Fatigue in Pregnancy
Written by Dr.M.D.Mazumdar, MD
Unfortunately, some women suffer from fatigue throughout their pregnancy.
If you feel that your fatigue is increasing rather than decreasing in the second trimester, or you feel unduly anxious or depressed, do contact your gynecologist as early as possible. It is possible that you may need treatment for your depression.
Causes of Fatigue in the First Trimester
Hormonal surgesAs soon as you become pregnant, the level of the hormone progesterone rises steeply. Progesterone is needed to maintain the pregnancy and help the baby to grow. But progesterone also causes the body to slow down. Metabolism of food slows down, the digestive process slows down and even your desire for any activity decreases.
But as you move into the second trimester beyond the 12th week, the increase in progesterone level is also more gradual giving your body time to adjust to it. You will begin to feel much better - more alert and less sleepy.
Lack of sleepEarly pregnancy is characterized by an increased frequency of passing urine. You may need to get up several times during the night to go to the bathroom, causing a break in the normal sleep cycle. This lack of sleep may make you feel exhausted during the day
Loss of a nourishing dietNausea and vomiting in early pregnancy can cause you to lose nourishment necessary to maintain your body. At this time the baby is also growing rapidly, drawing in food from your body, while your vomiting is preventing you from eating enough to replace the same amount of food. Inadequate diet in pregnancy can lead to the deficiency of essential nutrients. These causes can make you feel tired.
DehydrationMorning Sickness with nausea and vomiting also prevents you from taking in adequate fluids. Research has proved that even mild dehydration can make people feel tired and exhausted.
Mood swingsPregnancy can make many women feel worried and anxious. You may be worried about the outcome of your pregnancy, you may be worried about whether you will be able to cope with a newborn baby, or even with the stresses of pregnancy.
The surging hormones in pregnancy can also make you more prone to feel upset easily and lead to depression. This is emotionally draining, especially when you are at your most vulnerable stage of life, and leave you exhausted.
Tea, CoffeeMany women cut down abruptly on their caffeinated drinks like tea, coffee or cola as soon as they become pregnant. This can also lead to fatigue in the first trimester. But once the body adjusts to the decreased caffeine intake, you will feel much better.
Causes of Fatigue in the Third Trimester
Some of the previous causes will recur in your third trimester. Women who have had a number of children seem to suffer more at this stage than a woman who is pregnant for the first time.
- Lack of sleep: Insomnia or inability to sleep continuously for the whole night in the third trimester may be due to backache, abdominal bloating due to indigestion, severe heartburn and leg cramps. You may find that getting a comfortable position to sleep in gets more and more difficult as pregnancy advances, resulting in fatigue during the day.
The tendency for an increased need to pass urine at night also increases in this trimester as the enlarging uterus presses on the bladder. This can also result in loss of sleep at night.
Many women complain that the baby seems to move more at night than during the day. But this appears to be so simply because the women herself being at rest becomes more aware of the baby's movement.
- Increasing body weight: As your body weight increases, your posture during the day as well as during the night becomes uncomfortable and can lead to tiredness.
- Increasing size of the baby: This is another cause for a poor posture, backache, leg cramps and increasing fatigue.
- Emotional tensions : Tensions about the coming labor and childbirth can cause many women to have sleepless nights and fatigue.
- Nutritional deficiencies: Deficiencies of iron, vitamin B or many of the micronutrients can also cause fatigue.
What you can do about Fatigue
You cannot completely avoid feeling fatigued or exhausted. What you can do is to take certain measures that will decrease your fatigue and revitalize you to some extent.
- Take enough rest and sleep : A pregnant woman needs at least 10 hours of sleep in 24 hours. Aim for 8 hours at night and an afternoon nap of 2 hours after lunch. Go to sleep earlier and get up later in the morning if it is possible.
If you have to get up repeatedly at night to pass urine or find that other discomforts like backpain is keeping you awake at night, try to make up for it by increasing the number of times you rest during the day. Even 15 minutes of rest on the living room couch will help you feel better.
If you are a working woman, talk to your employers and see if they would give you a longer lunch break. Explain that you will be able to work better if you take a nap in the afternoon, rather than trying to work when you are fatigued.
If a longer lunch break is not possible, then try to take a quick catnap in your chair.
- Improve your diet : You need at least 300 extra calories every day. Eat every 2-3 hours to keep your blood sugar steady.
Deficiency of certain micronutrients in the diet during pregnancy can make you feel extremely tired. Of these, the most important is iron. Anemia due to iron deficiency can make you feel run down, fatigued and if severe enough, make you breathless. A simple blood test for the hemoglobin level in your blood can be diagnostic for anemia.
Deficiency of iodine, calcium and some of the Vitamin B's can also be responsible for your tiredness.
Diet in pregnancy should be a balanced diet with adequate nutrients. If you feel that your tiredness is increasing or continuing in the second trimester, consult your gynecologist for a proper diagnosis and treatment.
- Drink enough fluids : Dehydration, even mild dehydration can be responsible for extreme tiredness. Calculate the amount of fluid you are drinking in 24 hours. Remember that you need at least 1ml of water for every calorie of food that you eat. (1 standard teaspoon = 5ml).
- Exercise: Try and work in a mild exercise schedule. You will probably feel that you are just about sleep-walking your way through the day and taking exercise, even mild exercise, is just not possible. But slow stretching exercises will help to increase blood flow through your muscles making you feel better.
A short walk will give you plenty of fresh air. Mild exercise will also help you sleep better at night.
- Ask for help : Do not hesitate to ask your partner for help in doing the daily household chores. If you are a working women, ask your colleagues to help you out so that you can go home early once in a while. Promise to help them yourself when their time comes. Try to take an occasional day off in the middle of the week.
If you have other children, ask your extended family or relatives to look after them for a few hours. If you can afford it, hire a babysitter for an hour or two and catch up on your s sleep.
- Be patient : Above all, remember that you will soon be feeling better. And the joy of having your newborn in your arms will make you forget the problems during your pregnancy.
- Caring for a Pregnant Woman.
- Cephalo-pelvic disproportion during Labor.
- Breast Engorgement after Childbirth .
- Causes of Bleeding in Pregnancy.