Making love when pregnant...This is the bit nobody talks about - complete strangers will happily reveal more than you ever need to know about their emergency cesarean or difficulties with breastfeeding the moment your tell-tale bump arrives, but start delving beneath the sheets and watch them clam up.

Why so shy? Well, sex during pregnancy is still considered a subject a little too intimate to be aired at the school gates. But where does that leave the first-time mother who finds her libido lurching from frisky to frigid within the space of an hour? Confused, and a little bewildered. Here we'll answer questions aimed at allowing you to feel more comfortable about sex during pregnancy.

Your sex drive during pregnancy. First, your body is giving you mixed messages. One minute you’re feeling nauseous, exhausted and panicky because you can't even get into your fat-day jeans. The next you're blooming, with skin like Christy Turlington and cleavage rivaling that of Pamela Anderson. Secondly, your hormones are out of control, making you feel like a sex goddess one minute and a frump in a housecoat the next.

Then there's the man in your life, who is probably feeling equally confused, but desperate to please. Not only does he still desire you, but having read all the right books, he's worried about putting on the pressure. He says you look beautiful, but seems scared to touch you. You, of course, interpret this as physical revulsion, and burst into tears wailing: "It's because I'm fat isn't it?" while he repeats over and over again: "You're not fat, you're pregnant." No wonder you don't know which way to turn. Relax, whether your sex life perks up or goes AWOL for the duration, it's all perfectly normal and (among professionals anyway) finally beginning to be talked about.

Varying ideas on sex during pregnancy. As humans, the awe and wonder of pregnancy have led to mysterious and varied views on the nature of sexuality during pregnancy. While these amazing and rapid physical events alter a woman's body and being, the fundamentals remain: We are sexual beings. Our attitudes and beliefs may vary, but as our biological understanding of the events have eased our restrictions, and unfounded fears and concerns, couples have come to enjoy their sexual relationships during pregnancy.

Throughout all of time, cultural, religious and scientific influences have shaped our attitudes. The full range of perspectives-from woman as goddess, all powerful, mysterious and untouchable, to a more modern "scientific" view - traces through all of our collective human history. In Melanesian culture, it is believed that the fetus comes from the mother's blood (the menstrual flow ceasing) and the father's bone (semen). Therefore to, make a strong and healthy baby there should be frequent sex between the couple. Other religions and cultures forbid that the man be near the woman during pregnancy. In our Western culture, it was the, childbirth education movement that brought a surge of new information for couples. Out of this, the subject of sexuality and sex during pregnancy emerged as a legitimate topic of discussion, where as before it went virtually unmentioned between partners, and between couples and practitioners. Now discussion of sex during pregnancy is a standard in midwifery and obstetric care at prenatal visits, as well as in childbirth education classes. Pam Reo, a nurse-midwife from Howell, NJ, points out that along with nutrition, exercise, and growth and development, sex is brought up at prenatal visits as a matter of course. "It relieves some couples that I bring it up first, since they are always curious about AWOL for the duration, it's all perfectly it. Sometimes we have to urge them to enjoy themselves, that it's really okay."

"We've had sex a lot in the pregnancy," says Jennifer Wojciechowski, who lives in Newtown, PA. "We can't get enough of it!" she says, giggling. "But then, we had a very active sex life before I became pregnant. My husband and I had no problem with the transition from non-pregnant to pregnant as far as our sexual relationship goes."

In contrast, Heidi, a mother with two young babies living in Solebury, PA, with her husband Robert, recalls that when she was pregnant, sex was, "Out! I had premature rupture of membranes with my first pregnancy, and the second time we were advised to abstain. It was okay with both of us, because I didn't like my body. I felt fat, had leaky breasts, and just didn't like being pregnant. We found it incredibly frustrating, but approached it with a lot of humor. We made it through, and now we are making up for lost time...Well, between diapers, and middle-of-the-night feedings." These women represent very different, but very typical, and completely normal attitudes about sex in pregnancy.

Why should some women not have sex while pregnant? Couples may enjoy sex as much as they like, with a few exceptions:

• Bleeding in pregnancy
• Premature rupture of membranes
• Premature labor
• A history of miscarriages
• Placenta previa (placenta either partially or completely covers the opening of the cervix)

These are unusual circumstances that your healthcare provider will discuss with you should the need arise. When intercourse is restricted for any of these reasons, cuddling, massage, and open communication can provide an outlet for sexual needs. Otherwise, the comfort and adventure of sex during pregnancy can enhance a couple's communication in the rapidly changing dynamics on their road to parenthood.

What do men think? While most men find the changing female body erotic and attractive, some men are intimidated by the rapid physical changes. Reassurance that intercourse cannot harm the fetus is reinforced by obstetricians, nurse-midwives and childbirth educators.

"Men are often very uncomfortable about expressing their sexual needs and feelings during pregnancy," says Rita DeMaria of the Pennsylvania Council for Relationships. "Often they do not realize how essential these feelings are to enhancing the woman's sense of well-being and self-esteem. Communication is an essential element of intimacy and the more open these channels are the more likely a couple is to navigate the transition into parenthood. Sexuality is a significant and important force in maintaining the strength of the marital relationship."

Adjusting to your changing body. Part of this adventure will be witnessing the ever-changing physical body of the woman. A woman's sexual desire may fluctuate throughout the pregnancy. Typically the first trimester a woman feels tired, sometimes nauseated and a little nervous, but usually by the second trimester, she begins to feel good and, while adjusting to the physical changes, she may feel more sexual as she relaxes into her new role. In fact, the pregnant state can facilitate sexual enjoyment or heighten libido for women. Enhanced physical changes, such as increased blood flow to the genitals and breast enlargement, often make women more responsive to sexual arousal. Vaginal secretions are frequently increased, making for more receptive lovemaking. During orgasm, the uterus contracts which can be an intense, yet pleasurable sensation.

Trying new positions during sex may enhance both comfort and response. This may be a challenge for some couples. Again, humor can aid in this sometimes uncharted territory. It is good to find positions that allow for less pressure on the growing abdomen, and give more control over the depth of penetration.

• Side lying. Woman on side with partner entering from behind
• Woman on top. Allows the woman to control penetration depth, and reduces abdominal pressure.
• Man on top. His weight supported by his arms prevents abdominal pressure.
• All fours. Partner kneels and enters from behind
• Manual stimulation and oral sex. Can be an alternate source of mutual pleasure (with the exception of forcefully blowing air into the vagina, which can it can cause an extremely rare complication called air embolism or air bubbles in the blood stream)

Communicating with your partner. Remember, no one can read minds, and while having a baby will not remedy communication problems, it is an important time to express feelings and concerns. It is a great opportunity to enhance your relationship. Having a sense of humor is imperative for both partners!

A woman needs to remember that although her sexual feelings may be fluctuating, her partner's sexual needs still exist, and her sensitivity to this will enhance the sometimes-stressful stages of the pregnancy. A man can become detached and experience feelings of rejection as the woman receives so much attention. Again, this is an opportunity for the couple to extend themselves, showing mutual concern and sensitivity to their partner's needs.

Common concerns. Some concerns couples have are unfounded. While orgasm will not trigger miscarriage early in pregnancy, it can help trigger labor, a desired effect, late in the pregnancy. Semen contains prostaglandin, which has a beneficial effect on the softening or ripening of the cervix, making it ready for, and sometimes triggering labor. Another common concern is that intercourse will hurt the baby. Cushioned by the uterus, a bag of water, and a closed cervix, the fetus is well protected. So relax and enjoy, and when in doubt, talk. Talk to your partner. Talk to your practitioner.

*taken from “Sex during Pregnancy” by Barbara Winter, CNM, Every Baby magazine, Issue One.