Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-19T21:12:52.468Z Has data issue: false hasContentIssue false

Chapter 17 - Multiple Pregnancies and Sex

from Section 2 - Specific Issues

Published online by Cambridge University Press:  09 November 2022

By
Hayley Lipworth ,
Jon F. R. Barrett  and
Nir Melamed
Edited by
Dan Farine  and
Pablo Tobías González
Dan Farine
Affiliation:
Mount Sinai Hospital, Toronto
Pablo Tobías González
Affiliation:
Hospital Universitario Infanta Cristina de Parla, Madrid
Get access

Summary

Twin and triplet pregnancies have been associated with an increased risk for adverse maternal and neonatal outcomes. This chapter discusses select issues about sexual activity and twin pregnancy, especially with relation to preterm birth (PTB) and shortened cervix, two major concerns in this population. Two studies addressed the association of sexual activity with PTB in twin pregnancies. Overall, these studies do not support a relationship between sexual behavior and PTB in uncomplicated twin pregnancies. Unanswered questions still abound regarding twin gestations at higher risk of PTB, the effects of prostaglandins in semen on cervical length, the intensity of uterine contractions with orgasm on a compromised cervix, and sexual activity in the case of cervical cerclage. We suggest that sexual activity of any type should not be discouraged in twin gestations without other obstetric risk factors such as short cervix. Recommendations should be individualized bearing in mind patient history, comorbidities, and emotional needs.

Keywords

multiple pregnancypremature birthshort cervixsexual activityorgasm
Type
Chapter
Information
Sex and Pregnancy
From Evidence-Based Medicine to Dr Google
 , pp. 120 - 127
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Martin, J., Hamilton, B., Osterman, M.. Three decades of twin births in the United States, 1980–2009. NCHS Data Brief No. 80, January 2012. www.cdc.gov/nchs/products/databriefs/db80.htm (accessed December 16, 2020).Google Scholar
Fell, D. B., Joseph, K.. Temporal trends in the frequency of twins and higher-order multiple births in Canada and the United States. BMC Pregnancy Childbirth 2012;12:103.Google Scholar
Callahan, T. L., Hall, J. E., Ettner, S. L., et al. The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence. N Engl J Med 1994;331:244–9.Google Scholar
Conde-Agudelo, A., Romero, R., Hassan, S. S., Yeo, L.. Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metaanalysis. Am J Obstet Gynecol 2010;203:128.e1–12.Google Scholar
Melamed, N., Pittini, A., Hiersch, L., et al. Do serial measurements of cervical length improve the prediction of preterm birth in asymptomatic women with twin gestations? Am J Obstet Gynecol 2016;215:616.e1–14.Google Scholar
Lipworth, H., Hiersch, L., Farine, D., Barrett, J. F. R., Melamed, N.. Current practice of maternal–fetal medicine specialists regarding the prevention and management of preterm birth in twin gestations. J Obstet Gynaecol Can 2021;43:831–8.CrossRefGoogle ScholarPubMed
Howson, C. P., Kinney, M. V., Lawn, J. E.. Born Too Soon: The Global Action Report on Preterm Birth. Geneva: World Health Organization, 2012. www.who.int/pmnch/media/news/2012/201204%5Fborntoosoon-report.pdf (accessed June 5, 2020).Google Scholar
FIGO Working Group on Good Clinical Practice in Maternal–Fetal Medicine. Good clinical practice advice: management of twin pregnancy. Int J Gynecol Obstet 2019;144:330–7.Google Scholar
Barrett, J., Bocking, A.. SOGC consensus statement: management of twin pregnancies (Part 1). J Obstet Gynaecol Can 2000;22:519–29.Google Scholar
Society for Maternal–Fetal Medicine (SMFM), McIntosh, J., Feltovich, H., Berghella, V., Manuck, T.. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention. Am J Obstet Gynecol 2016;215:B2–7.CrossRefGoogle ScholarPubMed
Society for Maternal–Fetal Medicine Committee on Practice Bulletins – Obstetrics. Practice bulletin no. 169: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol 2016;128:e131–46.Google Scholar
Jarde, A., Lutsiv, O., Park, C., et al. Preterm birth prevention in twin pregnancies with progesterone, pessary, or cerclage: a systematic review and meta-analysis. BJOG 2017;124:1163–73.Google Scholar
da Silva Lopes, K., Takemoto, Y., Ota, E., Tanigaki, S., Mori, R.. Bed rest with and without hospitalisation in multiple pregnancy for improving perinatal outcomes. Cochrane Database Syst Rev 2017;(3):CD012031.Google Scholar
Yamasmit, W., Chaithongwongwatthana, S., Tolosa, J. E., et al. Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy. Cochrane Database Syst Rev 2015;(12):CD004733.Google Scholar
Olson, D. M.. The role of prostaglandins in the initiation of parturition. Best Pract Res Clin Obstet Gynaecol 2003;17:717–30.Google Scholar
Harmanli, O. H., Wapner, R. J., Lontz, J. F.. Human ejaculate. Effects on the biomechanical properties of the human chorioamniotic membranes. J Reprod Med 1998;43:779–82.Google ScholarPubMed
Kavanagh, J., Kelly, A. J., Thomas, J.. Sexual intercourse for cervical ripening and induction of labour. Cochrane Database Syst Rev 2001;(2):CD003093.Google Scholar
Bendvold, E.. Coitus and induction of labour. Tidsskr Jordmodre 1990;96:6–8.Google Scholar
Omar, N. S., Tan, P. C., Sabir, N., Yusop, E. S., Omar, S. Z.. Coitus to expedite the onset of labour: a randomised trial. BJOG 2013;120:338–45.CrossRefGoogle ScholarPubMed
Schaffir, J.. Sexual intercourse at term and onset of labor. Obstet Gynecol 2006;107:1310–14.Google Scholar
Platz-Christensen, J. J., Pernevi, P., Bokström, H., Wiqvist, N.. Prostaglandin E and F2α concentration in the cervical mucus and mechanism of cervical ripening. Prostaglandins 1997;53:253–61.CrossRefGoogle Scholar
Sayle, A. E., Savitz, D. A., Thorp, J. M., Hertz-Picciotto, I., Wilcox, A. J.. Sexual activity during late pregnancy and risk of preterm delivery. Obstet Gynecol 2001;97:283–9.Google Scholar
Pranzarone, G.. Sexuoerotic stimulation and orgasmic response in the induction and management of parturition: clinical possibilities. In Kothari, P., Patel, R., eds. Proceedings of First International Conference on Orgasm. Bombay: VRP Publishers, 1991: 105–19.Google Scholar
Goodlin, R. C., Keller, D. W., Raffin, M. M. Orgasm during late pregnancy. Possible deleterious effects. Obstet Gynecol 1971;38:916–20.Google ScholarPubMed
Perkins, R. P.. Sexual behavior and response in relation to complications of pregnancy. Am J Obstet Gynecol 1979;134:498–505.Google Scholar
Rayburn, W. F., Wilson, E. A.. Coital activity and premature delivery. Am J Obstet Gynecol 1980;137:972–4.Google Scholar
Georgakopoulos, P. A., Dodos, D., Mechleris, D.. Sexuality in pregnancy and premature labour. Br J Obstet Gynaecol 1984;91:891–3.CrossRefGoogle ScholarPubMed
MacPhedran, S. E.. Sexual activity recommendations in high-risk pregnancies: what is the evidence? Sex Med Rev 2018;6:343–57.Google Scholar
Stammler-Safar, M., Ott, J., Weber, S., Krampl, E.. Sexual behaviour of women with twin pregnancies. Twin Res Hum Genet 2010;13:383–8.CrossRefGoogle ScholarPubMed
Neilson, J. P., Mutambira, M.. Coitus, twin pregnancy, and preterm labor. Am J Obstet Gynecol 1989;160:416–18.Google Scholar
Grobman, W. A., Gilbert, S. A., Iams, J. D., et al. Activity restriction among women with a short cervix. Obstet Gynecol 2013;121:1181–6.Google Scholar
World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization, 2016.Google Scholar
American College of Obstetricians and Gynecologists Committee on Practice Bulletins – Obstetrics, Society for Maternal–Fetal Medicine, ACOG Joint Editorial Committee. ACOG Practice bulletin no. 56: multiple gestation: complicated twin, triplet, and high-order multifetal pregnancy. Obstet Gynecol 2004;104:869–83.Google Scholar
Taylor, R. B.. Sex discomforts with twins. 2021. www.webmd.com/baby/sex-discomforts-twins (accessed February 8, 2021).Google Scholar
Taylor, R. B.. Libido changes with twins. 2021. www.webmd.com/baby/libido-changes-twins (accessed February 8, 2021).Google Scholar
Grunebaum, A.. Having twins: should I avoid orgasms? 2020. www.babymed.com/having-twins-should-i-avoid-orgasms (accessed February 8, 2021).Google Scholar
National Health Service. Sex in pregnancy. 2020. www.nhs.uk/pregnancy/keeping-well/sex/ (accessed February 8, 2021).Google Scholar
Twins Trust. Pregnancy. https://twinstrust.org/group/pregnancy/discussion.html?id=6DF75CC6-FAD0-442E-BA62724DD3CD3035 (accessed May 29, 2022).Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×