Pregnancy Fatigue: An Exhaustive Guide to Your Exhaustion

While most parents-to-be expect to be tired once the baby arrives, many are thrown for a loop when the exhaustion of pregnancy kicks in. And it kicks in quick! Before your bump appears, before any gender reveals, before you start a baby registry, your little one will make their presence known by bringing the yawns to you earlier and earlier each day. If you’re nodding off on the couch, dragging yourself through the workday, or sneaking catnaps, you might be wondering: When does pregnancy fatigue end? And, What can I do about pregnancy exhaustion? For answers to all your pregnancy fatigue questions, keep reading!

What does pregnancy fatigue feel like?

Pregnancy fatigue hits different than run-of-the-mill feeling tired. Pregnancy fatigue is often a persistent and constant feeling of sleepiness that isn’t always made better by sleeping more. At the same time, pregnancy fatigue has been known to hinder your day-to-day activities.

Signs of Pregnancy Fatigue

• Difficulty getting out of bed in the morning
  
• Feeling sleepy throughout the day
  
• Sleeping more than usual
  
• Difficulty focusing
  
• Struggling to finish everyday tasks
  
• Irritability
  

Is it normal to feel tired all the time during pregnancy?

Yes! During early and late pregnancy, it’s incredibly common to feel very tired. In fact, roughly 94% of parents-to-be suffer from fatigue during pregnancy, notes a 2021 report in the journal Sleep Science.

What causes pregnancy fatigue?

There are a several factors that can cause pregnancy fatigue, including:

• Hormones: During your first trimester, your body produces way more of the hormone progesterone than usual. This is to thicken your uterine lining and keep ovulation at bay. But progesterone is also known as the “relaxing hormone” because it has a mildly sedative effect. Translation: The uptick of progesterone makes you sleepy.
  
• More blood volume: Your blood volume increases during pregnancy and, because of that, your heart pumps harder and stronger than normal…which ups your metabolism, lowers your blood sugar, and depresses blood pressure. All these factors contribute to feeling fatigued in pregnancy.
  
• New organ: Not only are you growing a brand new human, your body is responsible for creating an entirely new organ, too—the placenta! All of this so-called “passive work” saps your energy.
  
• Morning sickness: Nausea and vomiting related to pregnancy can be a big drain on your energy.
  
• Emotions: Stress—about pregnancy, your baby’s health, finances, or anything in between—and other big emotions can contribute to pregnancy exhaustion.
  

Extreme Pregnancy Fatigue: When to Worry

At times, pregnancy fatigue may be a sign that something bigger is going on with your pregnancy. For example, conditions such as anemia, gestational diabetes, thyroid issues, and prenatal depression can greatly impact your energy levels during pregnancy. 

Pregnancy fatigue can be a symptom of:

• Low iron level: While most prenatal guidelines recommend screening for low iron levels during pregnancy, only 40% of pregnant folks actually get screened for iron deficiency anemia. If your doc or midwife hasn’t tested you, ask! 
  
• Gestational diabetes: At the end of your second trimester, you’ll be given a glucose test to detect early signs of gestational diabetes. If you’re one of the 3 to 6% of parents-to-be with gestational diabetes, your healthcare provider will work closely with you to help you manage it, which will also help with fatigue.
  
• Hyperthyroidism: Tiredness is a tell-tale of hyperthyroidism in pregnancy…along with a fast and irregular heartbeat, shaky hands, and unexplained weight loss during. If your healthcare provider suspects hyperthyroidism, they’ll order blood tests to measure your thyroid hormone levels.
  
• Depression: Beyond exhaustion, feeling sad, tearful, or apathetic are signs of prenatal depression. Other signs may include sudden change in appetite, unable to find pleasure in activities that you used to enjoy, and thoughts of self-harm. If you suspect you may be dealing with pregnancy depression, do not hesitate to reach out to your nurse, midwife, or doctor, who will collaborate with you on next steps. 
  

It’s important to note that, regardless of what’s behind your pregnancy exhaustion, severe fatigue during pregnancy can be dangerous. Research shows that extreme exhaustion can increase your risk of preterm labor and cesarean birth. It can also factor into prolonged labor  and postnatal depression. If your pregnancy fatigue is persistent and feels severe, do not delay flagging it for your care provider.

How long does pregnancy fatigue last?

While tiredness in pregnancy is often dubbed “first trimester fatigue,” that’s misleading. The truth is, fatigue often hits hard during the first 12 weeks of pregnancy, recedes during the second trimester, then returns during the third trimester. In fact, a 2021 report found that pregnant individuals experience the most exhaustion during the third trimester. Part of the reason? In the third trimester, you are not only dealing with the physical demands of carrying a larger baby, that big baby can make it more difficult to sleep. (Learn how to sleep better during pregnancy.)

How do you fight pregnancy exhaustion?

While you can’t do anything about fatigue-inducing pregnancy hormones or blood volume, that doesn’t mean you’re powerless against pregnancy exhaustion. For help putting a little more pep in your step, try these exhaustion-fighting tips:

• Eat often. Eat three meals (they can be small) and two to three snacks daily. This helps keep your blood sugar stable and your energy up. At the same time, this eating strategy can thwart energy-sapping nausea, which can get worse when your stomach is empty. (Learn more about tamping down morning sickness.)
  
• Prioritise protein- and iron-rich foods. Including protein-packed foods in each meal helps stave off nausea and increases energy. And an iron-rich protein source (lean red meat, poultry, seafood, beans) will help combat iron deficiency, to boot.
  
• Move your body. When naps are a no-go, try some stretches, deep breathing exercises, or go out for a walk outside. All of the above can help to energise you—and may even help you rest better at night. 
  
• Get more sleep. Obvious? Yes…but still important! If you’re a natural night owl, hit the hay an hour earlier than usual, aiming for eight hours of sleep each night—and sneak brief naps during the day, if you can!
  
• Drink water this. Drink lots and lots of water during the day, but very little in the few hours before bedtime to help curb how many times you have to get up to pee in the middle of the night.
  
• Ask for help. Offload some of your typical household responsibilities until your energy returns. Order groceries online, designate your partner meal-maker, and/or consider hiring a house cleaner at least temporarily.
  

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REFERENCES

• UnityPoint Health: What Does Fatigue Feel Like?
• American College of Obstetricians and Gynecologists (ACOG): Having a Baby
• Fatigue and sleep quality in different trimesters of pregnancy. Sleep Science. January - March 2021
• Cleveland Clinic: Progesterone
• Yale Medicine: Women, Are Your Hormones Keeping You Up at Night?
• Stanford Health: First trimester fatigue: How long it lasts, how to ease it
• Penn Medicine, Lancaster General Health: Is This Normal? Pregnancy Exhaustion Edition
• Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnant Women: A Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Agency for Healthcare Research and Quality. March 2015
• Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Advances. November 2021
• National Institute of Diabetes and Digestive and Kidney Diseases: Thyroid Disease & Pregnancy
• Kaiser Permanente: Fatigue During Pregnancy
• Nausea and vomiting of pregnancy. Gastroenterology Clinics of North America. June 2011
• Johns Hopkins Medicine: First Trimester Fatigue

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider. Breastmilk is the best source of nutrition for babies. It is important that, in preparation for and during breastfeeding, mothers eat a healthy, balanced diet. Combined breast- and bottle-feeding in the first weeks of life may reduce the supply of a mother's breastmilk and reversing the decision not to breastfeed is difficult. If you do decide to use infant formula, you should follow instructions carefully.