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It's almost universal to feel tired in pregnancy. You may even feel more tired than you ever thought possible.
What is it?
Fatigue, and even extreme fatigue, in pregnancy is not only common but expected, especially in the first trimester. In most pregnancies, it tends to improve in the second trimester, but a lot of people experience it again in their third trimester and as you get closer to delivery. Increases in hormones like hCG (human chorionic gonadotrophin hormone), estrogen, and progesterone are the main causes of fatigue, as well as the intense work that your body is doing, running through incredible and dramatic transformations. All of this can result in feeling more tired than you may have ever thought possible.
How common is it?
Very common—almost universal in pregnancies. In fact, up to 90% report that they experience fatigue during pregnancy that interferes with their ability to function the way they did before they became pregnant.
How long does it last?
Fatigue varies for everyone, and every pregnancy is different, so the tiredness you may or may not experience now could be totally different in your next pregnancy and can be different to someone else, even if they are at the same point in their pregnancy as you. Fatigue is typically felt most intensely during extreme hormone shifts in the first trimester. In the second trimester, many people feel like they have more energy, and in the third trimester, for many people, the fatigue may return again.
Here’s a list of just some of the incredible bodily transformations taking place inside you during the first trimester that help explain some of why you might be feeling overwhelming fatigue:
Your blood volume increases by 50%
Your body’s blood volume increases by 50% throughout your pregnancy, resulting in lower blood pressure and a dip in iron levels as the body uses up its iron reserves to produce more red blood cells. The increased blood volume means your heart must work harder to pump more blood throughout your body, accelerating your heart rate by approximately 10-20 beats per minute. This increased work can also contribute to feeling exhausted.
Your body needs 20% more oxygen
The work of breathing becomes more demanding because your need for oxygen increases by 20% throughout pregnancy. This can lead to feelings of breathlessness and fatigue, though this is more common in the later stages of pregnancy when a fetus is also crowding your ribcage.
Nausea and vomiting can zap your energy
Nausea and vomiting affect 50-90% of all pregnancies, primarily due to the high levels of human chorionic gonadotrophin hormone (hCG) in the first trimester. Experiencing “morning sickness” (which for many can last all day and night) can quickly deplete your energy and hydration levels. Some medications that treat nausea and vomiting can also cause sleepiness. It is important to discuss your nausea and vomiting with your healthcare provider so that they can ensure you are hydrated and consuming enough to nourish yourself.
Your need for vitamins and nutrients increases
Changes in your metabolism and digestion also contribute to fatigue. During pregnancy, your need for essential vitamins, minerals, and protein increases as more nutrient stores are redirected to your growing baby.
You might make frequent trips to the bathroom overnight
The increase in blood volume, fluid, nausea and/or vomiting, and general bodily discomforts that accompany pregnancy can also make sleeping difficult, especially in the later weeks of pregnancy. Frequent trips to the bathroom throughout the night are common and can also make for poor sleep quality.
Pregnancy itself can just feel overwhelming
Pregnancy is an emotional process as well as a physical one. Beyond the physiological changes that occur, it can be a stressful time for many people. This time may feel overwhelming as you prepare for future parenthood. If you have previously experienced depression, anxiety, or other mental health conditions, you may need additional support during this time. Talking with your healthcare provider about how you are feeling is important.
- Postpartum support international hotline (call/text) 800.944.4773
- National suicide prevention hotline call/text 988
What can I do about it?
Fatigue can take a toll on you and can interfere with your ability to work and care for yourself and others, especially in the first trimester. Here are some things you can do to help cope with fatigue throughout pregnancy.
Rest whenever you can
Listen to your body and rest as often as possible. If your schedule allows, try to take short power naps during breaks. An earlier bedtime could be helpful if your schedule allows it. Read more about pregnancy sleep issues here.
Movement and walking can help improve fatigue
While exercise, even a neighborhood walk, may be the last thing you feel like doing when you’re exhausted, it can actually improve your fatigue. Several research studies found that physical activity a few days a week can positively affect energy levels while promoting general well-being and improving mental health. This is also true for alleviating postpartum fatigue. Establishing healthy activity habits during pregnancy can help you manage your energy after your infant is born. It is important to talk to your healthcare provider before starting any new exercise routine in pregnancy to ensure it is specifically safe for you and your pregnancy.
Prenatal vitamins and a balanced diet
The need for vitamins and nutrients increases in pregnancy, especially dietary folate, iron, and calcium, so eating frequent meals and snacks can help maintain energy levels throughout the day. Your healthcare provider will monitor your iron levels during pregnancy to determine if you need to supplement. Most prenatal vitamins contain iron.
Throughout your pregnancy, you can eat iron-rich foods like beans, lentils, enriched breakfast cereals, beef, turkey, liver, and shrimp. Try incorporating citrus (oranges and grapefruit) into your diet to help your body absorb iron. Keeping your glucose levels balanced by avoiding foods high in sugar can also help reduce dips in energy.Hydration is key in pregnancy
There has yet to be widespread consensus on how much water you should drink daily, but the general recommendation is to drink half your weight in ounces of water daily. If you’re exercising or are in a hot climate, you may need to increase your consumption. It may help to consume most of your water earlier in the day so you drink less before bed and reduce the likelihood of waking up to use the bathroom and interrupting your sleep.
Caffeine: yes, this is a quick fix, but it can actually cause more fatigue
While research does show that caffeine in moderation isn’t an issue during pregnancy, relying on it for energy can disrupt your sleep patterns and cause further fatigue.
When should I be worried?
If you think your fatigue is above and beyond what it should be, bring it up with your healthcare provider. They can identify or rule out potential physiological causes of fatigue (such as thyroid dysfunction, anemia, not responding to oral iron supplementation, or Lyme disease) and help you come up with a plan to manage your symptoms.
