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Coping with First Trimester Fatigue
Struggling with first trimester fatigue? Learn why early pregnancy exhaustion happens and practical ways to manage energy, nutrition and rest.
That all consuming feeling of exhaustion is often one of the first telltale signs that a new life is beginning to grow within. The depth of this exhaustion, often compared to jet lag, catches many expectant parents by surprise. First trimester fatigue goes way beyond a feeling of tiredness, it is a physiological response to the new life that has started to develop. The good news is that while it can feel incredibly overwhelming within those first weeks and months, it will usually subside by the time you reach the second trimester.
Why First Trimester Fatigue Happens
Hormonal changes
The biggest cause of early pregnancy exhaustion is the rapid rise in the hormone, progesterone. During the first trimester, progesterone levels rise significantly to support the lining of the womb and to help support a healthy pregnancy. Progesterone is well known for its sleep-inducing effect on the body's neurological system. This is demonstrated in research such as Nolan et al., (2021) who show how progesterone works on brain receptors, which can help you relax and sleep better. This hormonal shift often occurs before you even see that blue line on the pregnancy test.
Your body is working harder than usual
Hormones aside, your body is effectively building a new home for your baby. A brand new organ is being made in the form of a placenta and your body's blood volume is being doubled to support your developing baby. For your body to be able to withstand all of these physical changes, your heart needs to work much harder, and your body’s engine (your metabolism) has to speed up significantly.
These first three months have been described as a “maternal anabolic phase” (Parrettini et al., 2020) with the body focused on building up its energy and fat stores. While these physical adjustments are necessary and guarantee sufficient nutrients are available for your developing baby, they place a high energy strain on the expectant parent, right from the beginning.
Sleep changes in early pregnancy
Extreme fatigue in early pregnancy is often made worse by not being able to sleep properly. In addition to the body working hard behind the scenes, sleep is often more broken than usual. For example, it is common for sleep to be disturbed by needing to pass urine frequently or the onset of morning sickness. Other reasons include not being able to find a comfortable position, sore breasts or anxiety around the pregnancy. On top of that, early pregnancy hormones can make you feel more tired while also disrupting your usual sleep pattern, so even after a full night in bed, you may still wake up feeling drained rather than refreshed from restorative sleep.
Practical Ways to Cope with Early Pregnancy Fatigue
Prioritise rest without guilt
The trick to managing first trimester fatigue is to reframe how you view rest. It is a physical necessity rather than a luxury. It is important to remove any sense of guilt you may feel around it. During this phase it is crucial that you listen to your body and its needs. This might look like having a nap during the day or retiring to bed earlier than usual at night.
Eat little and often
What you eat and how often you eat will directly influence how you experience early pregnancy and tiredness. The goal is to keep your blood sugar levels as stable as possible as blood sugar crashes can have a negative impact on your energy levels.
Eating smaller, more frequent meals that are high in complex carbohydrates and protein are great for keeping blood sugar levels stable and for maintaining better and longer lasting energy levels. If nausea is a problem for you, it may be helpful to keep a snack such as a plain biscuit by your bed to eat before you get up. For more detailed advice you may wish to view HiPP's guide to eating well in pregnancy.
Support energy with balanced nutrition
Staying on top of good nutrition can support your energy requirements and help with extreme fatigue in the first trimester. Iron and Vitamin B are fundamental in maintaining good energy levels. Foods that are high in vitamin B include: Wholegrains, such as brown rice, barley and oats are excellent sources, particularly for B1 (thiamine) and B3 (niacin).
Many breakfast cereals are now fortified with the full spectrum of B vitamins. Eggs are one of the most convenient sources of B12 and biotin (B7). The yolk contains the highest concentration of these nutrients.
Leafy Greens including spinach, kale, and broccoli are famous for their high folate (B9) content, which is especially critical during the first trimester of pregnancy to support neural tube development. Legumes such as beans, lentils, and chickpeas provide a significant amount of folate (B9) and B6. They are also high in fibre, which helps maintain steady energy levels.
Meat and poultry are primary sources of B3, B6, and B12. Liver is particularly nutrient dense, though it should be eaten in moderation during pregnancy. Fish and seafood such as salmon and mackerel are rich in B12 and B3. Dairy Products include milk, cheese, and yoghurt provide good amounts of B2 (riboflavin) and B12. Seeds and nuts are great for B6 and biotin, making sunflower seeds or almonds a perfect snack for an energy boost.
You can find more information regarding the vitamins and supplements to take throughout pregnancy on our dedicated advice page.
Maintaining adequate iron stores is crucial. As your blood volume doubles, a deficiency in iron can lead to anaemia, of which the first symptom is extreme tiredness. A study by Means (2020) identified iron deficiency as a primary cause of fatigue in pregnancy. The main role of iron is to take oxygen all around the body. If the body doesn't have enough iron, this makes that job harder. This lack of oxygen stops the tissues from producing the energy your body needs, resulting in you feeling extremely fatigued and exhausted.
Making sure you are well hydrated will support energy levels. Even mild dehydration can cause blood pressure to drop, which in turn can further reduce energy levels. Aim to sip water regularly throughout the day. If you don't like or struggle to drink plain water, try adding a sugar-free cordial to make it more palatable.
Gentle movement can improve energy
It may sound counter-productive for energy levels, but putting on your shoes and heading out into the fresh air for a walk or doing a prenatal yoga session can actually improve your overall energy levels. Any activity that gets the body’s circulation going can improve your mood and energy levels. The aim is not high intensity exercise, but instead gentle movement that helps you feel more aligned and in tune with your changing body. Most people have a window of time during the day when they feel at their most productive. It’s always a good idea to reserve this time for your “must do” tasks
Plan your day around energy levels
It can help to think of your energy as something to budget, especially on the days when you feel most fatigued and don’t have much to spare. It is recommended to notice the times of day when you tend to feel at your best and use those small windows for the tasks that matter most, whether that is work, playing with your children, cooking or getting out for some fresh air. When your energy levels dip, allow yourself to slow down, relax when possible, and leave less important jobs for another day.
Don't be afraid to delegate tasks or ask for help with home life or work responsibilities, where possible. Limiting unnecessary personal or professional commitments, when you can, may give you the boost you need to get back on your feet again. Being selective about how you spend your energy can make everyday life feel more manageable and help you prioritise much needed energy for the things that are most important.
Managing fatigue at work
If you are working during your pregnancy, it can help to make some small changes to optimise your energy levels with work responsibilities. If possible, consider adjusting your work schedule so that the most demanding tasks occur at the times when you usually feel best. Some people find they have better energy in the morning, and others feel best later in the day. If this is the case, it’s advisable to plan meetings or important work around the peak energy periods.
Short, regular breaks can also be beneficial, especially in desk-based jobs that require sitting for long periods. A light walk or stretch for a few minutes can help feel more refreshed and improve energy levels.
Keeping healthy desk snacks close by, such as fruit, yoghurt, nuts or crackers, may also help you maintain your energy levels and avoid the slump in energy that can come from going too long without eating.
It can also help to be realistic about what your day needs to hold. Avoiding back-to-back meetings and leaving space between more demanding tasks can help time to reset. If your workplace supports flexible working arrangements, you could consider requesting temporary adjustments, such as reduced or flexible working hours, or more regular breaks. Finally, it is important to remember that pregnancy fatigue is very common. While it can feel frustrating, it is often temporary and commonly starts to ease as the pregnancy progresses.
When Does First Trimester Fatigue Improve?
For most expectant parents, first trimester fatigue begins to subside by the end of the first trimester. Once the placenta has become fully established, hormone levels stabilise and energy levels return. The second trimester has been nicknamed the ‘honeymoon trimester’ due to the welcome relief from nausea and extreme fatigue, for many.
When to Speak to a Healthcare Professional
While early pregnancy and tiredness are expected, there are certain circumstances where it will be important that you consult your health care provider.
If you have any tiredness or exhaustion that prevents you from carrying out your normal daily activities, or fainting or dizzy spells, it is important to let your doctor or midwife know. These can be signs that you have iron deficiency anaemia, which is often easily treated. It is always better to follow your gut instinct if you feel something is not right. If in doubt, get it checked out.
Looking after yourself is the single most important thing you can do for both yourself and your developing baby, right now. The first trimester is a time of substantial change. Tiredness is a symptom of the efforts your body is undergoing to support the new life growing inside of you. By incorporating rest, and ensuring adequate nutrition, you can navigate this tricky period with confidence.
FAQs about pregnancy fatigue
Yes, it is one of the most common symptoms and is caused by hormonal shifts and the enormous physical effort needed to grow the placenta and accommodate the increased blood volume.
It often starts just a few weeks after conception and before a missed period or a positive pregnancy test.
Prioritising sleep and short naps along with eating small frequent meals and staying hydrated can greatly help. Exercise like walking or prenatal yoga also improves circulation and energy.
Yes, a diet lacking in iron or B vitamins can lead to increased exhaustion. Keeping blood sugar stable with complex carbohydrates and protein is crucial.
In most cases it is perfectly normal, but you should consult with your midwife or doctor if the fatigue is accompanied by fainting, dizzy spells or if you feel unable to carry out your regular daily activities.
