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First Trimester Fatigue

Is it common to be so tired in the first trimester of pregnancy?

Feeling super tired, don't have the energy to do much of anything, and craving your bed? For many people, the extreme tiredness (fatigue) of the first trimester is quite a surprise. And it’s an especially hard transition for those who are normally go-getters with lots of energy. People who usually need only 6 hours of sleep at night often find they need nearly double that during these first weeks of pregnancy. And for others, daytime tiredness is paired with trouble sleeping deeply. Or having trouble sleeping for more than a few hours at night. Nausea and vomiting can also be a big drain on your energy.

What causes the fatigue?

Fortunately, this is normal. It’s a signal from your body to slow down. And to give it time to adjust to the incredible changes happening inside. Hormone changes play a big role in making you feel tired, especially the hormone progesterone. This hormone rises sharply in the first trimester. In addition, your blood volume increases to supply the developing placenta and fetal circulation. This makes your heart pump faster and stronger. This results in faster pulse and breathing rates. Low iron levels can sometimes make you tired too. But this is more common later in pregnancy.

How long will the fatigue last?

For most people, the extreme fatigue of the first trimester is soon forgotten. That's because the second trimester often comes with a glow and a boost in energy. So don't worry if it seems like all you’re doing these first few weeks is lying around, dozing, or napping. This is normal. Fatigue often returns in the third trimester. This is because of disrupted sleep and increasing discomforts. But this will also get better over time.

What can you do to feel better?

  • Eat well. Good nutrition and eating small, frequent, healthy meals can help. This can keep you going. It can also help with nausea.

  • Take a break at work. You may feel sleepy at work. If so, try some stretches or deep breathing exercises. Or get up and walk around the office. Or take a break outside. 

  • Go for a walk. When you can, go for a brisk walk around the block. A little exercise can give you energy. And it may help you rest better when you do get to sleep.

  • Change your sleep habits. Take naps, if possible, during the day. You may also want to try going to bed earlier.

  • Drink enough fluids during the day. And drink very little starting a few hours before bedtime. This may help prevent you from having to get up to pee (urinate) at night.

What should you stay away from?

Don't give in to the urge to drink coffee or other caffeinated drinks to stay alert. The caffeine really isn’t good for your developing baby. Instead, drink plenty of water.

It's easy to feel guilty about not being able to do everything like you’re used to. It's OK to pamper yourself.  By reducing any extra job or social commitments during these first few weeks, you can be as productive as possible in your regular responsibilities.

Medical Reviewers:

  • Donna Freeborn PhD CNM FNP
  • Heather M Trevino BSN RNC
  • Irina Burd MD PhD