A balanced diet is a basic part of good health at all times in your life.

During pregnancy, your diet is

even more important. The foods you eat are the main source of nutrients for your baby. Healthy
eating during pregnancy may take a little effort, but it will be a major benefit for you and your baby. If
you have not been eating a healthy diet, pregnancy is a great time to change old habits and start
healthy new ones.
This pamphlet explains
starting a healthy diet before pregnancy
basic and extra nutrients you will need
planning healthy meals
healthy weight gain
special nutrition concerns
Before You Become Pregnant
The best time to begin eating a healthy diet is before you become pregnant. Eating well before
pregnancy will help you and your baby start out with the nutrients you both need.
If you are planning to become pregnant, it is a good idea to visit your health care provider. As part of
your visit, you will be asked about your family life, work, and lifestyle, including your diet. You and
your health care provider will discuss how to eat right before and during your pregnancy and which
nutrients are especially important, such as folic acid.
Basic Nutrients
Every diet should include proteins, carbohydrates, vitamins, minerals, and fat. Dietary reference
intakes (DRIs) are recommended amounts an individual should consume daily of certain nutrients,
vitamins, and minerals. During pregnancy, the DRIs are higher for many nutrients (Table 1).
Table 1. Key Nutrients for You and Your Baby During Pregnancy
Nutrient (Dietary Reference
Intake [DRI]
Why You and Your Baby
Need It
Best Sources
Calcium (1,000 milligrams) Helps build strong bones and teeth. Milk, cheese, yogurt, sardines
Iron (27 milligrams) Helps red blood cells deliver
oxygen to your baby.
Lean red meat, dried beans and peas,
iron-fortified cereals, prune juice
Vitamin A (770 micrograms) Forms healthy skin and helps
eyesight. Helps with bone growth.
Carrots; dark, leafy greens; sweet
potatoes
Vitamin C (85 milligrams) Promotes healthy gums, teeth, and
bones. Helps your body absorb
iron.
Citrus fruit, broccoli, tomatoes,
strawberries
Vitamin D (200 international units; some
experts recommend 400 international
units during pregnancy)
Helps build your babys bones and
teeth.
Sunlight exposure; vitamin D fortified
milk; fatty fish such as salmon
Vitamin B6 (1.9 milligrams) Helps form red blood cells. Helps
body use protein, fat, and
carbohydrates.
Beef, liver, pork, ham; whole-grain
cereals; bananas
Vitamin B12 (2.6 micrograms) Maintains nervous system. Needed
to form red blood cells.
Liver, meat, fish, poultry, milk (found only
in animal foodsvegetarians who do not
eat any animal foods should take a
supplement)
Folate (600 micrograms) Needed to produce blood and
protein. Helps some enzymes
function.
Green, leafy vegetables; liver; orange
juice; legumes and nuts
You do not have to eat the DRI for each nutrient every day. Try to eat a variety of foods and eat the
recommended amounts from the basic food groups. If you do, chances are good that you and your
baby are getting the right amounts of nutrients (see box How Much Should You Eat?).
Extra Nutrients
Pregnant women need extra iron and folic acid. To get these extra nutrients, a prenatal vitamin
supplement is recommended for most women. These supplements contain all the recommended daily
vitamins and minerals you will need during your pregnancy, such as vitamins A, C, and D; folic acid;
and minerals, such as zinc and copper. Talk to your health care provider about the vitamins that you
are already taking before taking a prenatal vitamin supplement. Excess amounts of some vitamins or
minerals during pregnancy can be harmful.
Extra Nutrients
Folic Acid
Folic acid is a B vitamin that is also known as folate.
Before pregnancy and during the first 12 weeks of
pregnancy, you need 0.4 milligrams (or 400
micrograms) of folic acid daily in order to reduce the risk
of neural tube defects. Folic acid is added to certain
foods (breads, cereal, pasta, rice, and flour) and is
found in leafy dark-green vegetables, citrus fruits, and
beans. However, it may be hard to get all of the folic
acid you need from food sources alone. For this reason,
all women of childbearing age should take a
multivitamin supplement containing 0.4 milligrams of
folic acid a day.
Women who have had a child with a neural tube defect
or who are taking certain drugs need much higher
doses of folic acid4 milligrams daily. Women who
need 4 milligrams should take folic acid as a separate
supplement, not as part of a multivitamin.
Iron
The iron in red blood cells helps carry oxygen to your
organs, tissues, and baby. Women need more iron in
their diets during pregnancy to support the growth of the
baby and to produce extra blood. The recommended
daily amount of iron you should consume while
pregnant is 27 milligrams, which can be found in most
prenatal vitamin supplements. Women who do not have
enough iron stored in their bodies before pregnancy
may develop anemia. Some women may need extra iron in the form of an iron supplement. Taking an
iron supplement on an empty stomach or with a source of vitamin C (such as a glass of fruit juice)
helps the body absorb iron. Be sure to tell your health care provider if you are taking any other
medications because some drugs should not be taken with iron.
Planning Healthy Meals
The U. S. Department of Agriculture has designed an online interactive diet-planning program called
My Pyramid Plan for Moms specifically for women who are pregnant or breastfeeding
(http://www.mypyramid.gov/mypyramidmoms). This program gives you a personalized plan that
includes the kinds of foods in the amounts that you need to eat for each trimester of pregnancy.
How Much Should You Eat?
How much you eat is just as important as
what you eat. If you are a normal weight
before pregnancy, you need only an
average of 300 extra calories per day to
fuel your babys growth and keep you
healthy during pregnancythe amount in a
glass of skim milk and half a sandwich.
During the first trimester, you need less
than 300 extra calories per day. During the
third trimester, you will need slightly more.
Having healthy snacks that you can eat
during the day is a good way to get the
nutrients and extra calories you need. You
may find it easier to eat snacks and small
meals throughout the day rather than three
big meals a day.
If you are overweight or obese, you will
need to pay close attention to how much
you eat during pregnancy. Smaller
amounts of weight gain or even a small
weight loss may be recommended to
ensure a safe pregnancy and a healthy
baby (see Pregnancy and Weight Gain).
My Pyramid Plan for Moms is based on specific food groups. These groups are the best sources of
some of the nutrients that are needed during pregnancy and breastfeeding:
Vegetables
Fruits
Milk and dairy foods
Grains
Meat, beans, and eggs
Fats and oils
Also included is a group of foods that do not fall into any of these groups, such as high-fat or sugary
foods, or extra amounts of the foods in the other food groups.
The amount of food that you need to eat each day is calculated according to your height,
prepregnancy weight, due date, and how much you exercise during the week. The amounts of food
are given in standard sizes that most people are familiar with, such as cups and ounces (Table 2 on
the reverse side).
Pregnancy and Weight Gain
How much weight you gain during pregnancy depends on your weight before pregnancy (see box
How Much Weight Should You Gain During Pregnancy?). Body mass index (BMI) is a measure of
body fat based on height and weight. Women with a normal BMI before pregnancy should gain
between 25 and 35 pounds during pregnancy. The box Where Does the Weight Go? shows where
all of the extra weight goes during pregnancy.
Overweight and obese women are at
increased risk for several pregnancy
problems. These problems include
gestational diabetes, high blood
pressure, preeclampsia, and cesarean
delivery. Babies of overweight and
obese mothers also are at greater risk
for certain problems, such as
congenital abnormalities, macrosomia
with possible birth injury, and childhood
obesity. For women with a BMI of 30 or
greater, a weight gain of between 11
pounds and 20 pounds is
recommended during pregnancy. For
women with a BMI of 40 or greater, a
modest weight loss during pregnancy may be recommended. The weight loss should not be drastic,
should be individualized for each woman, and should be done only under a health care providers
close supervision.
How Much Weight Should You Gain During Pregnancy?
Prepregnancy
Weight Status
Body Mass
Index (BMI)*
Weight Gain
(pounds)
Underweight Less than 18.5 2840
Normal weight 18.524.9 2535
Overweight 25.029.9 1525
Obese 30 or more 1120
*You can find out your BMI by going to
https://www.yourpregnancyandchildbirth.com/topics.php?page=nutrition
Data from Institute of Medicine (US). Weight gain during pregnancy:
reexamining the guidelines. Washington, DC: National Academies Press; 2009.
Where Does the Weight Go?
Here is how much weight an average woman
gains in parts of her body during pregnancy:
Baby 7 pounds
Your breast growth 2 pounds
Maternal stores (your
bodys protein and fat) 7 pounds
Placenta 1 pound
Your uterus growth 2 pounds
Amniotic fluid (the 2 pounds
Special Concerns
As you plan your pregnancy diet and make
decisions about what to eat, there are a few special
issues to keep in mind.
Caffeine
Studies about caffeine consumption and miscarriage risk are conflicting. Because of these conflicting
results, it is not possible to say whether high caffeine intake leads to miscarriage. Moderate caffeine
intake (200 milligrams a daythe amount in approximately two 8-ounce cups of brewed coffee) does
not appear to lead to miscarriage or preterm birth. It is not clear whether caffeine increases the risk of
having a low birth weight baby.
It may be a good idea to limit your caffeine intake during pregnancy for other reasons. Excess
caffeine can interfere with sleep and contribute to nausea and light-headedness. It also can increase
urination and lead to dehydration.
Table 2. Daily Food Choices
These guidelines are for a pregnant woman who is a normal weight and who gets less than
30 minutes of exercise a week. They show the recommended daily food intake.
First Trimester Second Trimester Third Trimester Comments
Total calories
per day
1,800 2,200 2,400

Grains* 6 ounces 7 ounces 8 ounces
1 ounce is 1 slice of
bread, cup of cooked
rice, cup of cooked
pasta, 3 cups of popped
popcorn, or 5 whole
wheat crackers
Vegetables

2 cups 3 cups 3 cups

2 cups of raw leafy
vegetables count as 1
cup
Fruits 1 cup 2 cups 2 cups
One large orange, 1
large peach, 1 small
apple, 8 large
strawberries, or cup of
dried fruit count as 1 cup
of fresh fruit
Milk 3 cups 3 cups 3 cups
Two small slices of swiss
cheese or 1/3 cup of
shredded cheese count
as 1 cup
Meat and
beans
5 ounces 6 ounces 6 ounces
1 cup of cooked
beans, 25 almonds, 13
cashews, or 9 walnuts
count as 2 ounces
Extras 290 calories 360 calories 410 calories
These extra calories
come from high-fat and
high-sugar foods, or
higher amounts of foods
from the five food groups
Fats and oils 6 teaspoons 7 teaspoons 8 teaspoons
Some foods are naturally
high in fats and oils, such
as olives, some fish,
avocados, and nuts
*Make one half whole grain.

Make sure that you get a mixture of dark green, orange, starchy, and other vegetables, including dry beans and peas.
water around the baby)
Your blood 4 pounds
Your body fluids 4 pounds
Vegetarian Diets
If you are a vegetarian, you can continue your diet during your pregnancy. However, you will need to
plan your meals with care to ensure you get the nutrients you and your baby need. Be sure you are
getting enough protein. You will probably need to take supplements, especially iron, vitamin B
12
, and
vitamin D.
Mercury
Fish and shellfish are good sources of protein, omega-3 fatty acids, and other nutrients. However,
pregnant women should not eat certain kinds of fish because they contain high levels of a form of
mercury that can be harmful to the developing fetus.
You should avoid eating shark, swordfish, king mackerel, or tilefish during pregnancy. These large
fish contain high levels of mercury. Common types of fish that are low in mercury are shrimp, canned
light tuna (not albacore, which has a higher mercury content), salmon, pollock, and catfish. You can
safely eat up to 12 ounces (about two meals) of these fish per week while you are pregnant. If you
want to include albacore tuna as part of your two fish meals one week, limit your intake of albacore
tuna to no more than 6 ounces for that week.
Check local advisories about fish caught in local rivers and streams. If there is no advice about them,
it may be safe to eat up to 6 ounces (one meal) per week of fish from local waters. During that week,
do not eat any other fish.
Listeriosis
Listeriosis is an illness caused by bacteria that can occur in unpasteurized milk and soft cheese and
prepared and uncooked meats, poultry, and shellfish. It can be particularly harmful to pregnant
women and their babies.
Symptoms occur several weeks after you eat the food. They can include fever, chills, muscle aches,
and back pain. In some cases, there may be no symptoms at all. When a pregnant woman is infected,
the disease can cause miscarriage or stillbirth.
Because the symptoms of listeriosis are like the flu, it can be difficult to diagnose. If you have a fever
or flu-like illness, check with your doctor who may take samples from your vagina, cervix, and blood. If
the bacteria are found, you and your baby can be treated with antibiotics. If there is a chance that a
newborn is infected, he or she also can be tested and treated.
To prevent listeriosis, wash all fresh fruits and vegetables before using them. While you are pregnant,
do not eat the following foods:
Unpasteurized milk or soft cheeses
Raw or undercooked meat, poultry, or shellfish
Prepared meats, such as hot dogs or deli meats, unless they are heated until steaming hot
Always be sure to wash your hands and any utensils, countertops, or cutting boards that have been in
contact with uncooked meats.
Pica
During pregnancy, some women feel strong urges to eat nonfood items such as clay, ice, laundry
starch, or cornstarch. This condition is called pica. Pica can be harmful to your pregnancy. It can
affect your intake of nutrients and can lead to constipation and anemia. Talk with your health care
provider if you have any of these urges.
Finally...
Eating right during your pregnancy is one of the best things you can do for yourself and your baby.
Finding a balance between getting enough nutrients while maintaining a healthy weight is important
for you and your babys future health.
Glossary
Anemia: Abnormally low levels of blood or red blood cells in the bloodstream. Most cases are caused
by iron deficiency, or lack of iron.
Congenital: Refers to a condition that is present in a baby when it is born.
Gestational Diabetes: Diabetes that arises during pregnancy.
Macrosomia: A condition in which a fetus grows very large.
Miscarriage: Early pregnancy loss.
Neural Tube Defect: A birth defect that results from incomplete development of the brain, spinal
cord, or their coverings.
Pica: The urge to eat nonfood items.
Preeclampsia: A condition of pregnancy in which there is high blood pressure and protein in the
urine.
Stillbirth: Delivery of a baby that shows no sign of life.
Regular exercise builds bones and muscles, gives you energy, and keeps you healthy. It is just as
important when you are pregnant. This pamphlet will explain:
The benefits of being active
How to start a healthy exercise program
Exercises to avoid
Benefits of Exercise
You're tired. You're gaining weight. You may not feel your best. Although
most of the time these symptoms are normal during pregnancy, exercise may
help provide some relief. Becoming active and exercising at least 30 minutes
on most, if not all, days of the week can benefit your health in the following
ways:
Helps reduce backaches, constipation, bloating, and swelling
May help prevent or treat gestational diabetes
Increases your energy
Improves your mood
Improves your posture
Promotes muscle tone, strength, and endurance
Helps you sleep better
Regular activity also helps keep you fit during pregnancy and may improve your ability to cope with
the pain of labor. This will make it easier for you to get back in shape after the baby is born. You
should not, however, exercise to lose weight while you are pregnant.
Exercise during
pregnancy can help
prepare you for labor
and childbirth.
Exercising afterward
can help get you back
in shape.
Changes in Your Body
Pregnancy causes many changes in your body. Some of these changes will affect your ability to
exercise.
J oints
The hormones produced during pregnancy cause the ligaments that support your joints to become
relaxed. This makes the joints more mobile and more at risk of injury. Avoid jerky, bouncy, or high-
impact motions that can increase your risk of injury.
Balance
Remember that during pregnancy you are carrying extra poundsas much as 2540 pounds at the
end of pregnancy. The extra weight in the front of your body shifts your center of gravity and places
stress on joints and muscles, especially those in the pelvis and lower back. This can make you less
stable, cause back pain, and make you more likely to lose your balance and fall, especially in later
pregnancy.
Heart Rate
The extra weight you are carrying will make your body work harder than before you were pregnant.
Exercise increases the flow of oxygen and blood to the muscles being worked and away from other
parts of your body. So, it's important not to overdo it.
Try to exercise moderately so you don't get tired quickly. If you are able to talk normally while
exercising, your heart rate is at an acceptable level.
Getting Started
Before beginning your exercise program, talk with your
doctor to make sure you do not have any obstetric or health
condition that would limit your activity. Ask about any
specific exercises or sports that interest you. Your doctor
can offer advice about what type of exercise routine is best
for you.
Women with one of the following conditions will be advised
by their doctors not to exercise during pregnancy:
Risk factors for preterm labor
Vaginal bleeding
Premature rupture of membranes
Pregnant women with certain other medical conditions, such as high blood pressure, will be advised
by their doctors when and if exercise is appropriate.

Choosing Safe Exercises
Most forms of exercise are safe during pregnancy. However, some types of exercise involve positions
and movements that may be uncomfortable, tiring, or harmful for pregnant women. For instance, after
the first trimester of pregnancy, women should not do exercises that require them to lie flat on their
backs. Standing still for long periods of time also should be avoided as much as possible.
Certain sports are safe during pregnancy, even for beginners:
Walking is a good exercise for anyone. Brisk walking gives a total body workout and is easy
on the joints and muscles. If you were not active before getting pregnant, walking is a great
way to start an exercise program.
Swimming is great for your body because it works so many muscles. The water supports your
weight so you avoid injury and muscle strain. It also helps you stay cool and helps prevent
your legs from swelling.
Cycling provides a good aerobic workout. However, your growing belly can affect your
balance and make you more prone to falls. You may want to stick with stationary or
recumbent biking later in pregnancy.
Aerobics is a good way to keep your heart and lungs strong. There are even aerobics classes
designed just for pregnant women. Low-impact and water aerobics also are good exercise.
Other exercises, if done in moderation, are safe for women
who have done them for a while before pregnancy:
Running. If you were a runner before you became
pregnant, you often can keep running during
pregnancy although you may have to modify your
routine. Talk to your doctor about whether running
during pregnancy is safe for you.
Racquet sports. In some racquet sports, such as
badminton, tennis, and racquetball, your changing
balance may affect rapid movements. This can
increase your risk of falling. You may want to avoid
some racquet sports.
Strength training will make your muscles stronger and may help prevent some of the aches
and pains common in pregnancy.
The following activities should be avoided during pregnancy:
Downhill snow skiing. As with racquet sports, your changing center of gravity can cause
balance problems. This puts you at risk for severe injuries and falls. Even if you are skilled
and careful, some hazards are beyond your control. For instance, exercising at altitudes
higher than 6,000 feet can increase your risk of altitude sickness. This makes it harder for you
to breathe and may cut down on your baby's supply of oxygen.
Contact sports, such as ice hockey, soccer, and basketball, could result in harm to both you
and your baby.
Scuba diving should be avoided during pregnancy. The large amounts of pressure from the
water put your baby at risk for decompression sickness.
With some activities, such as gymnastics, water skiing, and horseback riding, there is an increased
risk of falling, which in some cases can cause injury. These activities also should be avoided during
pregnancy. With any type of exercise you'd like to try, be sure to discuss it with your doctor ahead of
time. If you are an athlete, let your doctor know so you can get any special care you may need.
Your Routine
Exercise during pregnancy is most practical during the first 24 weeks. During the last 3 months, it can
be difficult to do many exercises that once seemed easy. This is normal.
If it has been some time since you've exercised, it is a good idea to start slowly. Begin with as little as
5 minutes of exercise a day and add 5 minutes each week until you can stay active for 30 minutes a
day.
Always begin each exercise session with a warm-up period for 510 minutes. This is light activity,
such as slow walking, that prepares your muscles. During the warm up, stretch your muscles to avoid
stiffness and soreness. Hold each stretch for at least 1020 seconds.
After exercising, cool down by slowly reducing your activity. This allows your heart rate to return to
normal levels. Cooling down for 510 minutes and stretching again also helps you to avoid sore
muscles.
Things to Watch
The changes your body is going through can make certain positions and activities risky for you and
your baby. While exercising, try to avoid activities that call for jumping, jarring motions or quick
changes in direction that may strain your joints and
cause injury.
There are some risks from becoming overheated
during pregnancy. This may cause loss of fluids and
lead to dehydration and problems during
pregnancy.
When you exercise, follow these general guidelines
for a safe and healthy exercise program:
After the first trimester of pregnancy, avoid
doing any exercises on your back.
Avoid brisk exercise in hot, humid weather
or when you have a fever.
Wear comfortable clothing that will help you
to remain cool.
Wear a bra that fits well and gives lots of
support to help protect your breasts.
Drink plenty of water to help keep you from
overheating and dehydrating.
Make sure you consume the daily extra calories you need during pregnancy.
While you exercise, pay attention to your body. Do not exercise to the point that you are exhausted.
Be aware of the warning signs that you may be overdoing it (see box). If you notice any of these
symptoms, stop exercising and call your doctor.
After the Baby's Born
Having a baby and taking care of a newborn is hard work. It will take a while to regain your strength
after the strain of pregnancy and childbirth. Taking care of yourself physically and allowing your body
time to recover is important. If you had a cesarean delivery, difficult childbirth, or complications, your
recovery time may be longer. Check with your doctor before starting or resuming an exercise
program. Some women may resume their routine within days of giving birth; others may need more
time before resuming their prepregnancy routine.
Walking is a good way to get back into exercising. Brisk walks several times a week will prepare you
for more strenuous exercise when you feel up to it. Walking has the added advantage of getting both
you and the baby out of the house for exercise and fresh air. As you feel stronger, consider more
vigorous exercise.
You will want to pick an exercise program that meets your own needs. Your doctor, nurse, or
community center can help. There are also special postpartum exercise classes that you can join.
Finally...
Warning Signs
Stop exercising and call your doctor if you get
any of these symptoms:
Vaginal bleeding
Dizziness or feeling faint
Increased shortness of breath
Chest pain
Headache
Muscle weakness
Calf pain or swelling
Uterine contractions
Decreased fetal movement
Fluid leaking from the vagina
Exercise during pregnancy can help prepare you for labor and childbirth. Exercising afterward can
help get you back in shape. Before you begin an exercise program, talk to your doctor. Follow this
guide to help maintain a safe and healthy exercise program during pregnancy.
Glossary
Cesarean Delivery: Delivery of a baby through an incision made in the mother's abdomen and
uterus.
Gestational Diabetes: Diabetes that arises during pregnancy; it results from the effects of hormones
and usually subsides after delivery.
Premature Rupture of Membranes: A condition in which the membranes that hold the amniotic fluid
rupture before labor.
Sex during pregnancy: An overview
Highlights
Is it safe to have sex while I'm pregnant?
Will sex feel different now that I'm pregnant?
I haven't really been in the mood since I got pregnant. Is this normal?
Will my partner's sex drive change?
Is it safe for my partner to give me oral sex?
How can I protect myself from sexually transmitted infections during intercourse?
Which positions tend to be the most comfortable?
What kind of symptoms should prompt a call to my practitioner?
Is it safe to have sex while I'm pregnant?
Most women who are having a normal pregnancy may continue to have sex right up until their water breaks or
they go into labor. You won't hurt the baby by making love. The amniotic sac and the strong muscles of the
uterus protect your baby, and the thick mucus plug that seals the cervix helps guard against infection.
Pregnancy Calendar

And while orgasm may cause mild uterine contractions (as can nipple stimulation and the prostaglandins in
semen), they are generally temporary and harmless.
There are some circumstances, though, in which you may need to modify your activity or abstain from sex
altogether for part or all of your pregnancy. Your midwife or doctor should let you know whether you have or
develop any complications that make sex a no-go. If you're uncertain, ask your practitioner.
Will sex feel different now that I'm pregnant?
Many women report that sex feels different during pregnancy. Some find it more pleasurable, at least at times.
Others may generally find it less so, for part or all of the pregnancy. Here's what's going on.

Increased blood flow to the pelvic area can cause engorgement of the genitals. The heightened sensation that
results may add to your pleasure during sex. You may have more vaginal discharge or moistness, which could
also be a plus.

On the other hand, you may not like how these changes feel and may find that genital engorgement gives you an
uncomfortable feeling of fullness. And, as mentioned above, you may also feel some mild abdominal cramps or
contractions during or immediately after intercourse or orgasm.

Your breasts may feel tingly, tender, and unusually sensitive to touch, particularly in the first trimester. The
tenderness generally subsides, but your breasts may remain more sensitive. Some women will find this
heightened sensitivity to be a turn-on, while others won't (and may even prefer that their breasts not be touched
at all).

Let your partner know if anything feels uncomfortable, even if it's something you're used to doing together. If you
find you're feeling turned on but not enjoying intercourse, consider other erotic activities, such as mutual
pleasuring, oral sex, or self-stimulation. Experiment and make adjustments as a couple to make sex relaxing and
pleasurable for both of you.

Remember, too, that there's more to physical intimacy than sex. If you don't feel like having sex or your
practitioner has advised you not to, you can still hug, kiss, and caress each other.
I haven't really been in the mood since I got pregnant. Is this normal?
There's a wide range of individual experiences when it comes to sexual desire during pregnancy. Some women
have a heightened libido throughout pregnancy, while others find they're less interested in sex. Many women find
that their sexual appetite fluctuates, perhaps depending on how they're otherwise feeling physically and
emotionally.

You may feel too tired, moody, or nauseated to make love, especially in the first trimester. It's not unusual to feel
overwhelmed by the physical and emotional changes you're going through. But take heart you may find that
your libido returns in the second trimester after morning sickness and fatigue have eased up.

It's also not uncommon, however, for desire to wane again in the third trimester, particularly in the last month or
two. At this point, you may be too big, achy, or exhausted to make love comfortably. You may feel self-conscious
about how your body has changed or preoccupied with the approach of labor and birth.

Let your partner know how you feel and reassure him that you still love him. It's crucial to keep the lines of
communication open and to support each other as best you can as you go through these changes together.
Will my partner's sex drive change?
Most partners find their pregnant lover as attractive as ever or even more so, though not all do. But there are all
kinds of reasons your partner's desire may be dampened at least part of the time during your pregnancy. For
example, your partner may be apprehensive about the burdens of parenthood, and that anxiety may affect sexual
desire.

Probably the most common reason that men become more tentative about sex during pregnancy is a fear that
intercourse could hurt the baby. If your partner needs reassurance about the safety of sex during pregnancy,
bring him with you to your next prenatal appointment.

Most importantly, talk to each other about your fears and anxieties, as well as your needs and desires. Open
communication can defuse a lot of tension and allow you to relax, enjoy each other, and find ways to be intimate,
whether or not you're having intercourse.
Is it safe for my partner to give me oral sex?
For the most part, yes. Licking is fine, but your partner shouldn't blow into your genital area. Forcing or blowing
air into the vagina could cause an air embolism (a bubble of air that gets into your blood circulation). This
happens very rarely, but it could be life-threatening for you or the baby.

It's also not safe for your partner to give you oral sex during pregnancy if he has an active outbreak of oral herpes
or feels one coming on. And during the third trimester, if your partner has ever had oral herpes, he should avoid
giving you oral sex altogether, whether or not he has symptoms.

If you're not sure what your partner's HIV status is, use a dental dam (a sheet of latex that you place between
your genitals and your partner's mouth). There's some evidence suggesting that a person may be able to transmit
HIV through microabrasions or tiny cuts in his mouth.
If you have questions about other specific sexual activity, take a look at our expert answers on what's safe during
pregnancy.
How can I protect myself from sexually transmitted infections during intercourse?
If you're at risk for sexually transmitted infections (STIs) that is, you're not in a mutually monogamous
relationship with an uninfected partner you should abstain from intercourse or at least use latex condoms every
time you have sex. If latex isn't a good option for you, use polyurethane male or female condoms.
Which positions tend to be the most comfortable?
You may have to experiment to find the positions that are best for you. Finding a comfortable position for
intercourse becomes more of a challenge as your belly grows.

For example, the missionary position (man on top) becomes increasingly difficult as your pregnancy progresses
and is nearly impossible late in pregnancy. (If you do use this position after the first trimester, wedge a pillow
under you so you're tilted and not flat on your back, and make sure your partner supports himself so his weight is
not on your abdomen.
Some couples find pregnancy to be an opportunity to get creative and try some new positions. Here are some
suggestions:
Straddle your partner as he lies on his back. This way, there'll be no weight on your abdomen and you can
control the depth of penetration.
Straddle your partner as he sits on a sturdy chair.
Lie side-by-side with your partner facing your back and entering from behind. (Deep thrusts can become
uncomfortable as the months pass. Penetration tends to be shallower in this position.)
Lie on your side, tilted back somewhat with a pillow wedged under your back to support you as you face your
partner. This position allows him to keep most of his weight off your belly.
Shift your bottom to the side or foot of the bed and lie back with your knees bent and feet perched at the edge
of the mattress. (After your first trimester, wedge a pillow under one side so you're not completely flat on your
back.) Your partner kneels or stands in front of you.
Support yourself on your knees and elbows. Your partner kneels and enters from behind you.
What kind of symptoms should prompt a call to my practitioner?
It's normal to feel some cramping during or just after intercourse or orgasm, but if it doesn't go away after a few
minutes, or if you have any pain or bleeding after sex, call your caregiver.

Don't hesitate to talk to your practitioner whenever you have any questions or concerns about sex, particularly if
you're unsure whether you need to abstain or have fears about the baby's safety. If you are told to stop having
sex, make sure you understand whether you need to avoid penetration or orgasm or both.
Remember, too, to talk with your practitioner during one of your visits about sex after your baby is born.
Why you might need to say no to pregnancy sex

Highlights
Is it okay to have sex during pregnancy?
When would I need to say no to sex?
Is it okay to have sex during pregnancy?
In most cases, yes. Assuming that you don't have certain complications, having sex shouldn't pose a risk to you
or your baby. Your baby is surrounded and cushioned by amniotic fluid, and protected by your uterus and a layer
of muscles.
In addition, the mucus plug inside your cervix helps guard against infection. (It's not impenetrable, though, so if
you or your partner has sex with other people, you need to use condoms to protect yourself and your baby
from sexually transmitted infections.)
However, in certain circumstances, you may have to modify your activity or abstain from sex altogether for part or
all of your pregnancy.
When would I need to say no to sex?
Your caregiver will tell you to abstain from sex if you have:
Placenta previa
Premature labor in this pregnancy (even if it has stopped)
Unexplained vaginal bleeding or abnormal discharge
Abdominal cramping
Cervical insufficiency
A dilated cervix
Ruptured membranes (your water has broken)
An outbreak of genital herpes or feel one coming on in you or your partner. If your partner has a history of
genital herpes (and you don't), you'll need to avoid intercourse and other genital contact for the entire third
trimester, even if he has no sores or symptoms. The same applies to receiving oral sex if he has oral herpes
(cold sores).
Other sexually transmitted infections (unless you and your partner have been treated and follow-up testing
was negative)
There are other situations in which your healthcare practitioner may advise you to not to have sex. For example,
if you had a spontaneous preterm birth in a previous pregnancy, she will probably advise you to stop having sex
at some point during the second or third trimester and to remain abstinent until you reach 37 weeks.
Whatever your situation, don't be shy about talking about sex with your practitioner. If she has advised you not to
have sex, be sure you understand whether she's talking specifically about intercourse, or about putting anything
in your vagina, or about any activity that may bring you to orgasm. (Orgasm can cause mild uterine contractions,
as can nipple stimulation and the prostaglandins in semen.)
And, of course, if you notice any unusual symptoms during or following intercourse, such as pain or discharge, be
sure to let your practitioner know. If you can't have sex, explore other ways of expressing your love: Cuddle, kiss,
give each other long massages, and share your feelings for each other.