A positive pregnancy test may signal the end of your hot yoga class or glass of wine with dinner, but it doesn’t mean you have to give up everything you enjoy. Having sex while you’re pregnant is perfectly safe, and for many women, quite pleasurable. (Hello, second-trimester raging hormones!)
However, some women may experience bleeding after sex while pregnant, and wonder if it’s normal and what they can do to prevent it from happening.
We talked to two doctors about why you might be bleeding after sex, what you should do about it, and ways to prevent it while you’re pregnant.
Unless your doctor has told you otherwise, it’s safe to have sex during all three trimesters. While you may need to experiment with new positions, especially as your belly grows, in general, not a whole lot should change from your pre-pregnancy bedroom sessions.
That said, you may experience some new side effects such as vaginal spotting or bleeding after having sex.
But not to worry! Spotting or light bleeding in the first trimester is quite common. In fact, the American College of Obstetricians and Gynecologists (ACOG) says about 15 to 25 percent of women will experience bleeding during the first 12 weeks of pregnancy.
With that in mind, here are six typical causes of bleeding after sex.
You may experience bleeding after the fertilized egg implants in the lining of the uterus. This bleeding, while light, can last 2 to 7 days.
It’s not uncommon to have discharge after having sex, even when you’re not pregnant. And if you’re experiencing implantation bleeding, some of the spotting you see could be mixed in with semen and other mucus.
Your body undergoes significant changes during pregnancy, with your cervix being one area, in particular, that changes the most. Painless, short-lived, pinkish, brown, or light red spotting after sex is a normal response to changes in your cervix, especially in the first few months.
Since your cervix becomes more sensitive during pregnancy, a small amount of bleeding can occur if the cervix is bruised during deep penetration or a physical exam.
Kecia Gaither, MD, MPH, FACOG, an OB-GYN and director of perinatal services at NYC Health + Hospitals, says you may experience vaginal lacerations or cuts with excessively rough intercourse or use of toys. This happens if the thin epithelium of the vagina tears, causing vaginal bleeding.
During gestation, Gaither says the cervix can become more sensitive and easily bleed during intercourse. Cervical ectropion is also the most common cause of bleeding towards the end of your pregnancy.
Tamika Cross, MD, an OB-GYN based in Houston, says trauma or an infection can cause bleeding after sex. If you have an infection, cervicitis, which is an inflammation of the cervix, could be to blame. Cervicitis symptoms include:
- bloody vaginal discharge
- vaginal spotting
- pain with intercourse
Early sign of labor
Bleeding after sex might have nothing to do with your recent activity, but it could be an early sign of labor. Cross says a bloody show, which is a bloody mucus discharge, can occur as you get to the end of pregnancy. This happens as a result of your mucus plug loosening or dislodging.
If you notice this after having sex and you’re within a few days (or even hours) of your due date, mark the calendar, because that baby is getting ready to make their appearance.
In some cases, bleeding after sex could point to a more serious problem, especially if the amount of blood is more than light spotting.
According to the ACOG, heavy bleeding after sex isn’t normal and should be addressed right away. They also stress that the further along you are in your pregnancy, the more serious the consequences.
If you’re experiencing heavy or prolonged bleeding after sexual activity, contact your doctor. You may have one of these more serious medical conditions.
It’s important to note that all of these more serious conditions can occur absent from sex.
If the placenta detaches from the uterine wall during pregnancy, Gaither says you could be dealing with placental abruption, a potentially life-threatening condition for both mother and baby.
With placental abruption, you may experience abdominal or back pain during and after sex, along with vaginal bleeding.
When the placenta overlies the cervix, your healthcare provider will likely diagnose you with placenta previa. Gaither says this can cause catastrophic, life threatening hemorrhaging with sexual intercourse.
This typically occurs during the second to third trimester. Sex isn’t a cause of placenta previa, but penetration can cause bleeding.
What makes placenta previa sometimes tricky to spot is that the bleeding, while profuse, comes without pain. That’s why it’s critical to pay attention to the amount of blood.
Although sex doesn’t cause you to miscarry, if you notice heavy bleeding after penetration, your pregnancy may be at risk of ending.
Heavy vaginal bleeding that fills a pad every hour or lasts for several days is the most common sign of a miscarriage. Call your doctor right away if you’re experiencing these symptoms.
Any amount of vaginal bleeding after sex is likely to trigger some worry and concern in most moms-to-be. And since your doctor is the expert on everything pregnancy-related, checking in with them is a good idea.
However, if the bleeding is heavy and consistent or accompanied by pain in your abdomen or back, Cross says to go to the emergency room immediately, so the doctor can do a full evaluation to determine the cause of the bleeding.
The first line of defense for treating bleeding after sex is to abstain from intercourse, especially if you’re dealing with a more serious condition such as placenta previa or placenta abruption.
Beyond that, Cross says your doctor may recommend pelvic rest, which is avoiding anything in the vagina until further notice, or antibiotics if dealing with an infection.
Depending on the stage and severity, Gaither says medical interventions could be needed to treat the following conditions:
- For ectopic pregnancy, medical or surgical treatment and blood transfusion may be needed.
- For vaginal lacerations with profuse bleeding, surgical treatment and blood transfusion may be needed.
- For placenta previa and placental abruption, cesarean delivery and a blood transfusion may be needed.
Since bleeding after sex is often caused by underlying issues, the only true form of prevention is abstinence.
But if your doctor has cleared you for sexual activity, you might want to ask them if a change in sexual positions or decreasing the intensity of your lovemaking sessions could prevent bleeding after sex. If you’re used to rough sex, this may be the time to ease up, and go nice and slow.
Unless your doctor has told you otherwise, pregnancy sex is not something you need to put on the no-go list. However, if you experience light bleeding or spotting after sex, take note of the amount and frequency, and share that information with your doctor.
If the bleeding is heavy and consistent or accompanied by significant pain or cramping, call your doctor right away.