Bleeding After Sex During Pregnancy: Is this Normal?

Sex during pregnancy is considered safe as long as you feel comfortable and your doctor does not ask you to avoid it for some health conditions. It may also provide several benefits, including better sleep, good hormones, and intimacy with your partner. However, some women might worry if they experience bleeding after sex while pregnant. Bleeding after sex (also known as postcoital bleeding) may be due to multiple causes; however, in most cases, it is not an issue to worry about (1). Nevertheless, if you notice bleeding after sex, it is better to see a healthcare provider. Read the post to understand more about the causes of bleeding after sex during pregnancy, its treatment, and tips to stay safe and comfortable.

Is It Normal To Bleed After Sex When Pregnant?

Any bleeding, light or heavy, after 20 weeks of pregnancy is not normal (2). You should see a doctor immediately. But do not panic as not all bleeding is dangerous. You must avoid sex to prevent further complications and seek your doctor’s advice on when you can resume it.

What Causes Bleeding After Sex During Pregnancy?

A tender and sensitive cervixⁱThe lowest portion of the uterus that connects to the vagina to form a passage between the two organs. causes bleeding after sex while pregnant. The cervix could be sensitive–because of:

1. Increased blood supply: The rate of blood supply to the vagina and cervix increases considerably soon after you conceive. During sex, there would be added pressure over the cervical area, causing minor bleeding or spotting (3).
2. Increased capillaries: Several blood capillaries (tiny blood vessels) form during pregnancy to meet the high oxygen demands of the mother and fetus. Many of these capillaries develop in the vagina and cervix. They are so delicate that they rupture easily during intercourse.
3. Cervical polyps: Polyps are harmless growths on the cervix due to high estrogen levels. They are fragile, contain small blood vessels, and any pressure on the area during intercourse could cause bleeding. Experts recommend examining the polyps by removing them to rule out the possibility of cancer (4). According to the National Institutes of Health (NIH), although most cervical polyps are generally benign, malignant polyps can also occur, albeit rare, and account for approximately 0.2% to 1.5% of the cases.

You may also experience bleeding after sex for the following reasons:

4. Implantation: In four to five weeks of gestation, you may notice bleeding after sex when the pregnancy implants in the uterus (5).
5. Ectopic pregnancy: This condition is rare but happens when the fertilized egg starts growing outside the uterus. It may cause heavy bleeding and needs medical assistance (5).
6. Placenta previa: In this condition, the placenta lies low in the uterus and covers the cervix fully or partially. Therefore, the chances of miscarriage are high if you have intercourse (5).
   

   Image: Shutterstock

7. Placental abruption: Placental abruption is the condition when the placenta separates from the uterus much before birth, causing mild to heavy bleeding with abdominal pain. You should seek a doctor’s advice in this case (5).

Does Bleeding After Sex Mean Miscarriage?

Sex-triggered miscarriages are rare because the fetus is secured in the amniotic sacⁱThe membranous sac containing the amniotic fluid that protects and nourishes the developing fetus filled with fluid. This cushions the baby and acts as a shock absorber from physical harm. Moreover, the baby is placed away from the intercourse region (6).

However, if you have had a miscarriage earlier or weakened cervical walls, the doctor will recommend you to abstain from sex as a safety measure (7).

Treatment For Bleeding After Sex

If you experience bleeding after sex during pregnancy, your doctor will conduct a pelvic exam and advise an ultrasound or MRIⁱA medical imaging technology that helps evaluate and create detailed images of the organs and structures of the body (magnetic resonance imaging). You may also be asked to take blood and urine tests (8).

Based on the test results and your physical condition, doctors may advise (8):

• Bedrest
• Avoiding sex
• Avoiding travel
• Hospitalization

Image: Shutterstock

• Surgery in case of severe bleeding

Quick tip

If you notice bleeding after sex, avoid doing vigorous exercises and lifting heavy objects (8).

Tips For Being Physically Intimate During Pregnancy

You could minimize the bleeding risks and complications by following some simple rules.

1. Try comfortable and safe sex positions

Some sexual positions can increase the risk of vaginal spotting or bleeding by exerting pressure on the cervical area. You could try safe positions such as spooning and rear entry (9).

2. Consider oral sex

It is one of the safest practices to get sexual satisfaction without intercourse during pregnancy. Though not harmful to the baby, refrain from blowing air into the vagina as it can cause an air embolism (blockage of blood supply due to air bubbles in the blood vessels (10).

3. Have cozy moments

Image: Shutterstock

Be as gentle as possible with progressing pregnancy. You can enjoy the intimacy through cuddling, kissing, hugging, holding hands, and sharing a shower as they are more comfortable. Discuss with your partner what you like (11).

4. Use lubricants

Use water-based lubricants as they help reduce friction and discomfort during intercourse (9). They will also reduce bleeding and the chances of irritation in the cervical region. Avoid those containing glycerin as it is likely to cause thrush.

5. Use contraceptives

Use barrier contraceptives such as condoms during intercourse. They will protect you and your baby from sexually transmitted infections (STIs) (12).

Point to consider

Studies show that women generally lose interest in sex in the first and third trimesters (10).

When Should You Avoid Sex During Pregnancy?

You should avoid sex during pregnancy under these conditions (1).

1. Cervical incompetence: It is a condition where the cervix starts to open prematurely and increases the risk of miscarriage and premature loss.
2. History of miscarriage or premature labor: If you have had miscarriages or preterm labor leading to premature births during previous pregnancies, the doctor may advise you to avoid sexual intercourse. Semen has prostaglandinsⁱGroup of substances that play an essential role in producing inflammatory responses and other processes , whereas orgasm causes the brain to release oxytocinⁱA chemical messenger and hormone that is involved in childbirth, lactation, and social bonding . Both hormones may cause early contractions.

3. Leakage: If you feel your amniotic fluid is leaking, it may indicate the rupture of the amniotic sac. You should avoid sex in this case and contact a doctor.
   

   Image: Shutterstock

4. STIs: If you or your partner has STIs, avoid sexual intercourse until you both are treated. Contracting a sexually transmitted infection may potentially harm your baby.
5. Vaginal bleeding: If you are experiencing vaginal bleeding during your pregnancy, do not indulge in sex before getting diagnosed by a doctor. Undiagnosed vaginal bleeding may increase complications.
6. Multiple pregnancies: There are high risks if you indulge in sex when pregnant with more than one baby (13).

Quick tip

If you experience vaginal discharge that causes itching, foul smell, or sores on either partner’s genitals, refrain from sex during pregnancy (10).

How Much Bleeding Is Normal In Pregnancy?

Light spotting in early pregnancy during the first trimester is usually normal and not typically a cause for concern, though you should inform your healthcare provider, especially if you are unsure if it is light spotting or heavier bleeding. Causes of minor first-trimester spotting are often not worrisome, though some potential causes do warrant medical attention.

However, any bleeding resembling a menstrual period in flow or duration is not considered a normal symptom during pregnancy and should prompt an immediate call to your healthcare provider, as should bleeding accompanied by pain or occurring in larger amounts than light spotting. While not all bleeding indicates complications, heavier flow or bleeding with pain can signify issues needing medical care (8).

When To See A Doctor?

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Any bleeding concerns should be brought to your doctor’s notice. Evaluate the nature, appearance, and quantity of bleeding after intercourse, track any accompanying symptoms, and keep a record to let your healthcare provider assess the situation more accurately. You should ideally wear a sanitary pad to see the type of bleeding so you can give the right details to the doctor.

Here are some symptoms you should not ignore if they accompany bleeding or spotting after sex during pregnancy (8):

• Intense cramps and pain in the lower abdomen or pelvic region
• Heavy and consistent vaginal bleeding
• Vaginal discharge that may show tissues and clots
• Fainting or dizziness
• High fever with or without chills
• Shortness of breath (5)
• Uterine contractions that begin and continue even after sexual intercourse
• You should talk to your doctor to avoid complications even if you have mild bleeding without any pain or cramping.

Infographic: What Could Lower Sex Drive During And After Pregnancy?

Many reasons during pregnancy can decrease the sex drive in pregnant women, varying each trimester. New mothers have low libidos for at least the first few weeks after childbirth. Read the infographic below to get a sense of what is causing them to avoid physical intimacy.

Illustration: Momjunction Design Team

Illustration: Bleeding After Sex During Pregnancy: Is this Normal?

Image: Dall·E/MomJunction Design Team

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Reviewer Author Editor Fact Checker

Dr. Sangeeta AgrawalFRCOG, MD, DNB, DGO

Dr. Sangeeta Agrawal is an obstetrician and gynecologist with around 29 years of experience in the field. She worked in Royal London, St. Bartholomew’s, North Middlesex, and Barnet General hospitals in London and currently runs her clinic in Mumbai.

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Pragya BhargaviMSc, BEd

Pragya Bhargavi has been in the field of content research, writing and editing for over six years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology from Bangalore University and obtained a Bachelor’s degree in Education (BEd) from Acharya Nagarjuna University, Guntur.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction.

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