--- title: 'What Causes Fatigue in Pregnancy and What Can Help?' slug: fatigue-pregnancy-causes-what-helps lifeStage: pregnancy category: Energy author: 'Samaira Farid' medicalReviewer: 'Dr Shree Datta, Consultant Obstetrician and Gynaecologist ' reviewerId: 'https://blog.bloume.com/pregnancy/medical-board.md#dr-shree-datta' lastUpdated: '2026-08-29' primarySource: 'Tiredness and sleep problems in pregnancy' wordCount: 894 readTimeInSeconds: 224 --- # What Causes Fatigue in Pregnancy and What Can Help? The bone-deep tiredness of early pregnancy, the broken nights later on, and the heaviness that makes small tasks feel like effort are among the most common parts of pregnancy. The tiredness can come from normal hormonal shifts, or from iron deficiency anaemia. Knowing which kind you are dealing with helps you respond to it more effectively, and recognise when it is worth raising with your GP or midwife. **Q: Is it normal to feel exhausted in the first trimester even before my bump shows?** A: Yes. The tiredness in early pregnancy comes from rising progesterone, the placenta starting to form, and your blood volume climbing, all of which begin before anything shows on the outside. Feeling wiped out this early is common. The exhaustion that lands in the first weeks of pregnancy can feel out of proportion to anything you have done. It is a heaviness that sleep does not always fix, and one that is hard to explain to anyone who has not felt it. Fatigue is one of the most common parts of pregnancy, especially in the first and third trimesters, and what drives it shifts as the weeks go on. Knowing what sits behind your tiredness, and what helps with each cause, lets you respond to your body more accurately instead of pushing through something that is worth a closer look. ## Why the first trimester feels so draining The tiredness in early pregnancy can feel closer to illness than ordinary tiredness, and it often arrives before there is any visible sign you are pregnant. A lot is happening at once. Progesterone, the hormone that rises in early pregnancy, climbs quickly. The placenta starts to form, and your blood volume goes up to supply it. All of that takes real energy, which is part of why you can feel so wiped out so early. For many pregnancies, energy picks back up in the second trimester. Your body settles into the hormonal shift, and the placenta becomes fully formed and takes over much of the hormonal work. ## Why fatigue returns in the third trimester The tiredness in the third trimester feels different. This time it is more physical than hormonal. The extra weight you are carrying, backache, leg cramps, and the struggle to find a comfortable position all make deep, restful sleep harder to get. Waking through the night to wee adds to it. The broken sleep builds up, and the daytime tiredness tends to grow heavier as the weeks go on. > **WARNING**: From 28 weeks, sleeping on your side lowers the risk of stillbirth, and either side is fine. If you wake up on your back, just turn onto your side and settle again. ## When fatigue in pregnancy has another cause Sometimes the tiredness is more than the usual workings of pregnancy. One condition in particular can leave you more drained, or drained for longer, than typical pregnancy fatigue. ### Iron deficiency anaemia If your tiredness feels heavy and hard to shake, low iron can be part of it. Iron deficiency anaemia is a common cause of pronounced fatigue in pregnancy. Your body needs more iron now to support a higher blood volume for both you and your baby. When your iron falls short of that, the tiredness can tip from draining into severe. You might also notice dizziness, breathlessness, or pale skin. Your midwife checks your blood count at routine antenatal appointments, but if the tiredness feels out of proportion, raise it with your GP or midwife rather than waiting for the next test. ### Broken sleep Poor sleep is its own driver of daytime tiredness, on top of the hormonal and physical changes. Discomfort, getting up to wee, and an anxious mind can break up your sleep night after night. That shortfall builds and follows you into the day. Where you can do something about the disruption itself, it often makes a real difference to how you feel. ## What helps with pregnancy fatigue For ordinary pregnancy tiredness, the things that help most often are rest, food, and gentle movement. Making sleep a priority, and resting in the day when you can, chips away at the shortfall. Eating regular, balanced meals in smaller, more frequent portions tends to keep your energy steadier than fewer big meals. Gentle movement like walking or swimming can ease tiredness, though it makes sense to dial the effort up or down depending on how you feel that day. When the tiredness comes from iron deficiency anaemia, the route is medical. Getting the right diagnosis matters. ## When to speak to your GP or midwife Call your GP or midwife if your tiredness is severe and sticks around, or if it comes with dizziness or pale skin (which can point to anaemia), or feelings of deep sadness or hopelessness (which can point to antenatal depression). Each of these is a good reason to get checked promptly. > **INFO**: If low mood, anxiety, or feelings of hopelessness are sticking with you during pregnancy, speak to your midwife or GP. They can refer you to NHS perinatal mental health services. --- **Q: Is it normal to feel exhausted in the first trimester even before my bump shows?** Yes. The tiredness in early pregnancy comes from rising progesterone, the placenta starting to form, and your blood volume climbing, all of which begin before anything shows on the outside. Feeling wiped out this early is common. **Q: How do I tell the difference between normal pregnancy fatigue and iron deficiency anaemia?** Ordinary pregnancy tiredness tends to track the trimesters and ease with rest. Tiredness from iron deficiency anaemia is often heavier, and can come with dizziness, breathlessness, or pale skin. The only way to confirm anaemia is a blood test. If you are not sure, raise it with your midwife or GP. **Q: Does sleeping position matter for tiredness in late pregnancy?** From 28 weeks, sleeping on your side is recommended to lower the risk of stillbirth, and it can feel more comfortable than lying on your back. Either side is fine. If broken sleep is really affecting your daytime energy, mention it at your next antenatal appointment. ### Clinical Sources - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Tiredness and sleep problems in pregnancy](https://www.nhs.uk/pregnancy/common-symptoms/tiredness/) - [Fatigue During Pregnancy](https://americanpregnancy.org/pregnancy/fatigue-during-pregnancy/) - [wales.nhs.uk](https://111.wales.nhs.uk/livewell/pregnancy/newmumssleep/) - [wales.nhs.uk](https://111.wales.nhs.uk/livewell/pregnancy/newmumssleep/) --- Reviewed by Dr Shree Datta, Consultant Obstetrician and Gynaecologist | [Medical Board](https://blog.bloume.com/pregnancy/medical-board.md) | August 2026