What Pregnant Women Should Know About Sex Drive

Pregnancy is an adventure for any couple, combining the excitement (and anxiety) about welcoming a new little life into the world with the dramatic physical and hormonal changes that women experience.

In some cases, those hormones can fire up a woman's sex drive. But at other times, those same changes can make physical intimacy unwanted, difficult and painful.

A woman's libido while pregnant can vary from month to month, day to day, and even from pregnancy to pregnancy. Managing expectations around these challenges will help create a more joyful, and less stressful, nine months.

Changes by trimester

According to a 2009 study, women experienced declines in sexual activity at rates highly correlated with the progressing trimesters. In the first trimester, roughly 40 to 47 percent of all women (depending on their age) reported decreases in sexual activity. These rates rebounded some during the second trimester but then skyrocketed again in the third trimester, with 63 to 73 percent of all pregnant women reporting less sexual activity.

In the first trimester, when initial pregnancy hormones surge, you're more likely to feel exhausted and nauseated. You're not raring for more sex when you're worried you might be running to the bathroom to lose your lunch at any moment.

The second trimester is known as the "golden period" in pregnancy, when morning sickness subsides and energy levels increase. Plus, your belly hasn't grown to unwieldy proportions, so it's still easy(ish) to perform your go-to sex positions and moves without much concern. As such, increases in sexual intimacy during these three months makes sense.

In the third trimester, everything naturally becomes more complicated. As you're closing in on the finish line for childbirth, anxiety could be ramping up, and anxiety is known to affect sexual function. Not to mention that the baby belly is getting harder to work around, your movement patterns are changing, and your internal organs are all being compressed by your growing baby.

Even if you want sex, it may just be more awkward and less enjoyable overall, and if you're experiencing any complications, your doctor may advise against continuing sexual activity. Keep in mind, though, that as long as you're given the doctor's go-ahead, sexual activity throughout your pregnancy is generally considered safe.

Why sex drive changes in pregnancy

A 2019 review and meta-analysis of studies published in Systematic Reviews found a wide variety of reasons why a woman might not want sex quite as much during pregnancy. Some of these are physical, particularly if you are experiencing pregnancy complications and might be at risk for miscarriage or preterm labor. But most of the causes are psychological or related to how your relationship might be changing during pregnancy.

For instance, if you're self-conscious about changes to your body or don't feel like your partner is offering the type of support you need, you're probably going to be less likely to feel desire. In fact, sexual desire disorder—a diminished desire for sexual activity—is the most commonly reported sexual change or dysfunction in pregnancy.

And, of course, if the regular sexual activity was an important bonding activity for you and your partner before pregnancy, ensuing sex declines can create more stress for a couple during an already stressful time.

The key is to try to keep an open line of nonjudgmental communication during every stage of pregnancy.

Your doctor can help, too

According to an article in Contemporary OB/GYN, two-thirds of pregnant women don't remember discussing sex-related pregnancy issues with their doctors, and instead, turn to the internet for information on the subject. However, by bringing the topic up with your doctor—especially during a visit when your partner is present—you may be able to alleviate some of your fears or worries and get a bigger benefit from online research.

Communication and honest discussions with your doctor and partner may help you find a way to maintain sexual activity, even if it's in a new or different way than before you got pregnant. Rather than feeling guilty or defensive about the changes you're experiencing, you should be empowered and prepared.