Pregnancy Fatigue: Why It Happens and What To Do

Sure, you’ve been tired before. You’ve pulled the occasional all-nighter studying for finals. You’ve stayed out too late when you were having too much fun.

But pregnancy fatigue? That can hit differently.

It’s a kind of tired you can feel deep in your bones. That an afternoon nap doesn’t even scratch the surface of. That makes you yearn for an extra cup of coffee, even when you know you’re supposed to be keeping your caffeine intake low.

But you’re not alone. Feeling fatigued, or even flat-out exhausted, during pregnancy isn’t uncommon. In fact, it’s among pregnant people’s most frequent complaints.

We talked with Ob/Gyn Alison Stalzer, DO, about why pregnancy makes you so tired. And what to do about fatigue during pregnancy.

What is pregnancy fatigue?

Early in pregnancy, your body is working hard to set up shop to sustain healthy fetal development. And frankly, that takes a lot of energy.

First, there are the hormonal shifts that set the stage for sleepiness. Ramped-up levels of progesterone in particular can leave you exhausted.

What’s more is that during pregnancy, your blood volume increases, causing your heart to work harder with each beat. And even though you don’t notice it, it takes a lot of work to keep up.

And the mental and emotional load of being pregnant can be tiring, too. All the planning. The decisions to make. The prenatal appointments to juggle. The worry. The excitement. The financial questions. It can take up a lot of space in your brain. And leave you feeling tapped out.

Later on, your energy can be zapped by the physical toll of pregnancy. The aches. The discomforts. The middle-of-the-night trips to the bathroom.

It all adds up. And can leave you feeling like you’re running on fumes.

When does tiredness peak in pregnancy?

Pregnancy fatigue is usually at its height around the middle of your first trimester. That’s around weeks six to eight. But, of course, some people may find that their energy runs low sooner or later than that.

“Typically, we see that fatigue is worst in the first trimester,” Dr. Stalzer confirms. “Then, in the second trimester, you tend to get a little bit of burst of energy. In the third trimester, you may go back to feeling tired all over again.”

The reason for that?

Blame hormones for first-trimester fatigue. But as you’re in the homestretch of pregnancy, sleepiness is less about your body chemistry and more about the toll of lugging around a big bump all day — and the impact that has on your nights.

“In the third trimester, fatigue is more often related to the fact that it can be hard to sleep and you’re generally uncomfortable,” she adds.

Coping with pregnancy fatigue

Knowing that it’s normal to feel tired during pregnancy might be of little comfort when your entire body is protesting getting out of bed each morning. Not to mention staying awake throughout the day.

We get it.

And while it may seem like more sleep is the only way out of this fog (and it will certainly help!), there are some other ways to help get a bit more pep in your step.

Here’s what to try:

• Pregnancy-safe exercise. Yes, it sounds counterintuitive (How can you possibly ask me to hit the treadmill at a time like this?!), but getting your body moving releases endorphins — feel-good chemicals that can help increase your energy levels. Talk with your healthcare provider for recommendations of exercises to try and to avoid. You may be advised to adjust your fitness routine during pregnancy.
• Stay hydrated. Good ol’ H2O can help your body go about its business of caring for you and the developing fetus. Drinking enough water can help all your body’s processes do their job more efficiently — and drain less of your energy in the meantime. How do you know if you’re getting enough? Look for urine that’s light yellow in color.
• Limit caffeine. Sure, a double shot of espresso or your favorite energy drink might look tempting right now. But limiting your caffeine to no more than 200 milligrams a day (about two small cups of coffee) is important to a healthy pregnancy. What’s more, a caffeine crash isn’t going to do your fatigue levels any favors.
• Eat a balanced diet. Yes, it can be tough to eat well while you’re pregnant. Especially when you’re tired and (potentially) nauseated. But if you can aim for eating a mostly healthy diet with plenty of fruits, vegetables and lean protein, it can help keep your body nourished and your energy levels higher. Not sure where to start? Consider these fatigue-fighting foods.

When to see a healthcare provider

Yes, tiredness comes with the business of pregnancy. But extreme fatigue that lasts into the second trimester may also be a sign of an underlying health condition.

During your prenatal appointments, your Ob/Gyn or midwife should screen you for thyroid disease, which can complicate pregnancy and leave you extra sleepy.

Sleep apnea may also be a concern. That’s true especially if you were diagnosed or were at risk for sleep apnea before pregnancy.

Bottom line? If fatigue is affecting your day-to-day, talk with your healthcare provider to rule out an underlying health condition. And they may suggest pregnancy-safe medications to help you get the rest your body needs.