Kaci Mial Wants to Change Sex for Pregnant People

Sex and sexuality are still often taboo for pregnant people, and for members of the LGBTQIA+ community and other marginalized people who don’t fit a given culture’s ideas or ideals of pregnancy⁠ , it can be even more challenging. American sex⁠ coach Kaci Mial, M.Ed. works with people trying to get pregnant, during pregnancy, and postpartum.

Mial graduated in 2018 from Widener University, holds a Masters Degree in Sexuality Education, and is a Rutgers alumna with more than a decade in field experience. In this exclusive⁠ interview with Scarleteen, she educates us on some sexual⁠ challenges pregnant people face, how to be more of an ally⁠ , and some impacts she’s seen from COVID-19, racism⁠ , other systemic biases and harm, one-dimensional representation of pregnancy and more.

Scarleteen (ST): What can you tell us about what you see with the sex lives of pregnant people? 

Kaci Mial, M. Ed., (KC): There is no “one-size-fits-all” description I could give you about sex during pregnancy that would be true for all pregnant people. There are, however, some common experiences that many will have. Pregnancy is often a vulnerable experience and comes with many changes including those on a physical, mental, spiritual, social, psychological, sexual, and emotional level. Someone who is pregnant is likely trying to navigate most of these changes at one time and it is important to consider all of these aspects of wellbeing and how they impact one’s experience of sex.

ST: How can we demolish the taboo of pregnant people who feel sexual desire⁠ and want sexual pleasure?

KC: I think the first step …is talking about it and busting some of the myths that are out⁠ there. Unfortunately, in society today, many people still think in binaries which can be limiting and not representative of actual human experiences. Some believe that someone who is pregnant or a parent must give up who they are as a sexual person in order to be a good parent and from what I’ve seen in my work, that is not true.

People are multifaceted, and it is common to still feel sexual desire or want to be a sexual person while pregnant or postpartum. It is okay to engage in sexual activity while pregnant, unless directed otherwise by a medical professional, and it will not cause harm [to the fetus⁠ ]. Similarly, during the postpartum period⁠ , it is okay to breast⁠ or chest feed an infant or child and experience pleasure in this area of the body. People can have multiple identities and multiple things can be true at one time.

I would say the second step in demolishing this taboo is creating more accessible representation of people who are pregnant or parents also being sexual beings whether that is embracing a pregnant or post baby body, breast or chest feeding without shame, exploring kink with a baby bump, etc. Jet Setting Jasmine (@JetSetJasmine), Bae Leche (@BaeLeche_), Kayden X Coleman (@KaydenXofficial), and Sarah Forbes (@MamaSexBook) are people I think of as fabulous examples of this. They are sex-positive, parents, and just living their lives as people who can be great parents and know they deserve pleasure for themselves as well.

ST: You're a sex coach who does a lot of work with people who are trying to conceive, who are pregnant, or who have delivered. What are the main issues you’ve been working on most recently with your clients around conceiving, while pregnant and postpartum?

KC: There are many issues for those trying to conceive, who are pregnant, or who have delivered babies face, however, a big one I work with commonly is shame and guilt. The taboo that parents or parents-to-be cannot also be sexual beings is not without consequences.

Many of us internalize these messages and when it comes to navigating sexual pleasure either by ourselves or with a partner⁠ it can be difficult to overcome the belief that we “should” be doing something else.

For example, people trying to conceive [often] feel they “should” be getting pregnant quickly and that it “should” be a fun process to make a baby even though we know for many it can take many couples trying to conceive through sexual intercourse⁠ up to a year or longer if using IUI (Intrauterine Insemination)/IVF (In Vitro Fertilization). Making babies is not always fun and it can begin to feel like the process is a chore.

Another big topic that comes up is differences in desire. Pregnancy can disrupt routines that used to work well for people or make desire discrepancies worse if they were already present. There is no “right” amount of sex to have, however, when one partner wants more or less than the other it can become frustrating trying to figure out how to get on the same page.

Sometimes the person who is pregnant wants less sex because they do not feel well, are tired, navigating body image⁠ , or prioritizing how to prepare for baby while other times hormones⁠ create a surge in desire and partners may struggle to keep up!

For partners who are not pregnant, their desire may fluctuate due to fear of hurting [the fetus], not knowing how to tell when their partner is “in the mood”, feeling that they need to be more of a provider now, or they may view their partner differently now that they are a parent.

After a baby arrives, parents may realize they are too tired for sex, feel a pressure to have sex before they are ready, feel different about their body, be impacted by a perinatal mood disorder, or are healing from traumatic birth outcomes which are more common for Indigenous and Black birthing persons due to racism.

Many young parents I have worked with ask how to seek pleasure when their priorities have shifted to needing to care for the baby, focus on school and doctors appointments, and how to face stigma about being to young to be a parent or have sex.

ST: How do you find out what kind of care young parents you work with have access to, especially the person who is pregnant?  How do you help them find needed care?

KC: I started my journey of becoming interested in [working with] sex before, during, and after pregnancy during my time as a case manager working with young parents living in a group home. The young parents I had the opportunity to work with still inspire me today to advocate on the topic of sex and pregnancy because there is so much information, I wish I was able to provide to them then and resources I hope to provide to future and current young parents.

At the time, the parents I worked with all made their babies through having sexual intercourse and yet because they were teenagers a lot of people looked down on them [for still wanting to have sex]. It was as if they were expected to stop having sex because they were pregnant or parents now and some people even described their pregnancies as a consequence of their actions or told them they were too young to be good parents. When people have these beliefs or say these statements to young people it can cause an environment of stigma, shame, and prevent them from asking questions or seeking help.

For me, the best approach has been to ask young parents directly what kind of care they have access to and what their current/future needs are. Looking for parenting resources can be overwhelming so finding a trusted adult, peer with similar experiences, a reliable website, or local resource is important when looking for support.

In the United States where I am located, there is a phone number and website you can access from all 50 states, Washington D.C. and Puerto Rico (Dial 2-1-1 or visit to access a referral specialist who can then offer local community services that may be useful to parents such as child care, educational programs, family resource centers, housing, food and utility assistance, health insurance, mental health resources, access to language services, and more.

You will also want to ask 211 to connect you with your state, city, or county department of social services to see if you are eligible for any government funded programs such as Temporary Assistance for Needy Families (TANF), WIC, Early Head Start, Nurse-Family Partnership, or Parents As Teachers.

Other helpful websites include Scarleteen which lists other articles for young parents. Planned Parenthood can offer contraceptive services, options counseling, and in some locations prenatal care. [editor’s note: Independent abortion⁠ and sexual health clinics also typically offer the first two services: you can find these by using a search engine, your zip/postal code, county or province, and “abortion,” “sexual health,’ “ birth control⁠ ,” “family planning,” or other related terms. We can also help you find local services through our direct services here on Scarleteen.]  Sex Positive Families has an amazing resource section including topics for parent’s sexual health, LGBTQIA+, gender⁠ , reproduction, and more. Postpartum International offers a helpline (1-800-944-4773) to get connected with mental health services and support groups including those for queer⁠ and trans parents. Finally, doulas can be an amazing support to parents during the birthing process and postpartum. They can also provide personalized 1:1 support and get you connected with more resources in your area. Those interested should check out Doula Match to find a doula near them.

ST: Do you believe the institutions that are supposed to provide such care respect sexual and gender identities also considering race and social class or are people who are let down by the system? 

KC: There are stories from parents and data available that largely points to people being discriminated against by institutions and providers based on age, sexual orientation⁠ , gender identity⁠ , race, social class, insurance and immigration status even still today in 2021. Many same-sex parents looking for options to build their families are faced with limited options, high costs, and a lack of understanding from many providers to point them in the right direction. Trans and nonbinary⁠ parents face misgendering, misuse of pronouns, and lack of guidance when it comes to hormones and reproductive health.

In the United States, pregnancy related deaths have been steadily rising and those who are Black and pregnant face the highest risks due to racism and implicit biases. For Black women in the United States, this risk for maternal mortality spans across socioeconomic status, and can be demonstrated by listening to the stories such as Beyonce’ and Serena Williams. Furthermore, for people [in the United States] who are uninsured, on Medicaid, or are undocumented getting access to quality respectful maternity care can be challenging or impossible.

The harm that is happening is rooted in systems of oppression. I believe it is the responsibility of providers and institutions to change these statistics and make sure family building is possible and safe for everyone. We can start to make change by acknowledging our own implicit biases, which we all have, and by listening to the voices of those impacted. Many people such as doulas, midwives, researchers, and advocates are already working toward better systems based on community practices. A great example of advocacy is by Kimberly Seals Allers who created the Irth App ( which allows space for the sharing of birth experiences.

ST: How do you work with a pregnant person who is going through a gender transition⁠

KC: I approach everyone I work with from a person-centered perspective. This means I would find out the unique needs of the individual who is pregnant and work holistically to make a plan that works for them.

I would want to know what is important to the person who is transitioning, what support they need from me, and what resources I can connect them with to make their experience as safe and enjoyable as possible. I affirm all of my clients by using their correct pronouns and if they change during the process of us working together, I would be sure to make that transition with them.

Other needs that may come up for someone pregnant and going through a gender transition could be related to physical concerns such as what hormones are safe to take, how to give birth in a way that is affirming to their gender, finding providers that are either the same gender identity or who would understand their specific needs. They could face emotional challenges and could benefit from therapy or peer support groups. For any sexual concerns, a sex coach or sex therapist could also be a great support during this time.

ST: We are still going through the COVID-19 pandemic. There was a drop in the number of pregnant people. What do you think about this?

KC: According to the CDC, Center for Disease Control, the rate of births in the United States dropped in 2020 compared to 2019 but the decrease cannot fully be attributed to COVID-19. We are still going through the COVID-19 pandemic and 2021 data should help to add to the current picture of why births are decreasing and what the role of the pandemic has been but other reasons for the decreasing birth and fertility⁠ rates are due to other factors such as the loss of jobs, people choosing not to have children, less teen pregnancy, high cost of childcare, and lack of paid maternity leave. I think we should keep an eye out for more data from reputable sources such as the CDC and WHO, World Health Organization, to explain the declining rates.


Similar articles and advice

  • Valerie Jaharis

Historically, trans people and disabled people have had vocal training to change the way their voices sound; sometimes by choice and sometimes by way of strong culture pressure of what a gender and the voice of a person whose gender that is “should” sound like. Scarleteen volunteer Val was thrilled to sit down with a teacher who approaches the voice completely differently; not in the pursuit of “normal” or with an attitude of “fixing” but rather in the pursuit of uplifting self-expression and showing people the power of the tools their body has to express themselves.