This article is an excerpt from our Sefer
During pregnancy and nursing:
The above minimum obligation of Onah [i.e. twice a week] applies even when one’s wife is pregnant or nursing. [Nonetheless, if the husband is not interested, and his wife is not particular and forgives him, then it is permitted for him to skip the times of Onah. However, if she does not forgive him, then he must fulfill it. Likewise, those times of intimacy which are auspicious to bringing new souls into the world, may not be skipped even if his wife forgives him.]
The first trimester: During the first three months [90 days] of pregnancy, [possibly all, and certainly excessive] intercourse is difficult for both wife and child. [During this time, the wife commonly experiences bouts of nausea, cramps, morning sickness, exhaustion, and other ailments which can affect her interest in intimacy. Likewise, some say that intercourse during this time can lead to miscarriage. Thus, the husband is to try to balance his requests for intimacy during this time in accordance with his wife’s physical capability, and his actual needs. Nevertheless, in general, the nature of people from the times of the Talmud versus today has changed, and hence, the above Talmudic health warning may no longer be applicable today neither to wife nor baby. Indeed, according to modern medicine today, some doctors claim, and so is the accepted position of medicine information websites, that there is no known health risk, or extra risk of miscarriage, to have intimacy during a regular pregnancy [not high risk], including the first three months. However, other doctors say that indeed a health risk, and danger of miscarriage, does exist and that therefore the couple is to diminish in intercourse during the first trimester, and try to have it only once a week, or halve their normal frequency. An article in the British Journal of General Practice gives an overview of the different medical opinions, and in conclusion it can be said that not enough study or data exists either way to give a conclusive directive on the question of whether intercourse during the first trimester can raise the risks of miscarriage. In a case of doubt, the couple should discuss the matter with a doctor who can advise on their personal situation. Whatever the case, the couple should not diminish from the minimum Onah obligations unless they both agree to do so, or there is evident medical reason for it, such as a high risk pregnancy.]
The 2nd-3rd trimester: Intercourse in the last six months of pregnancy is beneficial for the child, and helps him come out further developed and enhances his. [It helps the child be strong and beautiful. However, in the second trimester, the Talmud states that intercourse is [medically] difficult for the wife even though it is beneficial for the child. In the third trimester, the Talmud states that it is [medically] beneficial for both wife and child. Regarding the current medical perspective, there is no clear medical position regarding the second trimester, although regarding the third trimester there is agreement that it is beneficial. However, some write that since intercourse during this time can bring on early labor, therefore a woman who suffers from early births is advised not to have intercourse in the last months. Practically, the couple is to consult with their doctor for their personal situation.]
Day 90 of pregnancy: It is forbidden to have intercourse on day 90 of the pregnancy, due to danger to the fetus as it can cause miscarriage. Nonetheless, in today’s times, one is not required to be stringent in this matter, and Shomer Pesa’im Hashem. [However, according to Kabbalah, this stringency applies even today. Accordingly, some Poskim conclude that it is proper to be stringent, even today, to avoid intercourse on the 90th day from her last Mikveh night, during pregnancy.] See Chapter 4 Halacha 8 for the full details of this subject!
Saying Lamnatzei’ach: See Chapter 7 Halacha 4D!
Loss of interest during pregnancy:
Loss of interest by the wife: See in the above Halacha regarding the loss of interest during the first trimester, and the same may apply during the third trimester. Every woman and situation is different. Thus, the husband is to try to balance his requests for intimacy during this time in accordance with his wife’s physical capability and his actual needs. Nonetheless, the wife cannot refuse the husband’s need for intimacy during this time, and a balanced and agreeable approach is to be followed.
Loss of interest by the husband: Occasionally, it is specifically the husband who loses interest for intimacy while his wife is pregnant. This may be due to a variety of reasons, but whatever the case, he remains Biblically obligated in his minimum Onah obligations towards her, irrelevant of his disinterest, as explained in Halacha 1A. See there for the full details of this matter!
Certain high-risk pregnancies, especially if they require bedrest, carry doctors’ orders for the couple to avoid intimacy for a prolonged period throughout the pregnancy. It is advised for one to seek council with a Frum gynecologist and Rav in the event that such orders have been given, and see if there are any ways that intimacy can continue during this period.
Mikveh after birth:
The general medical advice is for a wife to delay going to Mikveh from between four to six weeks after birth. Intimacy prior to this time period, which allows the body to heal, can cause extra and unnecessary tearing and bleeding of her birthing wounds. Nonetheless, some suggest waiting longer intervals, such as 9 or 10 weeks, or even 12 weeks, from the birth, in accordance with her strength and stamina. All in all, while the wife should discuss the matter with her husband, and hear his perspective before making any decisions, she is not obligated to immerse in the Mikveh and rebegin marital intimacy until she feels physically capable of doing so. However, there is no need at all to wait 40 days after the birth of a boy and 80 days after the birth of a girl, so long as she has stopped bleeding and is physically ready. Regarding the custom of some to abstain from Mikveh/relations within 40/80 days after birth, see Chapter 4 Halacha 9.
Going to Mikveh even if intercourse cannot take place, such as after birth: Some Poskim rule that a woman may go to Mikveh at night in order so that the couple can engage in hugging and kissing, even if intercourse will not take place that night, such as due to a medical concern, so long as there is no worry of it leading to Zera Levatala. Other Poskim, however, rule that she may not immerse in such a case, due to worry of it leading to Zera Levatala. Practically, one is not to be lenient if the husband is prone to have Zera Levatala due to this.
Postpartum-Loss of interest after pregnancy:
It is common after pregnancy for women to have disinterest in intimacy. This is due to a variety of factors, including vaginal pain, motherhood stress and fatigue, including sleep deprivation, hormonal changes, postpartum depression, inability to reach climax. Therapy, and gynecological consultation can help guide the couple in relieving these issues.
 M”A 240:1; Siddur Ya’avetz Mosach Hashabbos Mitos Kesef 7 Chulya Gimel 1; Kitzur SHU”A 150:7; M”B 240:2 and 10; Biur Halacha 240:1 “Ela B’onah”; Igros Moshe E.H. 1:102; See Nitei Gavriel 103:1-2; Piskeiy Teshuvos 240:8; Sheyikadesh Atzmo Chapter 13 p. 218-226
 The reason: As the Mitzavh of Onah is independent of the Mitzvah of Peru Urevu. [Igros Moshe ibid]
 Kaf Hachaim 240:1
 Sha’ar Hamitzvos Bereishis; Kaf Hachaim 240:1
 M”A 240:5; Tur 240:1; Niddah 31a; Menoras Hama’or Ner Gimel K’lal Vav 5:1; Sh’lah Hakadosh Sha’ar Ha’osyos Erech Kedusha 408; See Ezer Mikodesh 76:1 that perhaps during this time the Mitzvah of Onah is not a real obligation; Meiy Hada’as 240:6 that some communities are accustomed to abstain from intimacy during the first three months of pregnancy, and that so rule some Rabbanim
 Implication of Sefer Chassidim 380
 See Orchos Rabbeinu 1:98 and 5:27 in name of Chazon Ish, brought in Piskeiy Teshuvos 240:8, that the intent of the Talmud is not to say that all intercourse is difficult, but that excessive intercourse is difficult, and that having intercourse according to the minimal Onah frequency is not damaging. See Kedushas Moshe p. 14; See medical opinion at end of this paragraph; However, see Sefer Chassidim ibid brought in previous footnote
 Nonetheless, intercourse is permitted during this time even if it is difficult for the child, as we suspect that the husband or wife may have forbidden thoughts if it were to be prohibited, and hence it is better for intercourse to be permitted to prevent the forbidden thoughts and not prohibit something which they cannot control. [Sefer Chassidim 380]
 See Kedushas Moshe p. 14; Meiy Da’as ibid; Dr. Mordechai Halprin of the Shlezinger institute, brought in Sheyikadesh Atzmo ibid footnote 4
 See Sefer Chassidim ibid that one who indulges without need will be punished; See Igros Kodesh 15:316, printed in Shulchan Menachem 6:241; See Meiy Hada’as ibid; See Sheyikadesh Atzmo 13 footnote 2
 Igros Kodesh ibid; See Rama E.H. 156:4; Maharam Shick Y.D. 244; S’dei Chemed K’lalim Mareches Tes:5
 Encyclopedia Hilchatit Refu’it 3:11; See Nishmas Avraham Basra 3:397; Sheyikadesh Atzmo 13 footnote 4
Other opinions: See Kedushas Moshe p. 14 that the doctors today say that having excessive intercourse during the first trimester can cause miscarriage.
 Dr. Mordechai Halprin of the Shlezinger institute, brought in Sheyikadesh Atzmo ibid footnote 4; Kuntrus Derech Hamelech p. 11; Kedushas Moshe ibid; Meiy Da’as ibid
 Written in 2012 by doctor Andrew Moscrop with the University of Oxford
 Interestingly, he notes that in the 1980’s the majority of gynecologists advised abstinence, but later on in the 90’s, many retracted their claims
 Igros Kodesh ibid
 Setimas Kol Haposkim, that the obligation of Onah applies also during the first trimester and hence only if the wife is Mochel, and the husband agrees, may they abstain
 Michaber 240:1; Tur 240:1; Niddah 31a; Menoras Hama’or Ner Gimel K’lal Vav 5:1; Sh’lah Hakadosh Sha’ar Ha’osyos Erech Kedusha 408; See Sanhedrin 70b regarding Batsheva and Rashi there; Sheyikadesh Atzmo 13:3
 See Rashi ibid; Abudarham Birchas Hashachar
 Naturally, women tend to enjoy intercourse during the second trimester more than any other time of pregnancy, and possibly more than any other time of marriage. Thus, the above Talmudic statement is quite puzzling, and therefore perhaps one can suggest that it refers to the medical effect of intercourse on the woman, and not on her personal enjoyment. Alternatively, one can offer to say that the nature of women have changed from the times of the Talmud, thereby explaining the omission of this statement by majority of Poskim. See Igros Kodesh 15:316 for a similar approach. Vetzaruch Iyun!
 M”A 240:5; Niddah 31a
 Niddah ibid
 Dr. Mordechai Halprin of the Shlezinger institute, brought in Sheyikadesh Atzmo ibid footnote 5
 Nishmas Avraham Basra 3:297
 Igros Kodesh 15:316
 See Encyclopedia Hilchatit Refu’it 3:11; Sheyikadesh Atzmo 13:4
 Shiureiy Shevet Halevi 194; Piskeiy Teshuvos 240:8
 Taharas Yisrael 194 Beir Yitzchak 19
 See Taz 197:4
 Michaber Y.D. 194:1; Rama ibid that in a place without a custom, one should not be stringent at all; Teshuvas Rama 94, brought in Taz 194:3, that so is custom today in his provinces; See Taz ibid at length for negation of the stringent opinion and the harsh words of the Bach against one who is lenient; Shach 194:1
 Even Shoham 14, brought in Pischeiy Teshuvah 184:22; Sheilas Ya’avetz 2:10; Chut Shani Niddah 197:3; Shevet Halevi 8:271; See Rama 184:10 and Admur 184:33-35; Or Tzadikim 32:4
 See Posei’ach Sha’ar 23:27; Beir Moshe 8:91; Piskeiy Teshuvos 240 footnote 44; Regarding prohibition of night of Veses, see: Aruch Hashulchan; Taharas Yisrael; Darkei Teshuvah; Maharam Shick 364; Nitei Gavriel Niddah vol. 2 102:2; So ruled to me Rav Farkash in a phone conversation and so he rules in Taharah Kahalacha 24:109 and footnote 177; See also Piskeiy Teshuvos 240 footnote 44; Sheyikadesh Atzmo 11 footnote 4; Shut 38 in back of Sefer
The reason: As this can lead to them having intercourse. [Poskim ibid; however see Taharah Kahalacha ibid footnote 177 which negates this reason] Alternatively, it is because it is a danger for her to immerse and not have relations, as stated in the below Q&A. [Taharah Kahalacha ibid]
 See Getting Closer pp. 69-86
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