Sex During Pregnancy

It is usually perfectly safe to have sex during pregnancy. There are some rare reasons for a woman to abstain from sex during pregnancy. These rare cases where the risks may outweigh the benefits include certain cases of preterm labor with advanced cervical dilation; preterm, premature rupture of membranes; or placenta or vasa previa. Also, women who have had a cervical cerclage during pregnancy should probably abstain. Otherwise, have fun!

Most women find sex during pregnancy more satisfying and pleasurable than outside of pregnancy. Sex during pregnancy is not associated with an increased risk of miscarriage, preterm labor, or any other complications of pregnancy. Even in cases where penetration may not be the best idea, such as the situations listed above, orgasms during pregnancy are still perfectly fine. If you have a cervical cerclage and don’t need penetration to orgasm, then feel free to have fun!

As your uterus gets bigger during pregnancy, different sexual positions may help both with comfort and satisfaction. If you are having trouble with comfort during sex, ask your doctor about it.

Exercise During Pregnancy

Exercise is a beneficial activity throughout pregnancy and virtually all pregnant women should exercise. Almost every limitation to exercise that you have heard or read elsewhere on the Internet is not based in science. Women who exercise have better pregnancies in every aspect. Let’s talk more about exercise briefly.

Exercise is not only healthy during pregnancy, but it improves pregnancy outcomes! Pregnant women who exercise have less backaches, bloating, constipation, swelling, and gestational diabetes. They have improved energy, mood, posture, and sleep. Some studies have even shown that exercise can prevent gestational diabetes and increase the chance of having a vaginal delivery.

Historically, it was falsely assumed that physical activity could increase the risk of miscarriage, preterm deliveries, or contribute to growth restriction of the fetus. There have been drastic shifts in evidence pointing away from these concerns. There is no longer a restriction of maximum heart rate (no different from a non-pregnant woman, anyway). Healthy women should get at least 150 minutes (2 hours and 30 minutes, at least 10 minutes at a time) per week of moderate-intensity aerobic activity (such as brisk walking) during and after their pregnancy.

Healthy women who already do a vigorous intensity aerobic activity (such as running) or large amounts of other vigorous activity can continue doing so during and after their pregnancy. For women that want to begin physical activity during pregnancy, the activity should be gradually increased over time, working up to the moderate-intensity recommendations described above.

Pilates and yoga for pregnancy help with strength and flexibility. Walking, swimming, cycling, aerobics, and running are all safe and provide good cardiovascular exercise during pregnancy. Studies have shown that blood flow to the baby improves during cardiovascular exercise. It makes sense to not over-exert yourself to the point of being short of breath, but vigorous cardiovascular exercise (and even weightlifting, within reason) is safe during pregnancy and you don’t need to worry about how fast your heart-rate is.

Here are some examples of moderate activities:

• Walking
• Hiking
• Bicycling at 5 to 9 mph
• Aerobic dancing
• Water aerobics
• Dancing
• Doubles tennis
• Golf
• Recreational swimming
• Gardening
• Housework
• Playing with children or pets

And here are some examples of vigorous activities:

• Jogging or running
• Backpacking
• Bicycling more than 10 mph or on a hilly terrain
• Step aerobics
• Fast-paced dancing
• Singles tennis
• Soccer
• Swimming laps
• Shoveling snow
• Moving furniture
• Vigorously playing with children or running with pets

Signs or symptoms that you should stop exercising include vaginal bleeding, feeling faint, chest pain, headache, calf pain or swelling, uterine contractions, or fluid leaking from the vagina.

Obviously, avoid contact sports during pregnancy as well as other activities in which there is a high risk of falling (gymnastics, horseback riding, water skiing, etc.). Also, avoid downhill skiing and SCUBA diving.

There are some medical or pregnancy conditions where exercise or certain types of exercise might need to be limited. Some examples include:

• Significant heart disease
• Restrictive lung disease
• Placenta previa in the third trimester
• Abnormally short cervical length in the second trimester
• Persistent second or third trimester vaginal bleeding
• Premature labor
• Ruptured membranes (aka broken water)
• Preeclampsia

If you are unsure if you have any of these conditions, talk to your obstetrician or midwife about your medical history.

Unfortunately, as of 2011, 85% of pregnant women did not meet the recommended guidelines for exercise during pregnancy. Don’t be one of the 85%!

Dying/Coloring your Hair during Pregnancy

The Internet is full of advice recommending that you don’t dye your hair while pregnant, at least in the first trimester. This is born out of ignorance and a fear of everything during the first trimester. There is no scientific data that says that dying your hair is associated with any adverse problems, even in the first trimester. If you think about it, most female beauticians and hair stylists also become pregnant at some time, and they are exposed to these chemicals hundreds or thousands of times more than what you are exposed to when getting your hair dyed. We don’t recommend to those women that they should change their occupation while pregnant.

Travel in Pregnancy

Under normal circumstances, travel during pregnancy is safe until the last 5 weeks or so of pregnancy. This includes flying. Most cruise ships will not allow you onboard if you are pregnant past a certain gestational age. Be sure to drink plenty of fluids, walk, and stretch your legs on long trips.

You should take normal precautions while traveling, such as wearing seat belts. The lap belt should be below your belly so that it fits snugly across your hips and pelvic bone; the shoulder belt should be across your chest (between your breasts) and over the mid-portion of your collarbone (away from your neck). Never place the shoulder belt under your arm or behind your back; also, ensure there is no slack in the belt and that your airbags are turned to “on.” Keep 10 inches between the steering wheel and your breastbone. You may need to angle the steering wheel toward your breasts, not your belly or head.

There is nothing inherently dangerous about traveling by ground, sea, or plane during pregnancy. However, you do have to consider how long you will be separated from the ability to seek medical care, and how far away that medical care might be. This is more important in the third trimester, particularly in the late third trimester when labor is more likely. It’s for this reason that many cruise ships will not allow you to embark after 24 weeks’ gestation. They do not want any liability related to premature delivery when the baby has a chance to survive preterm. It’s not that sailing isn’t safe, it’s only that it is many hours away from a hospital.

Planes do not often limit travel by gestational age, but you should consider how long your flight is. There is a big difference between flying from Atlanta to New York versus flying from New York to Melbourne. In general, many doctors recommend avoiding flying after 35 weeks’ if the length of the flight is particularly long.

Some people worry about traveling by car due to the concern of increased risk of blood clots secondary to the immobilization of sitting in a car. This is probably not a valid reason to avoid travel by car, particularly when you consider that pregnant women will be taking pit stops every two or three hours anyway. When you stop for a potty break, be sure to walk around for a couple of minutes.