This section aims to provide an evidence-based evaluation of sexual activity during pregnancy in terms of maternal and fetal safety.

A narrative synthesis of current literature was conducted to examine hormonal, physical, and psychological changes affecting sexual function during pregnancy, as well as clinical conditions influencing maternal and fetal safety.

Sexual function during pregnancy follows an inverted U-shaped pattern, peaking in the second trimester and declining in the first and third trimesters. In low-risk pregnancies, regular sexual activity does not increase maternal morbidity or adversely affect fetal heart rate. However, vaginal dryness and dyspareunia are reported in 40–60% of pregnant women, often associated with fear of harming the fetus. Similar concerns are observed among male partners, with 41.2% believing sexual activity may harm the fetus, leading to reduced sexual satisfaction. In high-risk pregnancies, including placenta previa, unexplained vaginal bleeding, premature rupture of membranes, and cervical insufficiency, sexual activity may be contraindicated.

Sexuality during pregnancy should not be considered a medical barrier but rather a component of well-being that requires appropriate support. Healthcare professionals should provide individualized, evidence-based counseling to address concerns and promote maternal and fetal well-being.