Pregnancy and BDSM
Disclaimer: This article is offered as a starting point for risk awareness, risk mitigation, and harm reduction. It is not medical advice. Always consult your physician and take the full picture of your individual health and pregnancy into consideration.
The idea of a pregnant person tied up and flogged will almost certainly evoke complicated emotions and concerns. It’s easy to say (or imply) that people “should” 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 offers information on risk mitigation and harm reduction during a healthy pregnancy and is intended for the players and the knowledge 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).
Note that any high-risk pregnancy (pre-eclampsia, incompetent cervix, gestational diabetes, etc.) is beyond this article's scope.
Pain/Sensation Play
In a healthy pregnancy, most sensation play shouldn’t be an issue (light/moderate flogging on the upper back and ass, wax play, etc.). Many people find their skin more sensitive during pregnancy, so a pregnant bottom may not have the pain tolerance they once had. Of course, stay away from anything to do with the impact on the belly — not a significant part of most people’s BDSM repertoire anyway and, therefore, probably reasonably 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 muscles, and the baby is floating in a cushion of amniotic fluid. While miscarriage is quite common, especially in early pregnancy, trauma is an infrequent 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 core a no-go area for any impact play during 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, some of which may be unscheduled — while I encourage you to be “out” to your doctor, even the most open-minded MD is at the least going to express concern if you come in for a prenatal check with huge bruises and abrasions. Pregnant people are more likely to scar, so that’s a consideration anytime you break the skin.
Of course, there are the breasts — oh, how the breasts change during the pregnancy/birth/breastfeeding process! One of pregnancy's first symptoms can often be extreme sensitivity in the nipples. So, you may find yourself retiring the clover clamps for 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 yellowish, sweet-tasting liquid. Around that time, I began 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. While breastfeeding (for over three years), my boobs were getting messed with for at least a couple of hours daily. I’m “full up” on any boob stimulation… maybe they’ll eventually become an erogenous zone again, but I’m not counting on it.
Blood and Blood Clots
Blood volume increases during pregnancy. While the number of red blood cells (responsible for carrying nutrients and oxygen) increases the volume of plasma (the liquid component of blood) increases even more. Because of this, pregnant people have a type of functional anemia (low blood count). Furthermore, hormonal changes tend to decrease average blood pressure, with the lowest blood pressure occurring around 28 weeks gestation. Pregnant people are 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 pressure 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 a greater risk of dizziness or discomfort during prolonged 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 OK, 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 or kink activities constituent “high fall risk” is perhaps so subjective as to be pretty useless in this discussion, however, there are several 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 the 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. The center of 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 not tell a pregnant person they can’t be suspended. Still, I would advise that they need a lot of body awareness and a skilled rigger knowledgeable regarding pregnancy's physiological changes.
Breathing Issues
Many changes 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. I recommend avoiding breath play altogether during pregnancy because of potential risks to both parent and fetus. (I recommend avoiding breath play at all times, actually…)
Fainting and near-fainting are not uncommon during pregnancy. If you feel faint or dizzy, lie 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 accompanying 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 a conducting medium surrounds the fetus, I recommend avoiding the pelvic or abdominal application of electricity during pregnancy. Using your violet wand or TENS unit on the extremities is still OK.
Burns can be severe injuries in pregnant people, although typically, a large surface area needs to be affected before significant consequences to the fetus occur. The general safety rules (short duration of exposure, accessibility of fire blankets, etc.) should be followed while pregnant, with even an extra level of caution.
Penetration/Sex During Pregnancy
Vaginal and anal penetration during pregnancy is generally safe 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 eight months pregnant. I did quite a bit of research first, including asking a friend who was an L&D nurse for advice, and the consensus was that as long as my cervix was still closed and water not broken, fisting was no problem. As a side note, I didn’t require any sutures after my delivery, so maybe fisting is an excellent pre-game warm-up, as it were? It’s a bit similar to the perineal massage that OBs recommend.
Social Issues
If you are playing in a public dungeon, keep in mind that seeing a pregnant person in scene does tend to throw the Dungeon Monitors (DMs) and event hosts for a loop—many of them are entirely flummoxed. If you’re going to do a public scene while pregnant, I’d recommend checking in with the DM and host first (always a good idea anyway). Describe 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 also applies to bottoms — those stilettos will have to go into storage for a bit! Many people tire easily during pregnancy, especially in the first and third trimesters. So you may want to plan scenes less ambitious than your usual triathlon of pain. This would be a perfect 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 the incidence of injury increases (falls, twisted ankles, etc.) — 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, 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, and lost my desire to bottom at all.
Conclusions
Keep common 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 going out and playing without worrying about all the logistics (babysitting, having enough milk in the fridge, etc.) that must be dealt with after the baby’s birth! Your life won’t be over — it will just be more complicated and busier.
About the writer:
This article was written by me (Shay). I’m a medical professional who has spent WAYYY too much time geeking out over BDSM safety. However, I would note that nurses and medical professionals can and do say wrong things, so using your judgment no matter how “qualified” the source is always good. 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 five 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 improving this article.
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
