Pelvic rest is a temporary, protective step your medical team may recommend to safeguard your health and the health of the intended parents’ baby.

Following these clinical instructions provides the best possible environment for the intended parents’ baby to thrive while giving you peace of mind.

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What Does it Mean to Be on Pelvic Rest During Your Surrogate Pregnancy?

The term pelvic rest is a clinical directive from your doctor, usually a Reproductive Endocrinologist (RE) or your Obstetrician (OB), that restricts activities that cause stimulation or increased blood flow to the pelvic area.

Unlike full bed rest, which requires you to limit most physical activity, pelvic rest is specific. It focuses on limiting anything that could stimulate the cervix or uterus. This restriction is almost always temporary and is considered a proactive measure.

Surrogates typically encounter these restrictions during the embryo transfer phase or if responsive medical needs arise later in the pregnancy. Common restrictions include:

• Sexual intercourse or vaginal penetration
• Inserting anything into the vagina (including tampons, douches, or menstrual cups)
• Orgasms, which cause uterine contractions
• Sometimes, specific types of exercise or heavy lifting

This medical guidance is always given with the goal of protecting the pregnancy. Your medical team will provide clear, specific instructions tailored to your unique situation.

Proactive vs. Responsive Pelvic Rest

If your doctor advises you to be on pelvic rest, it is not a sign of failure or that you have done anything wrong. It is simply a precaution used to reduce the risk of complications.

The reasons a surrogate would be placed on pelvic rest generally fall into two categories: proactive precautions related to the medical process and responsive measures due to a potential complication during the pregnancy.

• Proactive Pelvic Rest: This is a standard part of the surrogacy medication timeline. REs prescribe rest 2–3 weeks before and immediately following an embryo transfer to ensure optimal implantation conditions.

• Responsive Pelvic Rest: This occurs later in the pregnancy if an OB identifies specific conditions. Common triggers include vaginal spotting, placenta previa (where the placenta covers the cervix), or signs of a shortened cervix that could lead to preterm labor.

Who Decides Pelvic Rest – and Who Supports You?

When you are a surrogate, many individuals are involved in your medical and contractual well-being, but the lines of authority for medical decisions are clear.

The Role of the Medical Clinic

Your Reproductive Endocrinologist (RE) and, later, your OB/GYN are the only parties who will advise or mandate pelvic rest. You should always follow your clinic’s recommendations above all else. They are the medical professionals guiding the pregnancy. Here’s how they support you:

• The RE manages the protocol leading up to and immediately after the embryo transfer.
• The OB takes over once the pregnancy is confirmed and manages your health for the remainder of the pregnancy.

The Role of the Surrogacy Contract

While the medical decision is always the doctor’s, your surrogacy contract is the document that legally binds you to following that medical guidance.

American Surrogacy works with reputable attorneys to draft contracts that protect all parties. The contract will not typically require pelvic rest during the entire pregnancy but will include wording about following the clinic’s guidance, which is legally enforceable.

The Role of Your Surrogacy Specialist

Your specialist at American Surrogacy serves as your medical advocate and emotional support system.

If you receive a pelvic rest order, your specialist can help you clarify the doctor’s instructions, communicate the news to the intended parents, and ensure everyone is aligned. This means we will:

• Act as the primary communicator between you and the intended parents (IPs), ensuring the IPs receive timely, sensitive updates without overwhelming you.
• Clarify medical terminology and logistics, helping you understand exactlywhat restrictions are in place so you can follow them confidently.
• Confirm contractual obligations are being met, especially concerning expense reimbursement if the rest order impacts your work or childcare needs.
• Provide emotional support to help manage any anxiety or frustration that comes with physical limitations.

What’s Not Allowed on Pelvic Rest During Pregnancy – and Why It Matters

Pelvic rest is a focused restriction meant to keep the uterus and cervix calm. The restrictions are in place to reduce the risk of irritation, infection, or uterine contractions. The restrictions typically include:

• No Sexual Intercourse: The primary goal is to prevent penetration and the associated risk of infection or cervical irritation.
• No Orgasms: Orgasms cause involuntary contractions of the uterus, which can irritate the cervix or, in a high-risk situation, potentially trigger premature labor.
• No Vaginal Insertion: This includes tampons, or any medical exam that is not strictly necessary and approved by your doctor.

How Pelvic Rest differs from Full Bed Rest

Full bed rest is a much more intensive and less common restriction that limits most activities, requiring you to remain in your bed for most of the day.

Pelvic rest is often a partial restriction, meaning you can typically continue light activities, work (if not physically demanding), and carry out daily tasks.

Unless your doctor specifically restricts it, you may still be able to:

• Walk and perform light chores
• Engage in non-strenuous, non-pelvic exercises (like arm stretches)
• Go to work or school
• Drive and run errands

Generally, high-impact activities, heavy weightlifting, or exercises that significantly jar the pelvis are restricted. Always confirm with your medical provider what activities are safe.

When Can You Have Sex While Being a Surrogate? Intimacy During Surrogacy

Concerns about intimacy are completely natural for a surrogate and her partner. These questions often center around three stages: before embryo transfer, immediately after transfer, and during the confirmed pregnancy.

Guidelines around intimacy will be driven by the RE’s specific protocol, and this protocol will be incorporated into your surrogacy contract.

When Should My Partner and I Stop Having Sex Before the Embryo Transfer?

The general recommendation is to abstain from sexual activity in the weeks leading up to the embryo transfer. The main reason is to eliminate any risk of infection or potential uterine irritation during the preparation phase.

The specific date you stop having sex before the embryo transfer will depend on your clinic and the contract, but it is typically advised to stop sexual activity approximately 2–3 weeks before the scheduled transfer or from the start of the preparation medications.

The RE is priming your body for the best chance of pregnancy, and following this advice ensures that your uterus is in the optimal condition.

When Can You Have Sex After the Embryo Transfer?

This is a time of high anticipation, and the rule is simple: be on pelvic rest until otherwise advised by the clinic. You will likely be instructed to remain on pelvic rest until the clinic confirms a positive pregnancy test, or sometimes until they release you to your OB/GYN (around 8–10 weeks).

Waiting until confirmation ensures that any potential irritation or contractions that sexual activity can cause do not interfere with the embryo’s ability to successfully implant and grow.

Sex During Confirmed Pregnancy

Once the RE releases you to your OB, the guidelines typically follow those of any healthy, low-risk pregnancy. If the pregnancy is uncomplicated, most doctors lift the pelvic rest restriction after the first few weeks, allowing you to return to normal intimacy.

However, if your OB identifies any of the responsive reasons mentioned above (like spotting or placenta previa), they will re-issue the pelvic rest order. The golden rule is always to communicate with and follow your OB’s advice throughout the medical process.

How Pelvic Rest Can Affect a Surrogate’s Emotional Wellbeing

Physical restrictions can impact your emotional health, and it is completely normal to feel frustrated, isolated, or anxious if you are placed on pelvic rest.

• Normalize Emotional Responses: Whether you are restricted for a few days after the transfer or a few weeks later in the pregnancy, it is natural to feel limitations. You may feel bored, miss your regular routine, or feel pressure to be perfectly still.
• Stay Engaged: Although your body is resting, your mind does not have to be. Use this time to read, catch up on movies, listen to podcasts, or engage in non-physical hobbies. Staying mentally active helps manage feelings of confinement.
• Focus on the Purpose: Remind yourself that this limitation is a direct sign of your commitment and care for the intended parents and their baby. It is a temporary sacrifice for an eternal gift.
• Our Support: Your specialist understands the emotional complexity of these limitations. We are here to check in, listen, and connect you with resources if you feel your emotional health is struggling.

Navigating Pelvic Rest With a Partner or Spouse

When a surrogate is placed on pelvic rest, it impacts the entire household, especially the spouse or partner.

Physical restrictions on intimacy are a temporary sacrifice to help a family grow. Maintaining a strong connection with your spouse or partner during this time requires clear communication and a reframing of intimacy.

Partners can support the journey by taking over strenuous household tasks or childcare duties involving lifting.

To maintain closeness without physical stimulation, many surrogates focus on “non-pelvic” intimacy, such as shared hobbies, movies, or focused conversation.

If physical limitations cause friction at home, your agency specialist can provide resources to help you and your partner navigate this stage as a team.

How Pelvic Rest Fits into the Bigger Picture of a Healthy Surrogacy

Pelvic rest is not a contractual red flag or a sign that the entire surrogacy is at risk. It is a standard medical precaution that reinforces the protective nature of your journey.

Legal and Contractual Clarity

Your surrogacy contract will detail how lost wages or unexpected costs are handled. If a doctor’s order for pelvic rest causes you to miss work, the contract ensures you are appropriately reimbursed for your time, just as you would be for any other medical inconvenience.

The contract, the medical guidance, and the agency support all work toward the single shared goal: a safe, healthy pregnancy and a successful delivery. When you are on pelvic rest, everyone involved is doing their part to support that goal.

Get Support from Surrogacy Specialists

Choosing to be a surrogate is an incredible act of compassion, and it deserves an agency partner that prioritizes your health, support, and clarity at every turn.

When medical instructions like pelvic rest come up, you deserve to have an expert who can advocate for you, communicate with the intended parents, and ensure your contract protections are honored.

If you have questions about the surrogacy journey, how our specialists handle medical protocols, or what support is available to you, fill out our contact form to get free information.