Fatigue During Pregnancy

Nothing sounds more appealing or necessary most of the time than a plunge into your pillows. Sound familiar?

If it does, you're in good company. It's normal to feel tired when you're pregnant. Pregnancy fatigue can be especially pronounced early in the first trimester and again later, in the third.

Here's what to do about it, and when it might signal something more serious.

Is extreme fatigue normal in early pregnancy?

It's normal to feel fatigued and even exhausted during the first months of pregnancy. Fatigue, even extreme fatigue, is an early sign of pregnancy that nearly all women experience in the first trimester. It's also very normal in the third trimester, affecting an estimated 60 percent of all pregnant women.

What does pregnancy fatigue feel like?

Fatigue is officially considered a constant lack of energy. During pregnancy, you might feel like you can't get up in the morning or can't wait to hit the sack as soon as you get home in the evening. Or you may feel like you're just dragging and sluggish from the moment you get up to the time you go to sleep.

To keep track of what is normal fatigue for you, log how tired you are in the What to Expect app.

How early does pregnancy fatigue start?

Fatigue can begin in the very first weeks of pregnancy. Some women notice pregnancy exhaustion as early as one week after conception. Trusted SourceNational Institutes of HealthWhat Are Some Common Signs of Pregnancy?See All Sources ^[1]

While fatigue typically gets better around the start of the second trimester, it often returns in the third trimester, though like every symptom it can vary from pregnancy to pregnancy. Trusted SourceAmerican Academy of Family PhysiciansSleep and PregnancySee All Sources ^[2]

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What causes pregnancy fatigue?

Pregnancy is sort of like running a marathon while carrying a backpack that weighs a little more every day. In other words, it's hard work! While you're not aware what your body is up to, it's working harder than ever, even when you're at rest.

Causes of fatigue during early pregnancy 

In the first trimester, a number of factors may cause pregnancy fatigue, including:

• Building the placenta. Throughout the first trimester of pregnancy, your body is creating the placenta, an organ manufactured especially for pregnancy that supplies your baby with nutrients and oxygen necessary to grow and thrive. It's an enormous task that saps your body of energy.
• Your hormones. Pregnancy fatigue is primarily due to ramped-up production of the hormone progesterone, which supports your pregnancy and increases production of milk glands required for breastfeeding later on. Hormone changes can also cause mood upheaval, and riding the emotional roller coaster of pregnancy can be tiring.
• Increased blood supply. The demands of creating and pumping extra blood to supply your baby with nutrients and oxygen can make you feel fatigued. 
• Other physical changes. Your metabolism is running high, your heart rate is up, your blood sugar and blood pressure are down, and you're using more nutrients and water — all of which can wear you out. 

By the end of the first trimester, your body will have completed the Herculean task of manufacturing the placenta and grown a bit more used to the hormonal and emotional changes that have occurred, which means the second trimester is usually a time of renewed energy levels.

Causes of fatigue in the third trimester

Tiredness from early pregnancy could return with a vengeance later on in pregnancy. Third trimester fatigue is due to:

• Your growing baby bump. Your baby is growing fast, and you're carrying more weight than you were earlier on in pregnancy. Carting around all those pounds can be exhausting.
• Pregnancy insomnia and other symptoms. Your burgeoning bump along with pregnancy symptoms including heartburn, backache and restless leg syndrome may make sleep more elusive than ever. Trusted SourceMayo ClinicSleep During Pregnancy: Follow These TipsSee All Sources ^[3]
• The stress of having a baby. Your baby-overloaded life, which may be jam-packed with shopping lists, to-do lists, baby-name lists and other decisions to be made, could also be costing you sleep and energy.
• Multi-tasking. Add responsibilities like a job and other kids to the mix, and the fatigue factor often multiplies.

Can fatigue hurt my baby?

For the vast majority of women, fatigue during pregnancy is completely normal and won't harm you or your baby. In fact, it's a sign to get the rest you need.

After all, your body is undertaking the monumental task of making another human being, so it's normal to feel more tired. While you might think you could fall through the floor, your baby doesn't feel a thing. 

However if at any point during pregnancy your fatigue is severe and persistent, or if it lasts throughout your entire pregnancy, talk to your practitioner. Sometimes severe pregnancy fatigue can be a sign of a more serious condition that requires treatment.

Pregnancy fatigue remedies and tips

Fatigue during pregnancy is a signal from your body that you need to take it easier these days. So listen up, and get the rest you need. You may be able to recapture some of that get-up-and-go with the following tips:

Take it easy

If you don't already have a little one at home, enjoy this (last) chance to focus entirely on caring for yourself. 

If you already have kids, this isn't the time to be Supermom. Let the dishes wait until later, and try not to worry about constantly cleaning. Order your groceries online if that's easier for you. Choose healthy takeout instead of cooking sometimes, or ask your partner to take on kitchen duty. 

If you're able to hire someone to do the housework for you, all the better. Enlist help with checking off your to-do's, and don't book too many activities all at once if you can avoid it. 

Ask for help

There'll be no rest for the bleary-eyed in the months to come. Don't hesitate to let your partner, family and friends know how sapped you are so they can take on a fair share. 

If anyone in your circle asks about giving you a hand, say yes! Having someone else pick up the groceries can mean you might feel motivated to take an energizing walk or a stress-busting online yoga class. 

Push up your bedtime

Getting even an extra hour of sleep at night makes a huge difference in your energy levels during the day, and the easiest way to clock more Zzzs is to hit the sack earlier at night. A total of seven to eight hours is ideal; much more can actually leave you feeling more tired.

If you are struggling with aches and pains that keep you up, a pregnancy pillow may be worth the investment.

Prioritize rest and sleep

If you're tired, try to rest when you can, and pace yourself. Spend evenings relaxing with your feet up. Don't feel obligated to join a dinner with friends or an after-work (non-alcoholic, of course) drink with colleagues. 

Don't wait until nightfall to take it easy, either: If you have the option, take a brief snooze during the day. Not much of a napper? There's never been a better time to try! 

If you're at work all day, a nap may not be an option, but you'll likely find that putting your feet up at your desk or in a break room during lunch or downtime may give you a quick boost of energy or simply help with swelling in the feet and ankles in the latter part of pregnancy. 

Get your other children involved

If you have other kids at home, it's no wonder if you're feeling extra tired. (You might also fail to notice fatigue, since you're so busy.) Either way, it's not easy but still important to make yourself a priority.

Explain to your kids that you're feeling sleepy because growing a baby is hard work. Ask for their help around the house. Spend more time on quiet pursuits together, like reading, doing puzzles, playing doctor where you're the patient (or house when you're the napping child!), and watching movies. 

Squeezing in extra shut-eye may be difficult, but if you can time your rest with their naptime or quiet time, you may be able to swing it.

Choose healthy foods

Focusing on nutrient-packed foods will help keep your energy levels stable all day. Follow the guidelines for a good pregnancy diet, focusing on long-lasting energy found in meals that combine protein and complex carbs. Think: a tablespoon of peanut butter spread on whole wheat toast, or berries mixed into Greek yogurt.

Make sure you're getting enough calories (which may be easier said than done if you've got some morning sickness — but is definitely worth the effort). A well-balanced, healthy diet is key to a healthy pregnancy. 

Also scale back on the coffee and candy. If you typically reach for caffeine or sugar for your mid-afternoon slump, remember that the jolt they'll give you will likely be followed by an energy crash.

Eat often

Resist meal-skipping. Eating six small meals instead of three large ones can keep your blood sugar and energy steady. It'll also help reduce other common pregnancy symptoms, like morning sickness and constipation.

Get a move on

Sure, the couch has never looked more inviting. But paradoxically, the right amount of the right kind of exercise can be more rejuvenating than a sofa break. 

Take a hike in the woods, a slow jog around the block or park, a prenatal yoga class or even a short brisk walk to the grocery store when you can. Not only will you feel peppier (and happier thanks to those mood-elevating hormones, endorphins), but you'll sleep better at night. 

Plus, exercise is good for both you and your baby, in more ways than one. Just don't overdo it — you want to finish up your workout feeling energized, not exhausted.

Consider acupuncture

If fatigue is really dragging you down, consider acupuncture. Researchers have found that inserting needles at specific points that correspond to certain nerves leads to the release of endorphins, which may help relieve pregnancy fatigue as well as other pregnancy symptoms like headaches, nausea and backaches.

When to call the doctor

Though pregnancy fatigue is a totally normal symptom, if you're feeling unrelentingly tired or are otherwise concerned about your health, don't hesitate to check in with your health care provider. He or she can rule out any underlying conditions that may be causing your symptoms, which may include:

• Anemia: You're much more likely to experience a drop in red blood cell count after week 20, as your blood volume expands dramatically and depletes your iron stores. Beyond feeling extremely weak, other signs of pregnancy anemia include looking pale, feeling very breathless or having fainting spells.
• Hypothyroidism or hyperthyroidism: Having too little or too much thyroid hormone can show up for the first time during pregnancy and cause you to feel tired. You may experience other symptoms of thyroid problems during pregnancy, like sudden weight changes, temperature sensitivity, depression or irritability. 
• Gestational diabetes: If the body becomes resistant to insulin and less able to regulate the increased blood sugar of pregnancy, you may feel very tired (although it can be hard to differentiate from normal pregnancy fatigue). Watch for other gestational diabetes symptoms (like unusual thirst and frequent urination in large amounts), and be sure to attend all your prenatal appointments, including your glucose screening test at around 24 to 28 weeks. 
• Prenatal depression: Feeling fatigued and lacking energy beyond what's expected in a normal pregnancy may be a sign of prenatal depression alongside other symptoms like feeling sad or apathetic, or wanting to eat or sleep all the time (or not at all). If symptoms continue for longer than two weeks, let your doctor know so you can get connected with effective treatments.
• Chronic fatigue syndrome: In more rare cases, extreme fatigue may be a sign of chronic fatigue syndrome. While it usually isn't harmful to a fetus, it may be linked to a more serious form of morning sickness known as hyperemesis gravidarum.

Know that all of these pregnancy conditions are manageable and treatable, but you need to keep the communication lines open with your doctor. Seeing your practitioner regularly can help ensure you get the treatments you need, as necessary, to feel better.