This article is really a post in response to someone on our E-mail list who said "I'm still waiting for a book recommendation about sex and the pregnant woman ... I really don't want to buy Dr. Ruth's book, but I'm tired of hearing 'woman on top' or 'on your sides'..."

I don't know of such a book, so I guess I'll have write one. Here goes:

Any fellow who thinks he is going to poke the baby should be told, "You're not that big!"

In a "normal pregnancy," (yeah I know, nothing is normal when you're pregnant) both intercourse and orgasm are normally okay until her water breaks (Your mileage may vary, check with your ob/gyn.). The baby is VERY well-protected, mom would be unconscious from pain before any damage came to the kid; any fellow who thinks he is going to poke the baby should be told, "You're not that big!" Any kind of vaginal bleeding is, of course, a stop signal, but then that would be something that needs to be checked out ASAP any time it happens. The only other common warning is not to blow into the vagina of a pregnant woman (Why would anyone ... oh never mind.).

First a few odd notes: A pillow or two in the right place can make a big difference. Because the hormonal changes of pregnancy can make a woman drier than usual, it's also a good idea to have a lubricant handy. If deep thrusting is uncomfortable for her, she can grasp his penis with her thumb and forefinger to keep him from going too deep. During the last couple of months some women can't lay on their backs without getting dizzy. It's normal; just do something where she is not on her back. Many women are extremely aroused during the second trimester; this can be the result of hormones and/or the increased blood flow to the genitals. Both size and hormones tend to diminish sexual desire in the third trimester, but the woman may still desire the emotional closeness of sex even if she does not desire orgasm.

As mom becomes big enough for two, the main issues with sex are 1) comfort and 2) getting close enough to make her feel good too. It seems to us that her comfort has to be the biggest concern, and he needs to be ready to stop anything at anytime that she needs him to. On the other hand, it also seems clear to us that a loving wife needs to continue to do something sexual for hubby throughout pregnancy, even if she reaches a point of not wanting to bother for herself. Part of the "not wanting to bother"mentality can be based on some thought patterns or ideas about what's right and wrong. A women who thinks she "should" only climax during intercourse needs to rethink that during pregnancy. The husband should be ready to do whatever is needed to give her pleasure, and he needs to make it clear to her that he very much wants her to continue to enjoy lovemaking. Some couples want to continue to have the intimacy of penetration even if it becomes impossible for either of them to climax that way. There's nothing wrong with some no movement penetration followed by manual or oral stimulation for climax. Basically we're saying toss out all the rules and expectations and do what ever works. So, what works?

There are a few modified missionary positions which may be of use, especially through the second trimester.

Missionary: Obviously missionaries don't have sex during pregnancy, right? Actually there are a few modified missionary positions which may be of use, especially through the second trimester.
Putting a pillow under mom's rear can tilt her tummy away from his. This helps keeps his upper body off of her tummy.
Rather than being over her, he can kneel between her legs. His legs are slightly spread, his knees under her legs; this works well with a couple of pillows under her. The problem with this is it reduces stimulation of the clitoris, but either of them can stimulate it by hand.
He faces her feet rather than her head, putting his legs on either side of her body. She can stimulate his testicles (gently!) or herself as he thrusts.
The woman sits at the very edge of the bed or some other solid sturdy object (counter, table, washing machine). There are then three options:
She sits, he stands or kneels (depending on the height of the object she is on) between her legs. Not possible once she gets bulgy and not much stimulation for her.
She leans back on her arms so she is at a 30° to 45° angle. This moves her tummy out of the way, and it makes it possible for him to stimulate her clitoris with one hand.
She lays all the way back. Plenty of room now, but a problem if she is uncomfortable on her back. He will need to support her legs, which leaves him unable to manually stimulate her. Her hands, however, are free.

Rather than doing a lot of thrusting, she can be still as he brings her to orgasm manually, or with a vibrator.

Woman on Top: Yeah, I know, it's what everyone says, but it works.
If the woman is sitting straight up, rather than leaning over him, she will have more tummy room. She can do this either kneeling or sitting with her legs forward and bent as if sitting in a chair.
Reverse: She faces his feet rather than his head. His hands can do interesting things to her, but there is very little clitoral stimulation.
Squatting: Takes a bit of practice, and he may need to help with balance. He has great access to her clitoris. Rather than doing a lot of moving she can sit there while he brings her to orgasm manually, or with a small vibrator, then he should be so aroused that it will take only a bit of thrusting for him to climax.

Side by side facing: Sounds good, but how do you move? Penetration and intimacy yes, climax is more difficult.

Side by side, man behind: Not as bad as the above, but if she gets motion sick, forget it!

Standing sex tenses a man's leg and buttock muscles in a way that can result in very quick climax.

Rear entry: Probably the best option during the third trimester. Rear entry tends to make the vagina tight, so go slow and use a lubricant. Some women have powerful climaxes from rear entry, probably because it tends to stimulate the G-spot (this is most likely to happen when she is highly aroused or has already had an orgasm). Rear entry tends to be highly stimulating for men both visually and physically; if she wants to do something quick just for him to climax, this is it. Options are:
"Doggy style": She is on her hands and knees. Pillows can be put under her belly if desired. He should be able to reach around and stimulate her.
Rather than hands and knees, she drops to her arms and elbows, with her face on a pillow. Less G-spot stimulation than the above.
Standing: She stands, bends at the waist, and leans on the bed or some other object (a chair is good). He needs to hold her hips and counterbalance his thrusting. Standing sex tenses a man's leg and buttock muscles in a way that can result in very quick climax.
Sitting: He sits on a chair, or a couch, or the bed, and she sits in his lap facing away from him. Shallow penetration, and not much thrusting can be done unless the chair has arms and she is able to use them to raise and lower her body. ... which is a fair amount of work even if she's not pregnant. He can reach around and touch her face, her breast and her genitals, so he should be able to bring her to climax while he is inside her.
Combo: Place a chair near the foot of the bed, and go from the sitting (for her to climax) to the standing (for him to climax).
Male kneeling: He kneels (buttocks on his heels) and she backs up to him. She does the thrusting. He may not be able to get his hand to her clitoris.

None of the above:
She lays on her back. He lays on his side at a right angle to her and enters her this way. Her legs, bent at the knees, are over his body. Very shallow, but thrusting is easier than with the side by side positions. He can easily stimulate her by hand.
She is on her side with her bottom leg straight and her top leg forward. He kneels with her bottom leg between his legs, her top leg bent so that the bottom of the upper part of the leg is against his belly. He grasps the top leg to help him thrust. The sensation is odd since the penis is entering 90° from normal. Shallow penetration, easy on her, and he can easily stimulate her. This one is really worth a try.

You may not see manual sex as "the real thing," but it's easy at any stage of pregnancy.

Manual: Okay, maybe you don't see it as "the real thing," but it's easy at any stage of pregnancy. Use before, after or in place of intercourse as needed.
If laying on the back is a problem, try all fours, laying on side, or sitting on the edge of the bed with man sitting behind.
Manually stimulate her in the bath tub. Wash her all over, including hair, then slip a hand down and stimulate her to orgasm.
Lay side by side on your backs with heads at opposite ends. You can touch each other simultaneously and also see each other's genitals.
Add some penetration to clitoral stimulation with a lubricated finger or two.
G-spot stimulation can greatly add to her pleasure. The G-spot is on the roof of the vagina almost as far in as the fingers will go. See The G-Spot.
Thrusting may be enjoyed, but keep it to a minimum until close to climax. If you're going to thrust, use one finger and be sure there's plenty of lubrication.

Oral: Should be possible till the very end.
If she gets dizzy laying on her back, she can make her genitals accessible to him by sitting at the very edge of the bed or a chair. Or ...
She can get on all fours over him for mutual stimulation.

Other ideas:
Great time to get a vibrator. The generic kind from Wal-Mart with the head at a 90° angle to the body works well.
The knob tip works well on a woman, the cup-shaped one works on a man.
Try it on all fours or sitting in a chair.
In some intercourse positions one or the other of you can use the vibrator on her genitals. May give him a few good vibrations too.
Shower massage: A fast way to climax, but she will need to help him learn how to not blow her away. If the hose is long enough, she can sit.
Watch each other masturbate either simultaneously or one after the other.

For more helpful information sex during and after pregnancy, try this.

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