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By Dr. Ruth Westheimer
April 12, 2018

After 30 years of working as a sex therapist, the legendary Dr. Ruth isn’t done sharing her wisdom. Here, she answers your most pressing questions on sex, relationships and life. Email your own queries to drruth@time.com, or catch up on previous installments of the Ask Dr. Ruth series.

Q: How is sex different during pregnancy?

A: Pregnancy takes months and as the pregnancy advances, every woman will undergo changes in their bodies that will affect their sex life. But let me start by saying one important thing: while pregnancy may have negative effects on intercourse, there is absolutely no reason that a couple can’t give each other orgasms throughout the pregnancy using alternative means. I would even say that it is important that a couple remain as physically close as possible because immediately after the birth of the baby, a couple’s sex life will probably cease for a while, and the longer that period of celibacy stretches out because they weren’t having sex during the pregnancy, the stronger possibility of ill effects on their sex life later on.

Unless your obstetrician advises against having intercourse because your individual circumstances would mean intercourse would pose a danger to your baby, you can keep having intercourse safely throughout your pregnancy. Obviously as your belly grows certain positions will no longer be possible, but the penis cannot hurt the baby nor will the mother’s orgasms. Some couples stop having intercourse because he, she or both are concerned that they might harm their child, but that’s just not so (again unless an individual medical condition exists).

There’s no doubt that during the first trimester the mother’s feelings of being tired combined with any morning sickness will put a curb on the couple’s sex life but certainly not to the point of ending it. Most pregnant women feel re-energized during their second trimester and so having sex should once again become a priority. As I said earlier, the woman’s growing belly will mean that the missionary position, with the man on top, and possible other positions will be hard, or in some cases, impossible. But exploring new ways to have sex can make this time more arousing. But not every woman reacts the same way during the third trimester.

For some women, pregnancy makes them feel even more womanly and therefore more desirous of sex. They enjoy showing off the swells in their body to their partner, and since they often feel hot, are prone to removing as much of their clothes as possible, which can excite their partner. But the third trimester can also bring a renewed tiredness, as dragging around all that extra weight can be difficult. And just knowing how many sleepless nights lie ahead might make a pregnant woman decide that sleep is more desirous than sex. And a mate can be a little afraid of his partner’s swollen body and will be more willing to let her take the lead, and if that means sex falls by the wayside, so be it.

As a mother of two, I completely sympathize with mothers-to-be in their third trimester, however as a sex therapist, I must caution couples not to allow their sexual desires to die out completely. The first couple of months after the baby arrives are tough and filled with sleepless nights and tending to a baby that needs a lot of attention. That can mean that even after the doctor gives his or her OK to resume sex, not every couple starts right up again.

It can take time, and both new parents have to be patient. But that’s why I want to emphasize the importance of having sex while you’re pregnant to whatever extent is possible. The longer the time period that celibacy lasts, the harder it will be to get your sex life going again. If your partner has turned to masturbation to relieve his or her sexual tension, that could be problematic. And if the strong feelings you have toward your new baby keep your libido from blossoming, you may find yourself in a situation where neither of you have a strong enough need to spark the necessary fires. As sex is an important bond to your entire relationship, a prolonged period of celibacy could cause serious relationship damage. So when considering whether or not to stop having sex during pregnancy, take the long view, and do it as much as you feel comfortable doing it.

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