Pregnancy Fatigue Is So Real—Here Are Some Things That Can Help

Of all the pregnancy symptoms—morning sickness, swollen ankles, lightning crotch, to name a few—fatigue is the one that I heard people talk about the most before I got pregnant myself. My friends told me the first trimester was torturous: They shared stories about how they could barely keep their eyes open, but it was still too early in their pregnancies to tell their friends or coworkers, so they just had to suck it up and pretend they weren’t fighting to stay awake every moment. Considering experts recommend limiting your caffeine intake to under 200 mg a day during pregnancy, no one has any quick fixes or remedies to share.

Though I was tired in the first trimester, I didn’t experience that all-consuming type of exhaustion until I was about 31 weeks pregnant. It honestly hit me like a ton of bricks—I suddenly needed a nap just two hours after waking up, and had to stop working earlier in the day because I was so tired my brain just stopped working. So I started to wonder, What’s an exhausted pregnant person to do? After speaking with a number of experts, I learned there’s no magic remedy. But it turns out that zeroing in on healthy habits is your best bet to make it through.

Here’s why pregnancy makes you so stinkin’ tired and what experts suggest doing to maintain as much of your energy as possible.

When are you most likely to feel pregnancy fatigue and why?

“Fatigue is one of the most common pregnancy symptoms, right up there with nausea,” Clara Paik, MD, vice-chair of the department of obstetrics and gynecology and chief of the division of gynecologic specialties at the University of California, Davis, tells SELF. The main reason? Your body is working really dang hard to foster this new pregnancy.

“Your blood volume is increasing, your placenta is forming, you’re growing a baby, and that takes a lot of work and energy,” Dr. Paik says. Another thing that happens in early pregnancy is the hormone progesterone increases drastically. “That hormone in particular can make a person sleepy,” Dr. Paik says.

Many pregnant people describe first-trimester fatigue as all-consuming and unrelenting. “It is sort of an overwhelming fatigue, where you almost feel like you are sedated,” Angela Bianco, MD, director of maternal-fetal medicine at the Mount Sinai Health System and professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai, tells SELF. It’s even worse if you’re pregnant with multiple babies.

“In the second trimester, once progesterone levels have sort of plateaued, most people feel better,” Dr. Bianco says. “It’s called the ‘golden trimester’ because you’re feeling your best and some people even feel a burst of extra energy.” It’s unclear if that’s just because they’re comparing it to the first trimester or if there’s an actual surge in energy beyond prepregnancy levels during this time, she adds. Either way, there’s no denying that people tend to feel comparatively more energized. I didn’t think I had terrible first-trimester fatigue, but I definitely noticed a difference in the second trimester. I’m sure my energy did tank, but I was also just distracted by the excitement, the nausea, and honestly, the start of summer and extra hours of sunlight.

In the third trimester, a lot of people feel exhausted again but for different reasons. “Towards the end of pregnancy, fatigue is more from not being able to sleep as comfortably, thanks to a big belly, back pain, other musculoskeletal issues, and worry about if you’re sleeping the right way,” Dr. Paik says. General anxiety about the pregnancy and impending labor, plus symptoms like acid reflux and constipation, can also make it more difficult to sleep soundly.

Other physiologic changes can also zap your energy, Dr. Bianco says. “Now you have a larger fetus and placenta, gallons of amniotic fluid, and your plasma volume has almost doubled,” she says, explaining that all of these things require a lot of energy to carry around and support. The increase in plasma volume—the volume of blood circulating through your body—can also dilute the red blood cell concentration, potentially leading to anemia, Dr. Bianco explains. (Anemia during pregnancy can also be caused by iron deficiency, which can have multiple causes including insufficient dietary intake, increased demand for iron as the fetus develops, or impaired iron absorption from the gut.) One of the biggest symptoms of anemia? Yup, fatigue.

How to stay as energized as possible during pregnancy

Some amount of fatigue is inevitable during pregnancy. But there are definitely some things you can do to keep your energy levels as high as possible so that you can make it through each day.

Getting good sleep is, of course. important if you want to feel as energized as possible. The problem is that pregnancy also makes it hard to do that, especially in the third trimester. “Sleeping becomes more difficult later in pregnancy because you’re uncomfortable, whether because of trouble with digestion, you just can’t find a comfortable position, or you’re getting up frequently to urinate,” Dr. Bianco says. Many of us get lucky with all three (raises hand).

Dr. Paik suggests trying to aim for an extra hour of sleep than you’d usually plan for. That way, you can still clock a good amount when you subtract the time it took you to fall asleep or the times you woke up to pee. Taking measures to prevent acid reflux at night (like avoiding triggers, eating dinner a few hours before bedtime, and sleeping slightly propped up if that’s comfortable for you) and avoiding chugging water too late at night can help.

Practicing good sleep hygiene can make a big difference too, Dr. Paik says. “Make it easier for you to sleep by making sure you’re sleeping in a dark room and that it’s not too hot,” she adds. And of course, experts recommend sticking to the usual recommendations of avoiding screens and blue light an hour or so before bed and cutting off caffeine in the early afternoon.

It may sound counterintuitive to exercise when you’re exhausted, but hear me out: Regular movement improves endurance and blood flow throughout the body, which ultimately helps you feel more energized. “Even though you may not feel like exercising because you’re tired, there’s some renewal of energy with exercise—you just kind of feel more refreshed,” Dr. Paik says. “Sometimes that helps you sleep better at night as well.”

FYI, walking counts. It’s actually a great way to exercise when you’re pregnant. Don’t think you have to take a workout class or do something totally draining for it to “count.” Just moving in the ways you can will be extremely beneficial.

Before I got pregnant, working out in some form was a must for me every day. It has always helped me keep my stress levels under control and sleep like a baby. During pregnancy, I’ve tried my best to keep up with movement in ways that feel doable for me. On the days when I am so tired I don’t want to get up off the couch, I promise myself to just take one slow lap around the block. I almost always end up doing an extra lap or two because once I get moving I feel more awake and energized. (And on the days I’m really not feeling up to it, I listen to my body and promptly go back home to sit or lie down again.)

Even if you had relatively low levels of anxiety prepregnancy, I can assure you that you’ll experience it tenfold throughout these 40ish weeks. There are so many changes happening in your body, so many things to think and worry about in regard to the fetus’s development, impending labor, and an enormous life change on the horizon, whether it’s your first kid or not.

It’s totally understandable to have some sort of anxiety about all of that. (FWIW, I am a very low-stress person and have experienced my fair share of worry and anxiety throughout my own pregnancy.)

“A lot of those stresses and anxieties can definitely interfere with sleep and can make you tired during the day as well,” Dr. Paik says.

Finding a way to de-stress and calm your mind is essential. The best method is going to look different for everyone, but here are a few things to try: prenatal yoga, mindfulness meditation, deep breathing exercises, getting regular prenatal massages, going for walks, and connecting with people you love. Walking and at-home Peloton classes have been an important outlet for me. Another one of my go-to stress relievers: baking and cooking.

Let me first acknowledge that I know this is not possible for everyone. Depending on your job and if you’re running after other kids all day long, napping may be an absolute impossibility. But for those who are privileged enough to work from home or otherwise have a flexible schedule, I highly recommend taking advantage during this time.

Dr. Bianco suggests napping during the day if you can, even if it’s just for 20 minutes. When I feel too tired to keep working or get anything else done, I’ll lie down, set an alarm for 30 minutes (working in some time to actually fall asleep), put on an eye mask, and snooze away. On the weekends, I’ll nap for a lot longer if I feel like I need it.

Food gives you energy, so you want to make sure you’re loading up on stuff that’s full of nutrients and giving your body what it needs to keep chugging along at its new, high level. “Sometimes it’s hard to do that early on, because you’re combating nausea and vomiting and can only tolerate what you can tolerate,” Dr. Bianco says. If you’re not getting enough of your essential nutrients (and maybe loading up on simple carbs that don’t exactly give you sustained energy, like I did all first trimester) this can also contribute to fatigue.

Dr. Paik recommends avoiding foods that can make you lethargic and focusing on getting lots of nutrient-dense veggies, fruits, and protein. Iron-rich foods, like lean red meat, spinach, and dried beans, are important too, since, again, it’s common to become anemic during pregnancy. If you can’t get enough iron naturally through your diet and your bloodwork shows you’re anemic, your doctor will either recommend you take a prenatal vitamin with iron in it or a dedicated iron supplement. In some cases, you may benefit from iron infusions, Dr. Bianco adds.

The fact that pregnancy itself is so draining can also hide potential underlying conditions or health issues contributing to your fatigue. If your exhaustion is really bad, Dr. Paik recommends seeing your doctor to make sure nothing else is going on. How bad is really bad? “If you’re unable to get up to go to work in the morning, you can’t function during the day, you have to go home because you have to take a nap, people are telling you you’re falling asleep all over the place, or you can’t drive because you’re so fatigued, these are abnormal signs of fatigue,” she says.

Your doctor can check for anemia, other nutrient deficiencies, and rule out other common causes of fatigue, like a thyroid disorder, Dr. Paik says. Identifying and hopefully solving any underlying issues can help put some pep back into your step. And if you learn your fatigue is truly just a side effect of pregnancy, then your doctor can help suggest ways to work the energizing healthy habits above into your daily routine in ways that are doable for you.

Related:

• 5 Things I Learned From Dealing With Unrelenting Acid Reflux During Pregnancy
• Yes, RSV Can Spread to Adults From Kids—Here’s Why That Matters Right Now
• How to Prepare for the Emotional, Physical, and Social Realities of Life Postpartum