Understanding and Managing Fatigue During Pregnancy

Fatigue during pregnancy is absolutely normal—especially in the first few months and the last trimester. For some women, fatigue is overwhelming. For others, it's relatively mild. Either way, it is part of the process of making a baby.

Why Does Fatigue Occur During Pregnancy? 

Numerous physical, emotional, and hormonal changes during pregnancy can lower your energy levels and cause fatigue. Contributing factors can include:

• Back, hip, and pelvic pain
• Digestion issues
• Increased levels of estrogen and progesterone
• Insomnia
• Lower blood pressure and blood sugar
• Morning sickness
• Stress and anxiety

First Trimester

For the first trimester, your body is working overtime—creating a placenta and revving up to provide the nutrition and support needed by a growing baby. Your metabolism increases, as does your blood flow, so your body needs more than its usual allotment of nutrition and rest.

The first trimester can also be a time of hormone-induced mood swings. These can be exhausting in themselves, especially if you're trying to avoid spilling the beans about your pregnancy until after the first trimester is safely complete.

Second Trimester

During the second trimester, your body levels off a bit. Yes, you're still eating and sleeping "for two," but now that the placenta has formed and your body has adjusted a bit, you may feel a little more energetic. Morning sickness is usually over by this point.

This is the trimester when you'll likely feel your best. It's a good time to get the nursery ready and complete any important tasks on your agenda—because you won't be feeling this energetic again for a while!

Third Trimester

As you move into the third trimester, you'll start to feel fatigue again. This time, the reasons are more visibly obvious:

• Carrying a great deal of extra body weight
• Difficultly sleeping, due to the baby's movements and trouble getting comfortable
• Digestion and constipation issues
• Swollen ankles and other physical issues
• Nighttime cramps and "restless legs"
• Anxiety about childbirth

How to Combat Fatigue

Fortunately, pregnancy is a time when friends and family often rally around to make things easier for the mom to be. If you're feeling exhausted, take advantage of any help that others offer. As you get bigger, it's harder to cope with ordinary household tasks, so ask for or hire support, if possible.

In addition, these tips may help ease pregnancy fatigue: 

Take a Short Nap

If you're not getting enough rest at night, find a quiet spot, and take a half-hour nap to help reduce fatigue. Avoid napping for too long, however, and too close to bedtime.

Practice Good Sleep Hygiene

This means going to bed and waking up roughly the same time every day. In addition, it's important to spend time in natural light during the day to help regulate your circadian rhythm.

Get Daily Exercise

The American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) recommend 2½ hours (150 minutes) of exercise each week. There are many benefits of exercise, including less fatigue and improved circulation, which will reduce nighttime leg cramps. Avoid exercising late in the day, though, as exercise releases adrenaline into your body, which can keep you awake at night.

Limit Your Caffeine

According to the March of Dimes and the ACOG, it’s safe for pregnant women to have up to 200 mg of caffeine per day. That is equal to roughly one or two 8-ounce cups of coffee.

Stick to Small Meals

Aim to eat small, nutritious meals throughout the day. This can help level out blood sugar, making you feel a bit more energetic during the day. 

Stay Hydrated

Maintaining adequate hydration is essential for your health and that of your baby, and it can help combat fatigue. Be sure to cut down on fluids before bedtime, however, to minimize frequent nighttime urination.

When to Call the Doctor 

While it's perfectly normal to feel tired during pregnancy, a sudden increase in fatigue is not normal. This may be a sign that something is not quite right with your pregnancy. Other issues that can arise include depression-related fatigue or fatigue due to anemia (lack of iron in the blood) or gestational diabetes.

If you're struggling with fatigue along with the following symptoms, call your obstetrician:

• Dizziness
• Heart palpitations
• Less frequent urination
• Pain in your upper abdomen
• Severe headaches
• Shortness of breath
• Swelling of ankles, feet, or hands
• Vision changes