Fatigue in Pregnancy

July 03, 2009

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Fatigue in Pregnancy

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.

There are four time periods in pregnancy when fatigue is often significant: first trimester, near term, in labor, and postpartum.

Fatigue early in pregnancy

Early in pregnancy, most women feel severe fatigue. Many women find they can't get through the day without a nap, or that they go to sleep as soon as they get home from work. Why is this so? No one knows for sure, but there is probably a reason we have developed this tendency since it is so universal. Perhaps it is a signal for us to start listening to our bodies and treating ourselves well early in pregnancy.

Fatigue in late pregnancy

Mid-pregnancy, most women find that their energy level is back to normal or even increased. But by the end of pregnancy, the strain of carrying the extra weight makes most women again tire by the end of the day. Some women feel great right up until labor, while others already feel the strain by the sixth or seventh month. Women who have had many children often feel more fatigued. Whether this is due to the physical stresses of already having carried a few pregnancies or the responsibilities of the family isn't clear. The best you can do is to exercise regularly, get enough sleep when possible, and listen to your body when you need to rest.

Fatigue during labor

Fatigue in labor can interfere with labor's progress. Sometimes it can't be avoided, but here are some tips:

For first-time moms, try not to get too excited when you think labor is starting, particularly if it is evening or nighttime. Do not start timing your contractions until they are so strong that you can't have a conversation through them! So many first-time moms take such copious notes during their early labor that they exhaust themselves. As much as possible, ignore your contractions until they can't be ignored. Go about your normal activities, take a walk, stand in the shower, and if at all possible, SLEEP.

In active labor when you are working to get through each contraction, focus on relaxing between them. Consider a warm bath or shower if available. If you have chosen an epidural, try to sleep as soon as you are comfortable. There will be work to do later!

When you are , try to completely relax between contractions. Ask for help from your nurse or doula (birth attendant) so your pushing is effective. If you have an epidural, ask your practitioner if it is okay to wait until the baby descends more and you have an urge to push. Pushing without the urge can be ineffective and exhausting, particularly with a first baby. A common indication for is maternal exhaustion, in which the mother isn't able to make further progress pushing out her baby. Try pushing in different positions to see what works best. Sometimes squatting or pushing on all fours can help rotate a baby that is not coming easily.

Postpartum fatigue

Postpartum is a time that can be particularly exhausting. There is also a close relationship between postpartum exhaustion and post-partum (PPD). It is important to take care of yourself during this period, particularly the first 2-4 weeks after the baby comes home.

The secret of survival during this time is low expectations: set realistic goals, like getting the baby fed and changed as necessary and trying to eat, sleep, and shower when you need to. Notice that the list does not include meal preparations, cleaning the house, or entertaining guests!

If someone asks what they can do to help, here are some ideas: have them hold the baby while you take a shower, bring over a meal, do some laundry, do the dishes, empty the dishwasher, or clean up the kitchen.

As much as possible, limit guests to people who will really help you, and limit the time for visits from guests whom you might feel a need to entertain.

Tell your partner what you need; consider having your partner bring you the baby at night to nurse in bed.

If you get really exhausted, ask your partner to get up and feed the baby during the night, either with a bottle of formula or breastmilk that you pumped an hour after you nursed during the day. One whole night's sleep can make a huge difference.

If financially feasible, consider hiring a baby nurse or postpartum doula.

If you get totally exhausted or you begin to feel panicky, call your practitioner. Being tearful can be normal after the baby is born. Feeling hopeless or helpless, sleeping too much, or not being able to fall asleep all can be signs of depression.


RELATED INFORMATION

			Postpartum Fatigue
			Sleep Problems in Pregnancy
			Fatigue During Pregnancy

Created October 03, 2000
Reviewed August 14, 2004

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