Pregnancy and BDSM

The idea of a pregnant person tied up and being flogged is almost certain to evoke complicated emotions and concerns. It’s easy to say (or imply) that people “should” just stop playing during their pregnancies — it’s easy, and lacks nuance or a reflection of the realities of kinky play and healthy pregnancy. This article is intended to offer some information on playing as safely as possible during a healthy pregnancy, and is intended for both the players and for the information of Dungeon Monitors (DMs) and spectators. Most of this article addresses bottoming during pregnancy (simply because that is where I’ve heard the most safety concerns expressed).

big- stef and chey laughingNote that any sort of high-risk pregnancy (pre-eclampsia, incompetent cervix, gestational diabetes, etc) is beyond the scope of this article; please ask your doctor about specific activity limitations in those cases.

Pain/Sensation Play

In a healthy pregnancy, there shouldn’t be issues with most sensation play (light/moderate flogging on upper back and ass, wax play, etc). Many people find that their skin is more sensitive during pregnancy, so a pregnant bottom may find they don’t have the pain tolerance they once did. Of course, stay away from anything to do with impact on the belly — not a major part of most people’s BDSM repertoire anyway and therefore probably fairly easy to avoid. A pregnant person’s body is designed to protect the developing baby — generally an injury has to be severe enough to seriously injure them before the fetus is harmed. The walls of the uterus are thick, strong muscle, and the baby is floating in a cushion of amniotic fluid. While miscarriage is quite common, especially in early pregnancy, trauma is a very rare cause of fetal demise — chromosomal abnormalities, maternal health issues like diabetes, smoking, and drugs are much more frequent causes of miscarriage. However during the third trimester, a direct blow to the abdomen can cause the placenta to separate from the uterus, causing a life-threatening emergency for both the parent and the baby. Consider the abdomen a no-go area for any sort of impact play for the duration of the pregnancy.

Good places for mild to moderate impact play during pregnancy include the back, butt, and thighs. Keep in mind that pregnancy involves frequent visits to the OBGYN — while I encourage you to be “out” to your doctor, I think even the most open-minded MD is at the least going to give you major side-eye if you come in for a prenatal check with huge bruises and abrasions. Additionally, pregnant people are more likely to scar, so that’s a consideration anytime you may break skin. Use common sense with how far you go in your play.

Of course there are the breasts — oh, how the brests change during the pregnancy/birth/breastfeeding process! Often one of the first symptoms of pregnancy can be extreme sensitivity in the nipples. So, you may find yourself retiring the clover clamps for the duration of the pregnancy, and probably far longer, if they’ll be breastfeeding.  Somewhere in the third trimester, the milk factory starts cooking and breasts start secreting colostrums, or pre-milk, a clear yellow-ish sweet-tasting liquid. Around that time, I started warning my partners that “those work” when they would go to suck on my breasts — best to advise someone that they are about to encounter bodily fluids they may not have expected! Everyone’s experience varies. Just speaking for myself, even many years after my last pregnancy I’m no longer into nipple or breast play. It’s not that “my breasts belong to baby” or anything like that. While I was breastfeeding (for a total of over 3 years), my boobs were getting messed with for at least a couple hours a day. I find that I’m “full up” on any sort of boob stimulation… maybe they’ll eventually become an erogenous zone again, but I’m not counting on it.

Blood and Blood Clotsbig- belly IMG_7825bw

Blood volume also increases during pregnancy. While the number of red blood cells (responsible for carrying nutrients and oxygen) goes up during pregnancy, the volume of plasma (the liquid component of blood) goes up even more. Because of this, pregnant people have a functional type of anemia (low blood count). Furthermore, hormonal changes tend to lead to decreases in average blood pressure with the lowest blood pressures usually occurring around 28 weeks gestation. Pregnant people are therefore at increased risk of significant blood pressure drops which may lead to dizziness and fainting; BDSM play (topping OR bottoming) may exacerbate this, especially if combined with dehydration.

The changes in blood volume and flow may also affect the position a person may be in comfortably. In the later stages of pregnancy the large uterus may put pressure on the inferior vena cava (the large vein that carries blood back to the heart from the legs). In the supine (on the back) position this decrease in blood return can become significant, leading to greater risk of dizziness or discomfort during prolonged periods of lying on the back.

Pregnant individuals are prone to blood clots; prolonged periods of immobility can cause blood to pool and make clots more likely to form. Therefore, while light bondage with some “wiggle room” is perfectly OK during pregnancy, extreme or immobilizing bondage, or bondage positioning the bottom on their back, should be avoided.

Bondage

The American Congress of Obstetricians and Gynecologists recommends that pregnant people avoid activities that are “at high risk of falling” (including downhill skiing and horseback riding) — the idea of what bondage activities constituent “high fall risk” is perhaps so subjective as to be fairly useless in this discussion, however there are a number of more specific concerns with bondage during pregnancy, particularly suspension.

As mentioned above, tight and immobilizing bondage (mummifications and the like) should be avoided due to risk of blood clots. Bondage that restricts the chest/breathing (as suspension often does) would be a particular concern — see the below section on breathing issues for details. Hormone changes during pregnancy cause the ligaments/joints to become more relaxed and mobile, and they can be more prone to injury. Center if balance is changed, which can cause balance problems and back pain. Pregnant individuals are often advised to avoid full inversion. Face-up suspension would be concerning due to pressure on the vena cava.

My overall assessment is that I would certainly not tell a pregnant person they can’t be suspended, but I would advise that they need a lot of body awareness and a skilled rigger who who is knowledgeable regarding the physiological changes of pregnancy.

Breathing Issues

There are a multitude of changes that occur to the upper respiratory tract during pregnancy, all designed to improve oxygen flow to meet the needs of both parent and fetus. Pregnant people have a decreased ability to adapt to low oxygen levels and therefore will become distressed much more rapidly during breath play. Because of potential risks to both parent and fetus, I recommend avoiding breath play altogether during pregnancy.

Fainting and near-fainting are not uncommon during pregnancy. If you are feeling faint or dizzy, lay down on your LEFT side. For a pregnant person who has fainted, immediately laying them down on their left side in the “recovery position” is advised (unless there is concern about trauma, in which case, call 911. See this article for more information about fainting and BDSM).

Electrical/Fire Play

There isn’t a whole lot of data on electrical safety in pregnancy. In the medical literature relating to pregnancy, electrical injuries typically produce damage due to burns, electrical damage to the heart, or muscle injuries due to the spasms that go along with electrical current exposure.  The standard advisories for playing safely with electricity (avoid application to the face or across the heart) apply to pregnant people. Additionally, the amniotic fluid in which the fetus lies conducts electricity well. Because the fetus is essentially surrounded by a conducting medium, I recommend avoiding pelvic or abdominal application of electricity during pregnancy. Using your violet wand or TENS unit on the extremities is still fine.

Burns can be very serious injuries in pregnant people, although typically a large surface area needs to be affected before major consequences to the fetus occur. The general safety rules (short duration of exposure, accessibility of fire blankets, etc) with even an extra level of caution, should be followed while pregnant.

Penetration/Sex During Pregnancystef and chey on the bed

Vaginal and anal penetration during pregnancy is generally safe up until the water breaks (if there is any doubt, ask your doctor!). Speaking from personal experience, I bottomed in a fisting scene when I was 8 months pregnant. I did quite a bit of research first, including asking my L&D RN friend for advice, and the consensus was that as long as my cervix was still closed and waters not broken, fisting was no problem at all. As a side note, I didn’t require any sutures after my delivery (didn’t tear at all!) so maybe fisting is a good pre-game warm-up, as it were? It’s a bit similar to the perineal massage that OBs recommend.

Social Issues

If you’ll be playing in a public dungeon, keep in mind that seeing a pregnant person in scene does tend to throw the Dungeon Monitors (DMs) for a loop- many of them are completely flummoxed. So, if you’re going to do a public scene while pregnant, I’d recommend checking in with the DM and/or host first (always a good idea anyway), describing what you anticipate the scene will be and why it’s safe for you to do it. That way you can avoid scaring them and potentially having your scene interrupted by a concerned DM.

Topping while Pregnant

For the pregnant top, the first adjustment you may have to make is in your wardrobe. Due to changes in the back and hips during pregnancy, high heels are not recommended during pregnancy. Of course this applies to bottoms, as well — those stilettos will have to go into storage for a bit! Additionally, many people find they tire very easily during pregnancy, especially in the first and third trimesters. So you may want to plan scenes somewhat less ambitious than your usual triathlon of pain. This would be a very good time for pregnant tops to break out the lazy Dom toys- things like TENS or other electrical units, needles, sounds, clothes pins, rubber bands — anything you can do standing still, or even sitting down! People generally feel clumsy and less coordinated in later pregnancy, and incidence of injury (falls, twisted ankles, etc) increases — keep this in mind when planning your play.

Psychological considerations

Emotionally, pregnancy can be dangerous terrain. The potent hormone cocktail necessary to maintain the pregnancy and support the growing fetus can cause moodiness, crying spells, feelings of protectiveness (both of the baby and one’s mate), anxiety, vulnerability, etc. While humiliation play may have previously been very erotic, a pregnant person may find that it now just reduces them to tears, and not in a good way. Of course this is going to be very individual, and something that will require constant communication and ongoing negotiation. For myself, I got more toppy throughout my pregnancy — my partner called it going into “Mama-Lion” mode.

Conclusions

Keep standard warning signs in mind — if you have vaginal bleeding or haven’t felt any fetal movement, see a doctor. If this is your first pregnancy, enjoy the ability to go out and play without having to worry about all the logistics (babysitter, having enough milk in the fridge, etc) that have to be dealt with after the baby’s born! Your life won’t be over — it will just be more complicated and much busier.

 chey looking down at belly

About the writer:

This article was written by me (Shay)- I’m an ER nurse and ACLS (Advanced Cardiac Life Support) instructor who has spent WAYYY too much time geeking out over BDSM safety. However I would note that nurses (and doctors!) can and do say idiotic/incorrect things, so using your own judgement no matter how “qualified” the source is always a good thing. I also have quite a bit of personal experience with pregnancy and BDSM- I have two children and was at a dungeon party a day before (and 5 days after!) the birth of my first child!  Thanks for reading, and please feel free to email me (shay.sfblondie AT gmail) with any feedback or suggestions on how this article could be improved.

Contributions from Vitamin A and Miette Rouge, awesome kinky MDs.

REFERENCES:

Muench MV, Canterino JC.  Trauma in pregnancy. Obstetrics and Gynecology Clinics of North America 2007;34:555-83.

The American Congress of Obstetricians & Gynecologists, http://m.acog.org/

CURRENT Diagnosis & Treatment Emergency Medicine, 7e, C. Keith Stone, Roger L. Humphries

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