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Reproductive Health

Prenatal care for sex workers

Being pregnant while doing sex work can be challenging. Deciding whether to continue working or not isn’t always easy, but it’s your decision and it deserves to be respected. Whatever you choose, make sure to seek medical care and reach out to someone you trust for support.

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Índice

  1. Pregnancy follow-up
  2. Working while pregnant

Pregnancy follow-up

If you intend to continue with the pregnancy, schedule an obstetrics appointment at the health center closest to you.

In Portugal, prenatal care is free and available to all women, even if they are in an irregular migration situation.

Through these appointments, you will find out whether your pregnancy is healthy or high-risk. You will have access to blood tests, ultrasounds, vitamin supplements and any other necessary medication, as well as guidance on alcohol, tobacco, or drug use, among other aspects of your health.

Prenatal care usually includes regular appointments throughout the pregnancy:

Up to 12 weeks (1st trimester)

  • First medical appointment

  • Blood and urine tests

  • Screening for HIV, syphilis, hepatitis B and C

  • Blood group and anemia check

  • First ultrasound (to confirm gestational age and viability)

  • Start of folic acid supplementation

11–13 weeks

  • First trimester ultrasound

  • Screening for chromosomal conditions (combined test, if chosen)

20–22 weeks

  • Morphological ultrasound

  • Checks the baby’s development, organs, placenta, and amniotic fluid

24–28 weeks

  • Blood tests

  • Screening for gestational diabetes (glucose tolerance test)

  • Tetanus/diphtheria/pertussis vaccination (if recommended)

30–32 weeks

  • Growth ultrasound (if indicated)

  • Monitoring blood pressure and baby’s growth

36–37 weeks

  • Group B Streptococcus test (vaginal/rectal swab)

  • Discussion of birth plan and signs of labor

Throughout pregnancy, appointments also include:

  • Monitoring blood pressure and weight

  • Checking the baby’s heartbeat

  • Prescribing iron or other supplements if needed

  • Counseling on nutrition, alcohol, tobacco, and drug use

  • Mental health support

  • Information about maternity rights and birth preparation

If the pregnancy is considered high-risk, you may have more frequent appointments or be referred to hospital specialist care.

Prenatal care helps protect both you and your baby. Seeking care early and attending regular appointments increases the chances of a healthy pregnancy and delivery.

Working while pregnant

It is important to know that:

  • The baby is protected by the amniotic sac and the uterine muscles, but these do not protect the baby from most sexually transmitted infections. Always protect all sexual practices consistently.
  • In later stages of pregnancy (2nd or 3rd trimester), sex can increase contractions and may induce labor.
  • Pay attention to uncomfortable positions, and if you feel pain, change position immediately.
  • Avoid the missionary position (with the client on top) or other positions that put pressure on your belly. These can reduce blood flow between you and the baby, especially after the twentieth week.
  • Protected oral sex is safe. However, avoid the client blowing air into your vagina. Although rare, it can cause an embolism and be harmful to you and your baby.
  • If there is bleeding after sexual activity, contact your doctor immediately.