Wisdom from Elizabeth Davis: Sexuality Through the Trimesters

The following is an excerpt from Elizabeth Davis’ book, Women’s Sexual Passages: Finding Pleasure and Intimacy at Every Stage of Life which can also be found on her website: http://elizabethdavis.com/articles/the-sexuality-of-pregnancy-birth/.

I am inspired by the way she frames the three trimesters of pregnancy as initiation, integration & equilibrium and completion & transition. Enjoy!

Chapter Four: The Sexuality of Pregnancy and Birth (abridged)


Increased circulation in pelvic tissues as a means for uterine growth can lead to pelvic engorgement, similar to that in premenstrual or ovulatory phases of the cycle. This may cause a woman to wonder what’s hit her, and whether her desire for deep and forceful penetration is really safe. There is no doubt that orgasm causes uterine contractions, but to a degree so minor as to have no serious impact on placental circulation.

If there is a history of miscarriage or episodes of bleeding in the current pregnancy, sexual activity should probably be curtailed, at least for the first trimester. Barring these exceptions, sex brings physiological benefits of increased pelvic circulation, release of tension, and internal muscle toning particularly helpful in preparation for birth. Many couples describe their sexual encounters in pregnancy as re-bonding experiences, akin to those in the initial phase of their relationship. No wonder, for both partners are assuming new roles, and are discovering aspects of one another heretofore unknown.

A woman’s level of desire in the first trimester may also have something to do with the sex of the child she is carrying. At about six to eight weeks, when the baby’s brain is developing, male fetuses are exposed to an enormous dose of testosterone, the level of which is four times that of infancy and childhood.1 This undoubtedly has some impact on the mother, quite possibly increasing her libido. By the same token, it may be that a mother’s ability to recognize the sex of her unborn has a hormonal basis, since surges of testosterone continue to occur in male fetuses at regular intervals during gestation.


Throughout pregnancy, oxytocin levels continue to rise. Oxytocin initiates Braxton-Hicks contractions, which tone the uterus and prepare it for labor. In large amounts, oxytocin has also been shown to cause mood elevation and alleviate depression“perhaps this accounts for feelings of joy and well being many women experience at this stage of pregnancy. Take ample amounts of oxytocin, mix with high levels of estrogen, blend with vaginal engorgement, and no wonder many women in their second trimester find themselves sexually insatiable, surprising both themselves and their partners.

Let’s take a closer look at men’s reactions to sex in pregnancy. If a man feels concern about jeopardizing the pregnancy during the first trimester, feeling the baby move in the second may further compound his fear.

A surprising number of men struggle with conflicting images of Madonna/Whore, the Mother versus the Lover, unable to blend the two and hence uncertain of how to relate to their pregnant partner sexually. That a woman nurturing new life might also be blatantly lustful and erotic is a powerful merger of two culturally disparate aspects of femininity.

Some women feel this too and may manifest it either by avoiding sex or by wanting to focus exclusively on the baby. Resulting problems may be considerable; disrupted intimacy in a rapidly changing relationship will breed estrangement and mistrust unless lines of communication are kept open. In my practice, I remind women of the sexual nature of birth, and use it as a reference point to encourage them to stay open to their partners as much as possible. Labor is, after all, an intensely physical experience; the estimated caloric output of the first birth is equivalent to that of a 50-mile hike! And it involves the same kind of emotional surrender as spontaneous orgasm.

An important aside here about physical and sexual abuse: more and more women are becoming aware of forgotten or repressed experiences now that support is available. For many, the emotional vulnerability of pregnancy may trigger recollections for the first time that are doubly difficult to handle if their own parents or other relatives are implicated. The accompanying sorrows and fears are apt to interfere with the primary relationship. But wherever possible, it is better to bring these to the surface while pregnant than to have them arise and interfere with labor or mothering. Precisely because pregnancy is such a labile state, I recommend hypnotherapy, as it can be especially useful for reactivating and healing the past.


By overview, the first trimester is initiation into pregnancy; the second, integration and equilibrium; and the third, completion and transition to labor and parenting. Sexuality is often disrupted at this stage by the physical discomforts of extra weight. Sleep may be sporadic, especially if heartburn is a problem, and urination becomes frequent again as the baby moves low. None of this is particularly conducive to amour, but a midday rendezvous can help. These inconveniences promote readiness to give up pregnancy and get on with labor, simultaneously preparing a woman for the challenges of caring for her newborn.

Emotionally these are trying times, with mixed feelings in relationship. Sometimes a woman wants to cling to her partner and hold back time, aware that the baby will soon be out in the world (or in the middle of the bed) and nothing will ever be the same again. Sometimes she wants the privacy just to be with the baby, trying to get to know it as well as she can before it is born, so that sex seems extraneous, or more for her partner than for herself. Especially when she is thinking of the challenges ahead and her ongoing need for support, a woman may be demanding, moody, or fearful.

But in the last week or so, a drop in progesterone often leads to loss of water weight, and a feeling of lightness and well-being. Substances called prostaglandins, found in the brain as well as seminal and menstrual fluids, may also be responsible for labor’s onset. Or it may be the fetus that is responsible; it too releases prostaglandins as its brain matures. Prostaglandins soften the cervix and cause uterine contractions.

This is why many care providers now encourage intercourse at term, especially if the baby is overdue. Seminal fluid is extremely high in prostaglandins and thus may help trigger labor. (A substitute may be found in evening primrose oil, reputed to have a similar effect when rubbed gently on the cervix.)

Elizabeth Davis is a midwife, women’s health care specialist, educator and consultant. An advocate for woman-baby centered birth and an active leader in the international birth community, Elizabeth has been on the forefront of midwifery and home-birth practices and politics for 30 years.

Read more of her articles at http://elizabethdavis.com/articles/the-sexuality-of-pregnancy-birth/.

For more on the sexuality of pregnancy: Women’s Sexual Passages: Finding Pleasure and Intimacy at Every Stage of Life, by Elizabeth Davis, Hunter House Publishers, 2000.
Find it on Amazon.

Also check out her most recent book, Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience co-authored with Debra Pascali-Bonaro.
Find it on Amazon.

You might also be interested in Your Orgasmic Pregnancy: Little Secrets Every Hot Mama Should Know by by Danielle Cavallucci and Yvonne K Fulbright.


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