Understanding Libido Changes During Pregnancy: What to Expect

Quick take: It's completely normal for your libido to fluctuate significantly during pregnancy. These shifts, whether an increase or decrease in sex drive, are primarily driven by hormonal changes, physical discomforts, and emotional adjustments. Open communication with your partner and redefining intimacy are key to navigating these changes.

The journey of pregnancy brings with it a kaleidoscope of changes, from morning sickness and growing bellies to profound emotional shifts. Amidst all these transformations, it's common for your sex drive, or libido, to take its own unique path. For some, the desire for intimacy might wane, while for others, it surprisingly intensifies. If you've found yourself wondering, "Is this normal?" or "What's happening to my body?", you're certainly not alone.

These fluctuations in libido are a deeply personal and often unexpected part of the pregnancy experience. They're influenced by a complex interplay of hormones, physical sensations, and emotional well-being. Understanding these underlying factors can help you navigate your experience with greater ease and communicate openly with your partner.

In this article, we'll explore the common reasons behind libido changes during pregnancy, what to expect in each trimester, and practical strategies for maintaining intimacy and connection with your partner, regardless of your sex drive. We'll also cover when it might be helpful to talk to your healthcare provider about your concerns.

Is it normal for your libido to change during pregnancy?

Yes, it is absolutely normal for your libido to change during pregnancy. In fact, it's more common for sex drive to shift than to remain exactly the same. Many women experience a decrease in their desire for sex, while a significant number find their libido actually increases. There's a wide spectrum of normal when it comes to sexual interest during this unique time in life.

Pregnancy is a period of immense physiological and psychological upheaval. Your body is undergoing rapid and profound changes to support a growing life, and these changes don't just affect your physical appearance; they deeply influence your energy levels, mood, and, yes, your sexual desire. It's not uncommon to feel confused or even guilty if your sex drive isn't what it used to be, or if it suddenly feels amplified. However, these feelings are a natural response to a very dynamic situation.

The key takeaway here is that whatever you're experiencing – whether it's a complete lack of interest in sex, a renewed passion, or a fluctuating pattern – it's a valid and common part of pregnancy. Your experience is unique to you, and there's no single "right" way for your libido to behave. We recommend acknowledging these changes without judgment and focusing on understanding their roots and finding ways to maintain connection in your relationship.

What causes a decrease in sex drive during pregnancy?

Hormonal Rollercoaster

Pregnancy is a symphony of hormones, and while essential for supporting your baby's development, they can wreak havoc on your libido. Progesterone levels surge throughout pregnancy, particularly in the first trimester, and this hormone can have a sedative effect, contributing to fatigue and a decreased sex drive. While estrogen levels also rise, which can sometimes boost libido, the dominant effect of other hormonal shifts often leads to a dampening of sexual interest for many.

Physical Discomforts

The physical demands of pregnancy are considerable, and they can leave little room for sexual desire. Common discomforts that can contribute to low libido include:

• Extreme Fatigue: Especially prominent in the first and third trimesters, profound tiredness can make the idea of sex seem exhausting. Many women report feeling too tired to even think about intimacy, much less engage in it.
• Nausea and Vomiting (Morning Sickness): Persistent nausea can make anything beyond basic survival unappealing. The thought of physical intimacy can be the last thing on your mind when you're battling an upset stomach. This is a significant factor for "no sex drive first trimester."
• Breast Tenderness: Hormonal changes can make breasts incredibly sensitive, even painful to touch, which can make certain types of physical intimacy uncomfortable.
• Pelvic Pressure and Discomfort: As the uterus grows, it can put pressure on the bladder and other pelvic organs, leading to a feeling of fullness or discomfort that isn't conducive to sexual arousal.
• Heartburn, Backaches, and Headaches: General aches, pains, and digestive issues can make it difficult to relax and enjoy sex.

Emotional and Psychological Factors

Beyond the physical, the emotional landscape of pregnancy is rich and complex. These feelings can significantly impact your desire for sex:

• Stress and Anxiety: Worry about the baby's health, labor and delivery, becoming a parent, or financial concerns can consume mental energy, leaving little for sexual thoughts. The weight of responsibility can be overwhelming.
• Body Image Changes: As your body changes rapidly, it’s common to feel self-conscious or less attractive. While some women embrace their pregnant form, others struggle with feelings of unfamiliarity or discomfort with their new shape. These "body image and libido during pregnancy" concerns can directly impact sexual confidence and desire.
• Fear of Harming the Baby: A common and understandable concern for many expectant parents is the fear that sex might harm the baby. While generally safe in uncomplicated pregnancies (as confirmed by organizations like the American College of Obstetricians and Gynecologists, ACOG), this worry can be a significant psychological barrier.
• Mood Swings: Hormonal fluctuations can lead to heightened emotions, irritability, or feelings of sadness, which can all dampen sexual interest.
• Lack of Sleep: Poor sleep quality, often due to physical discomforts or anxiety, can further contribute to fatigue and decreased libido.

One BumpBites reader shared, "In my first trimester, I was so nauseous and exhausted that the idea of sex was literally repulsive. My husband was understanding, but I felt guilty. It was like my body had completely shut down that part of me." This sentiment is incredibly common and highlights how deeply these factors can affect a woman's desire.

Why do some pregnant women experience increased libido?

While a decrease in sex drive is widely discussed, it's equally common and completely normal for some pregnant women to experience an unexpected surge in libido. If you find yourself feeling more amorous than usual, you're not alone, and there are several compelling reasons why this can happen.

Hormonal Boosts and Enhanced Sensation

Paradoxically, the same hormonal shifts that can dampen desire for some can ignite it for others. As pregnancy progresses, particularly into the second trimester, estrogen levels continue to rise. Estrogen plays a crucial role in sexual desire and arousal. This increase, combined with a significant surge in blood flow to the pelvic area and genitals, can lead to heightened sensitivity and increased pleasure during sex. Many women report:

• Increased Vaginal Lubrication: The enhanced blood flow can lead to natural lubrication, making sex more comfortable and enjoyable.
• Heightened Clitoral Sensitivity: Increased blood flow to the clitoris can make it more responsive and lead to more intense orgasms, or even easier arousal.
• Breast Sensitivity: While some find breast tenderness uncomfortable, others experience increased sensitivity that can be pleasurable and contribute to arousal.

These physiological changes, often peaking around the second trimester, are a key factor behind "high libido second trimester pregnancy" experiences.

Psychological and Emotional Factors

Beyond the purely physical, a number of emotional and psychological shifts can contribute to an elevated sex drive:

• Feeling More Connected to Your Body: For some women, pregnancy brings a newfound appreciation for their body's capabilities and its power to create life. This can lead to a sense of empowerment, sensuality, and increased comfort in their skin, which translates to a higher libido.
• Reduced Anxiety (After First Trimester): Once the initial fears of miscarriage subside and the worst of the first-trimester nausea and fatigue pass, some women feel a renewed sense of well-being and energy. This reduction in anxiety can free up mental space for sexual desire.
• Anticipation and Excitement: The profound experience of carrying a baby can make some women feel incredibly fertile, feminine, and alive. This heightened sense of vitality can naturally extend to sexual desire.
• "Babymoon" Phase: For some couples, pregnancy can be a time of increased closeness and connection, as they anticipate their new family. This emotional intimacy can foster greater physical desire.
• Absence of Contraception Worries: For couples who previously used contraception, the absence of concerns about preventing pregnancy can sometimes remove a mental barrier, allowing for more spontaneous and uninhibited sexual expression.

One expectant mother recounted, "After the morning sickness finally lifted, I felt this incredible burst of energy and just... desire. It was like my body was telling me, 'Hey, you're creating life, and you're amazing!' My husband was pleasantly surprised, to say the least." This demonstrates how a combination of feeling better physically and a positive psychological shift can fuel an increased sex drive.

How does libido fluctuate across each trimester of pregnancy?

The journey of pregnancy is often divided into three trimesters, and your libido can follow distinct, though highly individualized, patterns within each. Understanding these general trends can help you anticipate changes and normalize your own experience. Remember, these are common patterns, not strict rules, and every woman's body responds differently.

First Trimester (Weeks 1-13)

For many women, the first trimester often brings a noticeable decrease in libido. This is largely due to the intense hormonal changes and the onset of early pregnancy symptoms:

• Fatigue: Profound exhaustion is a hallmark of the first trimester as your body works tirelessly to establish the placenta and support early fetal development. This overwhelming tiredness can leave little energy for anything beyond daily essentials.
• Nausea and Vomiting: Often dubbed "morning sickness" (though it can strike at any time of day), persistent nausea can make physical intimacy the last thing on your mind. The general feeling of unwellness is a major contributor to "no sex drive first trimester."
• Breast Tenderness: Hormonal shifts can make breasts incredibly sensitive and sore, making touch uncomfortable.
• Anxiety: Early pregnancy can be a time of anxiety about miscarriage, the health of the baby, and the enormous changes ahead. This mental preoccupation can overshadow sexual desire.

During this phase, it's common for couples to scale back on sexual activity, prioritizing rest and comfort. Non-sexual intimacy, like cuddling and talking, often becomes more important.

Second Trimester (Weeks 14-27)

Often considered the "golden trimester," the second trimester frequently brings a resurgence or even an increase in libido for many women. This is when some experience "high libido second trimester pregnancy" due to a combination of factors:

• Increased Energy: For many, the intense fatigue and nausea of the first trimester begin to subside, leading to a noticeable boost in energy levels.
• Stabilized Hormones: While hormones remain high, the initial dramatic shifts that caused early symptoms often stabilize, allowing for a greater sense of well-being.
• Increased Blood Flow: Enhanced blood circulation to the pelvic area and genitals can lead to increased sensitivity, natural lubrication, and more intense orgasms, making sex more pleasurable.
• Reduced Anxiety: With the first trimester behind them and often having heard the baby's heartbeat or seen them on an ultrasound, many women feel more reassured and less anxious.
• Embracing Pregnancy: Some women begin to feel more comfortable and even sensual in their changing bodies during this phase, leading to a boost in confidence and desire.

This can be a time when couples reconnect physically, enjoying sex more regularly and perhaps experimenting with new positions to accommodate the growing belly.

Third Trimester (Weeks 28-40+)

As pregnancy progresses into the final trimester, libido often decreases again for many women. The physical demands become more pronounced, and the anticipation of labor and parenthood takes center stage:

• Physical Discomfort: The sheer size of the belly can make many sexual positions uncomfortable. Backaches, pelvic pain, heartburn, shortness of breath, and frequent urination are common, making it hard to relax and enjoy intimacy.
• Fatigue Returns: Carrying more weight and preparing for birth can bring back significant fatigue, similar to the first trimester.
• Nesting Instinct: A strong urge to prepare for the baby's arrival can consume mental and physical energy, shifting focus away from sexual desire.
• Anxiety about Labor: Thoughts about childbirth, pain, and the overwhelming responsibility of a newborn can become dominant, reducing sexual interest.
• Body Image: Some women may feel less attractive or simply too large to feel sensual in the final weeks.

During this trimester, many couples shift towards non-penetrative intimacy, focusing on cuddling, massage, and emotional connection. It's important to remember that these are general trends, and your personal experience may vary greatly.

Common Libido Patterns Across Trimesters

Tips for coping with low libido while pregnant and maintaining intimacy

Experiencing a dip in your sex drive during pregnancy can be challenging, both for you and your partner. It's important to remember that it's a common and normal part of the journey. The goal isn't to force desire, but rather to find ways to maintain connection and intimacy that feel good and authentic to both of you. Here's how you can cope and keep your relationship strong.

Open and Honest Communication is Key

This is perhaps the most crucial step. Your partner can't read your mind, and they might be feeling confused, rejected, or even worried about your relationship. Talk openly about what you're experiencing, including the physical discomforts, emotional shifts, and fears. Explain that it's not a reflection of your attraction to them, but a natural response to pregnancy.

• Share Your Feelings: Say something like, "I've been feeling really tired/nauseous/uncomfortable lately, and my sex drive has taken a hit. It's not about you, but about what my body is going through right now."
• Ask About Their Feelings: Encourage your partner to share their thoughts and feelings too. They might be experiencing "partner's libido during my pregnancy" changes, or have their own anxieties. Active listening is vital.
• Reassure Them: Remind your partner that you still love and desire them, even if your physical expression of that desire has changed. Focus on the intimacy you *can* share.

Redefine Intimacy Beyond Penetrative Sex

Sex doesn't always have to mean intercourse. Pregnancy offers a wonderful opportunity to explore and expand your definition of intimacy. Think about all the ways you can connect physically and emotionally without the pressure of penetrative sex:

• Cuddling and Hugging: Simple physical closeness can be incredibly comforting and reassuring.
• Massage: Offer or receive a back rub, foot massage, or shoulder massage. This can relieve pregnancy aches and foster physical connection without sexual pressure.
• Kissing: Deep, passionate kisses can be a powerful expression of desire and connection.
• Shared Activities: Engage in activities you both enjoy – cooking together, watching a movie, going for a gentle walk, or simply talking and listening to each other. Quality time strengthens bonds.
• Foreplay and External Stimulation: If penetrative sex feels uncomfortable or undesirable, focus on foreplay, manual stimulation, or oral sex. Many women find clitoral stimulation remains pleasurable, and sometimes even more so due to increased blood flow.
• Sensual Baths: Share a bath, focusing on touch and relaxation.

Practical Tips for When You Do Feel Like It

Even with low libido, there might be moments when desire sparks. Here are some practical considerations:

• Timing is Everything: If you have more energy at certain times of day, try to schedule intimacy then. For many, this might be in the morning after a good night's rest, or after a relaxing bath.
• Experiment with Positions: As your belly grows, certain positions become uncomfortable. Experiment to find positions that are comfortable and don't put pressure on your abdomen. Side-lying positions, spooning, or woman-on-top can be good options.
• Use Lubrication: Increased vaginal lubrication is common during pregnancy, but if you're experiencing dryness, don't hesitate to use a water-based lubricant to enhance comfort and pleasure.
• Focus on Pleasure, Not Performance: Let go of any expectations about orgasm or "perfect" sex. Focus on the sensations, connection, and pleasure of the moment.

Prioritize Self-Care

Taking care of your own well-being can indirectly boost your desire. When you feel better physically and emotionally, you're more likely to feel connected to your body and open to intimacy.

• Rest: Listen to your body and get enough sleep. Naps can be incredibly restorative.
• Nutrition: Eat a balanced diet to support your energy levels.
• Gentle Exercise: Activities like prenatal yoga or walking can boost mood and energy.
• Stress Reduction: Practice mindfulness, meditation, or deep breathing to manage anxiety.

Navigating increased sex drive during pregnancy: what to consider

While many women experience a dip in libido during pregnancy, an equally valid and common experience is an increase in sex drive. If you find yourself feeling more amorous, sensual, or "horny during pregnancy," it’s a perfectly normal and healthy response to the hormonal and physical changes happening in your body. The key is to navigate this heightened desire safely, comfortably, and in a way that aligns with your and your partner's comfort levels.

Reassurance About Sexual Safety

One of the first considerations for many experiencing increased libido is whether sex is safe during pregnancy. For most women with an uncomplicated pregnancy, sexual activity is generally safe throughout all trimesters. The baby is well-protected by the amniotic sac, the uterus, and a thick mucus plug that seals the cervix. Intercourse will not harm your baby. The American College of Obstetricians and Gynecologists (ACOG) confirms that sex is safe unless your doctor advises otherwise.

However, there are specific situations where your healthcare provider might recommend abstaining from sex. These include:

• A history of preterm labor or a high risk of preterm labor.
• Unexplained vaginal bleeding, spotting, or discharge.
• Placenta previa (when the placenta covers the cervix).
• Cervical incompetence (when the cervix opens prematurely).
• Ruptured membranes (your water has broken).
• If your partner has an STI that could be transmitted.

Always discuss any concerns with your OB/GYN or midwife. If you have been advised to abstain, focus on other forms of intimacy that are safe and pleasurable for both of you.

Open Communication with Your Partner

Just as with low libido, open communication is essential when you have a high sex drive during pregnancy. Your partner may not be experiencing the same surge in desire, or they might have their own anxieties about sex during pregnancy (e.g., fear of hurting the baby, or feeling unsure about your changing body). They might also be wondering about "partner's libido during my pregnancy."

• Express Your Desires: Clearly communicate your increased desire and what feels good to you. Say, "I've been feeling really turned on lately, and I'd love to connect with you physically."
• Address Their Concerns: Reassure your partner about the safety of sex if that's a concern for them. Share information from your doctor or reliable sources like BumpBites.
• Ensure Mutual Comfort: Make sure both partners are enthusiastic and comfortable with the level and type of intimacy. Consent is always paramount.

Embracing and Exploring Your Sexuality

This can be a wonderful time to explore your sexuality and deepen your connection. Here are some ways to navigate and enjoy your heightened libido:

• Experiment with Positions: As your belly grows, certain positions will become more comfortable than others. Side-lying positions, spooning, woman-on-top (which gives you control over depth and pace), or rear-entry can be great options, especially in the later trimesters. The goal is to avoid pressure on your abdomen.
• Focus on Pleasure: With increased blood flow and sensitivity, you might find that certain areas of your body are more responsive. Pay attention to what feels good and communicate this to your partner. Many women find clitoral stimulation or oral sex particularly pleasurable during pregnancy.
• Utilize Natural Lubrication: The increased blood flow often leads to more natural vaginal lubrication, which can make intercourse more comfortable and enjoyable.
• Incorporate Sensual Touch: Don't limit intimacy to intercourse. Explore full-body massage, extended foreplay, or simply sensual touching that builds connection and pleasure.
• Body Positivity: Embrace your changing body. Many women find their pregnant form incredibly sensual and powerful. Allow yourself to feel beautiful and desired.

Remember that while your libido might be high, your energy levels might still fluctuate, especially in the first and third trimesters. Listen to your body, prioritize rest, and communicate openly to ensure a fulfilling and safe intimate life during pregnancy.

When should you talk to a doctor about pregnancy libido changes?

While fluctuations in libido are a normal part of pregnancy, there are times when it’s wise to bring these changes up with your healthcare provider. Your doctor or midwife is there to support your overall well-being, which includes your emotional and sexual health. Don't hesitate to discuss any concerns that are causing you distress or impacting your relationship.

Here are some specific situations when you should consider talking to your doctor about libido changes during pregnancy:

• When Changes Cause Significant Distress: If your decreased or increased libido is causing you significant emotional distress, anxiety, sadness, or frustration, it's worth discussing. Mental health during pregnancy is just as important as physical health.
• If Libido Changes Are Severely Impacting Your Relationship: While some adjustments are normal, if the shifts in your sex drive are leading to serious tension, arguments, or a profound sense of disconnection with your partner that you can't resolve through communication, professional guidance can be beneficial. Your doctor might refer you to a therapist or counselor who specializes in relationship or sexual health during pregnancy.
• If You Have Persistent Pain or Discomfort During Sex: Any new or persistent pain during sexual activity (beyond mild discomfort from position changes) should always be evaluated by your doctor to rule out underlying medical issues.
• If Libido Changes Are Accompanied by Other Concerning Symptoms:
  • Unexplained vaginal bleeding or spotting: This is always a reason to call your doctor immediately.
  • Unusual discharge or itching: Could indicate an infection that needs treatment.
  • Severe mood swings, persistent sadness, or feelings of hopelessness: These could be signs of prenatal depression or anxiety, which can significantly impact libido.
  • New or worsening pelvic pain or pressure: Especially if it's not related to sexual activity.
• If You Have Safety Concerns: If you are unsure whether sex is safe for you due to a specific pregnancy complication (e.g., placenta previa, risk of preterm labor, cervical incompetence), always consult your doctor for personalized advice.
• If You're Feeling Isolated or Alone: Sometimes, simply talking to a professional can provide reassurance and validation, even if there's no "medical" issue. They can offer resources or strategies to help you cope.

Your healthcare provider can offer reassurance, rule out any medical causes for your symptoms, and provide tailored advice based on your individual health profile and pregnancy progression. They can also connect you with mental health resources if needed. Remember, your sexual health is an integral part of your overall well-being, and it's okay to seek support for it.

Myth vs. Fact

Myth: Sex during pregnancy will harm the baby.

Fact: For most healthy pregnancies without complications, sex is perfectly safe and will not harm the baby. The baby is well-protected by the amniotic sac, the strong uterine muscles, and a thick mucus plug in the cervix. However, certain complications may require abstinence, so always follow your doctor's specific advice.

Myth: All pregnant women lose their sex drive.

Fact: Libido changes are highly variable during pregnancy. While many women do experience a decrease, a significant number find their sex drive increases, especially in the second trimester. Some women experience no change at all. Every pregnancy and every woman's experience is unique.

Myth: My partner will lose attraction to me because of my changing body.

Fact: While body image concerns are common for pregnant women, many partners find their pregnant loved one incredibly beautiful and sensual. Any perceived lack of attraction is often more about communication, understanding, and the partner's own anxieties about the pregnancy or sex during this time, rather than a genuine loss of attraction. Open dialogue can address these concerns and strengthen your bond.

Key takeaways

• Libido changes during pregnancy, whether an increase or decrease, are completely normal and widely experienced.
• Hormonal shifts, physical discomforts (like fatigue and nausea), and emotional factors (like anxiety and body image) all contribute to these fluctuations.
• Libido often decreases in the first and third trimesters, while it may increase or stabilize in the second trimester.
• Open and honest communication with your partner is vital for navigating these changes and maintaining intimacy.
• Intimacy can be redefined beyond penetrative sex, focusing on cuddling, massage, shared activities, and emotional connection.
• For most uncomplicated pregnancies, sex is safe throughout all trimesters, but always confirm with your healthcare provider.
• Consult your doctor if libido changes cause significant distress, severely impact your relationship, are accompanied by pain or concerning symptoms, or if you have specific safety concerns.

Frequently asked questions

Is it normal for sex drive to change during pregnancy?

Yes, it's absolutely normal for your sex drive to change during pregnancy. Many women experience a decrease due to fatigue, nausea, and hormonal shifts, while others find their libido increases, often in the second trimester, due to improved energy and increased blood flow to the pelvic area. These fluctuations are a common and natural part of the pregnancy journey.

What causes a woman's libido to increase during pregnancy?

An increased libido during pregnancy is often linked to rising estrogen levels and increased blood flow to the pelvic region, which can heighten sensitivity and lead to greater arousal and pleasure. Additionally, some women experience a boost in energy in the second trimester and feel a stronger connection to their body, contributing to a higher sex drive.

Does sex drive come back after pregnancy?

For most women, sex drive does return after pregnancy, but the timeline varies greatly. Postpartum libido is influenced by hormonal shifts (especially during breastfeeding), fatigue from newborn care, physical recovery from birth, and emotional adjustments to motherhood. It can take several months or longer for libido to return to pre-pregnancy levels, and patience and communication are key.

Which trimester is libido highest?

While individual experiences vary, many women report their libido is highest during the second trimester of pregnancy. This is often attributed to a decrease in first-trimester discomforts like nausea and fatigue, a surge in energy, and increased blood flow to the pelvic area, which can enhance sexual sensation and desire.

How do you deal with no sex drive during pregnancy?

Dealing with low sex drive during pregnancy involves open communication with your partner, explaining that it's due to pregnancy changes, not a lack of attraction. Redefine intimacy through cuddling, massage, and quality time. Prioritize self-care like rest and nutrition, and experiment with comfortable sexual positions if desire sparks. Remember, it's okay to not feel like having sex.

Is it safe to have sex during pregnancy if my libido is low?

For most women with an uncomplicated pregnancy, sex is generally safe throughout all trimesters, regardless of your libido level. The baby is well-protected. If your libido is low, you don't have to force yourself. Focus on comfortable, mutually desired intimacy. However, if you have specific pregnancy complications, always consult your OB/GYN about sexual activity.

When to see a doctor or specialist

While changes in libido are generally normal during pregnancy, it's important to consult your healthcare provider, such as your OB/GYN or midwife, if you experience any of the following:

• Significant emotional distress: If your libido changes are causing you profound sadness, anxiety, or guilt that impacts your daily life or mental well-being.
• Severe relationship strain: If the changes are creating significant conflict or emotional distance between you and your partner that you cannot resolve together.
• Pain or persistent discomfort during sex: Any new or worsening pain should be evaluated to rule out underlying medical issues.
• Accompanying concerning symptoms: Such as unexplained vaginal bleeding, unusual discharge, severe pelvic pain, or signs of prenatal depression or anxiety.
• Safety concerns: If you have specific medical conditions or pregnancy complications (e.g., placenta previa, history of preterm labor, cervical incompetence) and are unsure if sex is safe for you.

Your healthcare provider can offer reassurance, rule out medical causes, and provide tailored advice or refer you to a therapist or counselor specializing in sexual health during pregnancy. Remember, this article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

References

1. American College of Obstetricians and Gynecologists (ACOG). (Accessed 2024). ACOG website
2. Mayo Clinic. (Accessed 2024). Mayo Clinic website
3. National Institutes of Health (NIH). (Accessed 2024). NIH website
4. Cleveland Clinic. (Accessed 2024). Cleveland Clinic website