Navigating Sex and Intimacy After Pregnancy Loss: Healing Together During Pregnancy and Infant Loss Awareness Month

Healing after pregnancy loss takes time, tenderness, and support. You’re not alone in navigating intimacy, grief, and connection during this journey.

October is Pregnancy and Infant Loss Awareness Month, and October 15 marks Pregnancy and Infant Loss Remembrance Day. For many couples, this time of year invites mixed emotions. Grief, love, confusion, and hope all intermingle, especially when you’re navigating intimacy after a pregnancy loss. Because sexual connection is often intertwined with our sense of identity, safety, and partnership, figuring out how and when to return to sex after loss can feel daunting. If you’re struggling with these questions, know that you’re not alone. Research estimates that at least 10–20 percent of known pregnancies end in miscarriage, and some studies suggest the figure may exceed 30 percent.That means millions of people each year are moving through this very experience.

As a licensed marriage and family therapist and AASECT‑certified sex therapist, I have spent years helping couples and individuals rebuild intimacy after trauma. Beyond the professional training, I also know this journey personally. My own story of ectopic pregnancy and subsequent loss – shared later in this post – reminds me that there’s no “right” way to grieve or to reconnect with your partner. Healing takes time, intentionality, and support. This blog is my way of offering you insight, research, and compassionate guidance as you honour your own path.

And if you'd rather watch than read, feel free to check out my YouTube video on this very personal topic.

Understanding Pregnancy Loss and Its Prevalence

Pregnancy loss encompasses miscarriage, ectopic pregnancy, molar pregnancy, and stillbirth. It is more common than many people realize. The March of Dimes estimates that roughly 10 to 20 percent of known pregnancies end in miscarriage, and some research suggests more than 30 percent may end in loss – often before a person even knows they’re pregnant. The International Society for Sexual Medicine (ISSM) notes that up to 25 percent of women experience a pregnancy loss. Yet despite its frequency, couples often feel isolated because conversations around loss and sexual health remain taboo.

Pregnancy loss affects partners differently. Qualitative research from the Couples & Sexual Health Laboratory found that couples who experienced a recent loss reported lower sexual satisfaction than those without a loss, even though their sexual desire, functioning, distress, and frequency were similar. Non‑pregnant partners sometimes reported less sexual distress than their comparison counterparts, perhaps because they were focused on supporting their grieving partner. Another longitudinal study (the ALOE study) showed that couples 3–4 months after a loss experienced lower sexual satisfaction and greater discrepancies in desire compared with couples with no history of loss. These findings underscore that the effects of loss are relational as much as individual.

Psychological consequences are significant as well. FIGO (the International Federation of Gynecology and Obstetrics) reports that 30–50 percent of women experience anxiety and 10–15 percent experience depression following a miscarriage. Up to 40 percent of women may exhibit post‑traumatic stress symptoms within three months of an early pregnancy loss (figo.org). Marital disharmony and sexual problems are more common in couples who have endured fetal loss (Gravensteen et al., 2012). Clearly, pregnancy loss isn’t merely a physical event; it affects mental health, relationships, and sexual well‑being.

Physical Recovery: When Is Sex Safe After Loss?

After a pregnancy loss, many people worry about when it is physically safe to resume sexual activity. Guidelines vary depending on the circumstances, but most emphasize waiting until the body has healed. The United Kingdom’s National Health Service advises waiting until all pregnancy‑loss symptoms are gone before having sex to reduce the risk of infection. The American College of Obstetricians and Gynecologists (ACOG) suggests refraining from inserting anything into the vagina for 1–2 weeks. In general, your doctor may say that you can engage in penetrative sex as soon as 2 weeks after your miscarriage — usually after the bleeding has stopped. But there are some situations that require a longer wait and others that could prompt a visit to your doctor. If you underwent procedures such as a dilation and curettage (D and C), speak with your healthcare provider; you may need to wait longer.

It’s important to let bleeding and any physical discomfort fully resolve. People may bleed for 7–10 days after a pregnancy loss, and although it’s possible to ovulate as early as two weeks later, medical professionals typically recommend waiting until your doctor clears you or until you feel ready. Resuming sex too soon can increase the risk of infection. Listen to your body and communicate with your partner and doctor before engaging in intercourse.

Lastly, if you experienced loss due to a terminated pregnancy (such as was in my case, which I will explain later), you may have to wait longer if you want to conceive again given the medication may stay in your body for some time.

Signs to watch for before resuming intercourse

• Bleeding has stopped. Heavy or prolonged bleeding (soaking through a pad in an hour) warrants medical attention.

• No signs of infection. Fever, chills, foul‑smelling discharge, or severe abdominal pain indicate you should see a doctor.

• Pain has subsided. Mild cramping is normal, but persistent pain during sex could signal infection or other complications.

• Emotional readiness. Your body might be physically healed while your heart needs more time. There is no deadline for being “back to normal.”

  
  

Remember that having sex doesn’t automatically mean trying for another pregnancy. If you wish to prevent pregnancy, discuss contraception with your healthcare provider.

Emotional and Relationship Impact of Pregnancy Loss

Grief doesn’t follow a straight path. Some days bring closeness, others distance — but honest communication and small acts of care can keep connection alive.

Grief after loss is complex. People often imagine grief as a linear process, but in reality, it ebbs and flows. Some days you may feel functional, and the next, grief may wash over you unexpectedly. Each individual and couple navigates this terrain differently.

One partner may want to talk often, needing to process every detail out loud, while the other withdraws into silence. Some couples may feel frustrated, misunderstood, or disconnected after a miscarriage. These differences aren’t necessarily signs of incompatibility—they’re reflections of unique coping styles. But if they go unacknowledged, they can quietly push partners apart.

Pregnancy loss can also bring up questions of blame, guilt, or shame. One partner may secretly wonder if they did something “wrong,” while the other feels helpless in not being able to fix the pain. Sexual intimacy can become loaded with unspoken fears: What if it happens again? What if I can’t be the partner my spouse needs? These thoughts can make closeness feel risky instead of comforting.

At the same time, some couples discover that grief brings them closer. Shared sorrow can become a source of tenderness and vulnerability, deepening trust. Neither experience is right or wrong—it simply reflects the many ways grief can shape intimacy.

The most important piece is communication. Naming differences in coping styles and creating space for both partners’ grief experiences can prevent disconnection. Even if words are hard to find, small gestures of care—like holding hands, checking in with a simple “How’s your heart today?”—can keep the thread of connection alive.

How loss affects sexual desire and satisfaction

After loss, intimacy can feel distant—even when love remains. With time, understanding, and honest communication, connection can begin to heal.

Studies consistently find that pregnancy loss decreases sexual satisfaction. Couples in the ALOE study reported lower satisfaction and larger gaps in desire than those without loss. The Couples & Sexual Health Laboratory found similar results. Interestingly, these studies did not find differences in sexual frequency or functioning. This suggests that the quality of sexual experiences – the emotional connection and mutual pleasure – may be more affected than the physical act itself.

Several factors contribute to these shifts:

• Grief and anxiety: After a loss, memories may surface during sex, triggering sadness or fear. The worry of another loss can dampen desire.

• Physical changes: Hormonal shifts, vaginal dryness, or erectile changes can make sex uncomfortable.

• Body image: Some people feel disconnected from their bodies after a loss, leading to shame or avoidance.

• Guilt or blame: Even when loss isn’t preventable, individuals may feel at fault. That internalized guilt can make vulnerability during sex difficult.

• Partner differences: The pregnant partner often experiences lower sexual desire than the non‑pregnant partner. This discrepancy can create tension if not addressed.

  
  

Still, it’s important to recognize that not all couples experience sexual difficulties. Some report relationship growth and enhanced intimacy after a loss (issm.info). Their grief journey can foster deeper connection if they communicate openly and support each other. The variance underscores that there is no “normal” way to respond; your experience is valid no matter what it looks like.

Normalizing Shifts in Desire: Intimacy Beyond Intercourse

Feeling disconnected from sex after miscarriage is normal. Difficulty with intimacy is common even when the body has healed. Emotional wounds often take longer. But remember, intimacy doesn’t have to equal sex; closeness can be expressed through a spectrum of affectionate behaviors. If you’re craving connection but not intercourse, consider these forms of intimacy:

• Hugging and cuddling – physical closeness without pressure.

• Hand‑holding and kissing – gentle touch can release oxytocin and reduce stress.

• Massage or mutual touch – explore each other’s bodies at a pace that feels safe.

• Outercourse – erotic activities without penetration.

• Emotional closeness – long talks, shared hobbies, or even sitting quietly together can foster connection.

  
  

Giving and receiving affection in these ways can rebuild trust and closeness, laying a foundation for future sexual intimacy. There is no timeline; proceed only when both of you feel ready.

Intimacy isn’t just about sex—it’s about closeness, comfort, and connection in all its forms. Healing begins with gentle, pressure-free moments of togetherness.

My Personal Story: Navigating Ectopic Pregnancy and Loss

As October marks Pregnancy and Infant Loss Awareness Month, I feel called to share my own story. It offers a window into why I’m passionate about this work and why I believe compassionate, trauma‑informed sex therapy matters.

I still remember the excitement of that positive home pregnancy test. I called a friend to make sure I was reading it correctly – we were sure it was a honeymoon baby. When my husband came home from work, I surprised him with a tiny pair of Vans shoes. He assumed the gift was to celebrate his promotion, and his face lit up when he realized he was going to be a dad again.

A few weeks later I experienced intense pain on my right side. We had just gotten married, and because of paperwork delays I wasn’t on my husband’s insurance yet. I was uninsured and hesitant to miss work, but my husband insisted we go to the hospital. Initially doctors dismissed my pain as discomfort from implantation. We went home exhausted, only to be called back hours later. Looking at the ultrasound again, the staff realized my pregnancy was ectopic. The only option to save my fallopian tube – and my life – was to terminate the pregnancy. In minutes our joy turned to heartbreak. 

And for context, this happened shortly after the overturning of Roe v. Wade. Alongside our grief was relief that we lived in a state where abortion was safe and accessible. Abortion is the treatment for ectopic pregnancy; it saved my life. Not everyone has that option.

The nurse administered the medication, and we held each other and cried. Afterward I sank into a fog. I self‑medicated and hid in the bathtub for a week. I couldn’t work, couldn’t talk. My husband was grieving too, and though he tried to support me, nothing could ease the rawness. 

We then waited the mandated three months for the medication to leave my system before trying again. Even then, fear haunted us. The thought of another loss wasn’t exactly sexy, but we found ways to connect and this loss actually brought us closer, despite fumbling and crying through the first few times we tried to re-engage in sexual intimacy.

Eventually, hope returned. We welcomed our rainbow baby, and we’re endlessly grateful, though I know not everyone gets to see the rainbow after the storm. And if you’ve read this far, thank you for witnessing my story. ❤️

When to Seek Professional Support

You don’t have to face loss or healing alone. Therapy offers a safe space to process grief, rebuild intimacy, and strengthen your connection.

It’s possible to navigate pregnancy loss and sexual healing on your own or with your partner. Still, there are times when professional support can make a world of difference. You might consider reaching out to a therapist if:

• Grief feels overwhelming or unending. Anxiety, depression, or PTSD symptoms persist beyond a few months.

• Sexual avoidance or pain continues after physical healing. Persistent distress around intimacy or body‑based trauma may benefit from modalities like EMDR.

• Relationship tension escalates. If coping differences are causing resentment or disconnection.

• You find yourself blaming yourself or your partner. Therapy can help unpack guilt and foster compassion.

• You want guidance on reconnecting sexually. A sex therapist can provide tools, exercises, and communication strategies tailored to your situation.

Practical Tips for Rebuilding Intimacy After Pregnancy Loss

Rebuilding intimacy after loss takes patience, tenderness, and open communication. Go slowly, honor your pace, and let connection guide the way.

While every journey is unique, these suggestions can provide a starting point as you navigate sex and intimacy post‑loss:

1. Communicate openly and often. Share your feelings, fears, and desires even when it’s uncomfortable. Use “I” statements to avoid blame: “I feel anxious when…” instead of “You always…”. For some couples, side‑by‑side conversations (like on a walk) feel easier than face‑to‑face.

2. Validate differing timelines. Recognize that you and your partner may be ready for sex at different times. Avoid pressuring each other. Grief is not synchronized.

3. Prioritize non‑sexual intimacy. Cuddle, hold hands, share a bath, or give each other massages. These activities release bonding hormones and remind you of your connection.

4. Reintroduce touch slowly. When you decide to resume sexual activity, consider sensate‑focus exercises. Start with non‑genital touch, gradually incorporating erogenous zones as comfort grows.

5. Focus on pleasure, not performance. Let go of expectations about orgasm or frequency. Tune into sensations and allow sex to be about mutual enjoyment rather than a means to conceive.

6. Manage anxiety through grounding. If fear arises during intimacy, pause and breathe. Name the fear out loud if possible. Techniques from mindfulness and EMDR can help reorient you to the present moment.

7. Seek medical guidance. Check in with your healthcare provider about physical readiness, especially if you had complications like D and C or infections.

8. Use contraception if you’re not ready for another pregnancy. Ovulation can occur as soon as two weeks after loss.

9. Connect with support networks. Organizations such as Share Pregnancy & Infant Loss Support, The Compassionate Friends, or CLIMB offer peer support. Talking to others who’ve walked a similar path can reduce isolation.

10. Consider therapy. A skilled therapist (or sex therapist) can guide you through exercises and conversations tailored to your needs. Therapy is not a sign of weakness; it’s an investment in your relationship and individual well‑being.

Final Thoughts

Grief shared is grief softened. With patience, compassion, and connection, healing —and even intimacy — can find its way back.

Pregnancy loss is a profoundly personal experience that reverberates through every aspect of life, including sexuality. The research makes clear that while the physical ability to have sex returns fairly quickly, emotional readiness often lags behind. Couples may encounter lowered sexual satisfaction, discrepancies in desire, and increased anxiety and depression. Yet the same research offers hope: sexual function, desire, and frequency can remain stable, and some couples even experience deeper intimacy after working through grief together.

You deserve a space where your grief, your body, and your sexuality are honored. Whether you’re months into your healing or years removed, there is no expiration date on seeking support.

If pregnancy loss has touched your life, please know you’re part of a vast community of people who understand. There is no need to rush your healing or your return to sex. Hold yourself and your partner with patience and compassion. And when you’re ready, intimacy can once again become a source of comfort, connection, and joy.

References

• Allsop, D. B., & Rosen, N. O. (2024). Addressing the sexual difficulties of pregnancy loss for couples in clinical care and research. The Journal of Sexual Medicine, 21(6), 507–508. https://doi.org/10.1093/jsxmed/qdae044

• American College of Obstetricians and Gynecologists. (2020). Early pregnancy loss. ACOG. https://www.acog.org/womens-health/faqs/early-pregnancy-loss

• Gravensteen, I. K., Helgadottir, L. B., Jacobsen, E. M., Sandset, P. M., & Ekeberg, Ø. (2012). Long-term impact of intrauterine fetal death on quality of life and depression: a case-control study. BMC pregnancy and childbirth, 12, 43. https://doi.org/10.1186/1471-2393-12-43

• https://www.healthline.com/health/pregnancy/sex-after-miscarriage

About the author

Dr. Holly is a leading expert in sexual health based in Orange County, certified as both a clinical sexologist and AASECT sex therapist. With extensive experience in sex therapy, sexual wellness, and relationship counseling, Holly provides evidence-based insights to clients in Orange County, the state of California and beyond. Recognized for expertise in sexual trauma recovery, sexual dysfunction, and intimacy, Holly is dedicated to empowering individuals with practical advice and research-backed strategies. For more, follow Holly for expert advice on sexual health and relationships.

Visit www.thehollywoodsexologist.com to learn more and request a consultation.