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Key takeaways

• Feeling tired or exhausted is very common during pregnancy.
• Hormonal changes and physical discomfort often cause fatigue.
• Gentle exercise, healthy eating, and good sleep habits can help.
• Talk to your doctor or midwife if tiredness is severe or affects your mental health.

Why am I so tired during pregnancy?

It is common to feel very tired or even exhausted during pregnancy. This is especially true in the first 12 weeks. It can also be hard to get to sleep or stay asleep.

First trimester tiredness

During the first three months of pregnancy, hormonal changes can make you feel tired. You may also feel nauseous and emotional. You might feel completely exhausted after a normal day's activities.

Third trimester tiredness

Later in pregnancy, you may feel tired because of the extra weight you are carrying. Your bump can make it difficult to get a good night's sleep. You might find lying down uncomfortable.

You may also need to use the toilet more often which can disrupt your sleep. Hormonal changes and more blood circulating can make you feel too hot, which can also affect your sleep.

How tiredness can affect you

Feeling tired will not harm you or your baby. However, it can make life feel more difficult.

Discomfort, pain, sickness, and tiredness can affect your mind as well as your body. Understanding this link can help you look after both.

You may also have strange dreams or nightmares about your baby, labour, and birth. This is normal. Talking about them with your partner or midwife can help.

Tiredness and mental health

Sometimes, sleeplessness with other symptoms can be a sign of depression. If you have symptoms like feeling hopeless or losing interest in things you enjoy, speak to your doctor or midwife.

Tips for managing fatigue and improving sleep

There are many ways to help manage tiredness and improve your sleep during pregnancy.

Bedtime routine

Try to relax before bedtime so you are not wide awake. Relaxation techniques may help. Your midwife can offer advice.

Antenatal classes or pregnancy relaxation CDs might also be useful.

• Avoid caffeine – Do not have caffeinated drinks like tea, coffee, or cola in the evening. You should have no more than 200mg of caffeine a day during pregnancy.
• Avoid alcohol and smoking – These can harm your baby and stop you from sleeping.
• Limit screen time – Stay away from screens in the hour before bed. Bright light can make you more awake.
• Create a soothing routine – Have a warm bath or read a book.
• Go to bed at the same time – Try to keep a consistent bedtime each night.
• Make your bedroom calming – Keep it dark, quiet, and cool.

Do not take any sleeping pills or medications without speaking to your GP first. This includes over-the-counter aids.

Diet and hydration

Eating well and staying hydrated can help with tiredness.

• Healthy snacks – Stock up on healthy snacks that are easy to prepare. Good choices include raw vegetables with dip, a boiled egg, and wholegrain toast.
• Cook extra portions – When you cook, make extra portions to freeze for quick meals later. Soups and stews are easy to reheat.
• Limit sweet treats – Sweet snacks or processed foods give a quick boost but can lead to a crash later. Keep sweets, cakes, and biscuits as rare treats.
• Stay hydrated – Drink plenty of fluids, ideally 6 to 8 medium (200ml) glasses of fluid a day (about 1.6 litres). Drinking enough water can help you feel well and reduce tiredness.
• Check your urine colour – Your urine should be a pale, clear colour if you are drinking enough.
• Signs of dehydration – Symptoms of dehydration include feeling thirsty, dark yellow urine, and dizziness. Other signs are tiredness, a dry mouth, and infrequent urination.

Exercise

Regular exercise can help you feel less tired.

• Stay active – Try to do some activity, even if you feel tired.
• Gentle activities – Brisk walking, swimming, or using a static bike are good options.
• Antenatal classes – Consider joining an antenatal yoga or Pilates class. Make sure the instructor knows you are pregnant.
• Benefits of activity – Being active can give you more energy and help you cope better. It can also make you stronger and more flexible, which may help with labour and birth.

Napping strategies

• Avoid afternoon/evening naps – It is best not to nap in the afternoon or evening. This can make it harder to fall asleep at bedtime.
• Rest when you can – Try to rest whenever possible. If friends or family offer help, accept it to allow yourself time to rest.

When to talk to your doctor about tiredness

If lack of sleep is bothering you, talk to your partner, a friend, or your healthcare team (your doctor or midwife).

When to seek medical advice

• Extreme fatigue – If extreme tiredness makes everyday tasks a struggle, it might indicate heart strain. For example, you might find it hard to get dressed or prepare meals. This level of tiredness is unusual, so it is important to call your doctor or maternity unit.
• Palpitations with other symptoms – Seek urgent help if you have palpitations along with other symptoms. These include chest pain, breathlessness, or fainting.
• Anaemia – If your fatigue is not improving with the lifestyle changes this might be a sign of anaemia. Speak to your midwife or GP as this can be tested through a blood test if needed.
• Mental health concerns – Sleeplessness can be a sign of depression or anxiety. If you or your family are worried about your mental wellbeing, reach out to your GP or midwife for support.

It is important for you and your baby that you seek help for mental health concerns. The sooner you get support, the better you will feel.