationship between sexual activity during pregnancy and preterm labor, premature rupture of the membranes, and fetal outcome (birth weight, APGAR, need for NICU admission) was shown.
There was a significant negative relationship between intercourse in the second and third trimesters and the need for induction (p=0.03). The need for induction was reduced due to the increase in frequency of intercourse.
Vaginal intercourse, secretion of semen in the vagina, the position during intercourse (side-toside or man-on-top), breast stimulation, condom usage, and female orgasm were not related to preterm labor. These factors were not related to membrane rupture except for the presence of semen in the vagina during the third trimester (p=0.03).
According to the present study, the most prevalent reasons for the decreasing frequency of intercourse during pregnancy was fear of abortion (39.45%), declining libido in the second trimester (26.28%), and fear of membrane rupture in the third trimester (19.3%). No significant relationship was seen between sexual activity during pregnancy and preterm labor, gestational age, membrane rupture, and fetal outcome (birth weight, APGAR, need for NICU admission).
The rate of avoiding any kind increased during pregnancy (20% in the first trimester, 21.3% in the second, and 49.7% in the third). This pattern has also been reported in other studies.
Leite et al. conducted a cohort study on 271
healthy Brazilian pregnant women. The rate of
sexual dysfunction significantly decreased during
the pregnancy as follows: 46.6% in the first, 34.2%
in the second, and 73.3% in the third trimester (
In the present study, there was a significant relationship
between intercourse in the second and
third trimesters and the need to induce labor. But
in a study in Kuala Lumpur, the results of 210
pregnant women showed no differences between
the groups who had coitus before delivery and the
control group in regards to the rate of spontaneous
This study suggests that sexual intercourse does not adversely affect the fetus; it is a proper stimulus for the induction of delivery. The low rate of sexual activity in our study, regardless of the trimesters of the pregnancy, raises an important question about the taboo of sexual intercourse during pregnancy. It could be related to a cultural background in which women avoid speaking about their desires and sexual needs more attention should be pay.
It has been discussed in other studies that the low
interest and insufficient knowledge of health care
providers on the issue of sexuality during pregnancy
can lead to a lower amount information given
to patients, and this is among the most common
reason for the lack of discussion on this topic (