What causes second-trimester fatigue?

It is common to feel fatigued at any point of your pregnancy, not just in your second trimester. This can result from health conditions such as anemia or sleep disorders. Recognizing the signs of fatigue can help you receive treatment more quickly.

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How tired should I be?

When you’re pregnant, it’s very common to feel tired out. After all, your body is busy growing a new human. But while exhaustion might be a sign of pregnancy, you shouldn’t feel rundown for the entire 9 months.

It’s common to feel more tired than usual during early and late pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG). However, if you notice persistent, unusual fatigue during your second trimester, you may want to speak with a doctor to rule out an underlying medical issue.

What can cause fatigue during pregnancy?

Several pregnancy-related health conditions can decrease your energy levels and leave you feeling fatigued. This includes:

Anemia

When you’re pregnant, your risk of iron-deficiency anemia increases. This means your body isn’t producing enough red blood cells to carry oxygen to your body’s tissues. Your body needs more iron than usual because you’re also carrying blood and oxygen to the fetus.

According to the World Health Organization (WHO), the prevalence of anemia in pregnancy is 36.5% globally.

Your risk may increase if you:

• have had two pregnancies back-to-back
• are carrying multiples, such as twins or triplets
• regularly experience morning sickness

You may experience frequent headaches and mood changes, although these symptoms are common throughout pregnancy, regardless of whether you have anemia.

More telling symptoms of anemia include brittle nails, a sore tongue, and a craving for nonfood items like clay, dirt, or ice. If you have symptoms of anemia, a doctor will run a test known as a complete blood count to measure your red and white blood cells.

Often, taking supplements like vitamin C and B12 can help treat anemia. Incorporating iron-rich foods like lean red meat, chicken, iron-fortified breakfast cereals, and dried beans into your diet can also help.

Thyroid disease

Many symptoms of thyroid disease are also a common part of pregnancy, such as fatigue, constipation, and weight gain. However, watch out for other symptoms, such as constantly feeling cold, muscle or joint aches, and trouble concentrating.

Around 3% to 5% of people have low thyroid hormone levels during pregnancy. The condition is known as hypothyroidism. It can occur even if you’ve never had thyroid disease before.

Without treatment, hypothyroidism can raise your risk of pregnancy loss and serious pregnancy complications. Complications include preeclampsia, a condition that causes high blood pressure and protein in your urine.

Most cases of hypothyroidism during pregnancy are easily treatable.

A doctor will begin by ordering a blood test to measure for the hormone known as thyroid stimulating hormone (TSH). If your levels are outside the typical range, your doctor may prescribe a synthetic thyroid hormone, such as levothyroxine (Levoxyl).

In minor cases of hypothyroidism, a doctor may closely monitor your TSH levels to check whether it increases by itself first.

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Sleep disorders

Experiencing a sleep disorder, such as insomnia and sleep apnea during pregnancy, can cause you to feel fatigued the next day.

Research from 2018 suggests that 15% of pregnant people worldwide have sleep apnea. It’s a serious condition that temporarily causes you to stop breathing while sleeping.

A common sign of sleep apnea is snoring. This may mean you are not sleeping as soundly as you think. Other symptoms of sleep apnea include mood changes and trouble concentrating.

Pregnant people with sleep apnea are at greater risk of complications such as preeclampsia and gestational diabetes.

A doctor will likely recommend a continuous positive airway pressure device (CPAP). This machine connects to a mask that covers your mouth and nose. It delivers a constant flow of pressurized air to keep your airway open while sleeping.

A doctor may also refer you to a sleep specialist for an overnight study, which can help confirm the diagnosis.

When does pregnancy fatigue start?

Pregnancy fatigue usually starts in the first 12 weeks, called the first trimester. Some people may find that this continues into their second trimester as their energy levels drop. Some people find it more difficult to sleep at this point in the pregnancy as the fetus grows.

Many people also find they wake up lots of times during the night by the frequent urge to urinate. This can also disrupt sleep quality and cause fatigue the next day.

Tips to overcome pregnancy fatigue and get more energy

Ways to manage fatigue during pregnancy and have more energy throughout the day include:

• Getting plenty of rest: Getting enough quality sleep at night can be difficult, especially during your second and third trimesters. This is why it can also be helpful to rest during the day whenever you can.
• Reducing your caffeine intake: Drinking caffeine can give you a short-lived burst of energy, but it may leave you feeling even more fatigued in the long run. Limiting your caffeine intake, especially before bedtime, can help you get a more restful night’s sleep.
• Eating foods high in iron: Your risk for anemia increases during pregnancy, which is why it can be beneficial to eat plenty of iron-rich foods, such as leafy green vegetables, lean meat, and lentils. This can also help decrease fatigue levels and give you much more energy.
• Going for regular walks: Going on a walk may seem counterproductive when you are feeling tired. However, it can increase your overall energy levels and even help with other pregnancy-related symptoms, such as back pain.

Summary

Fatigue is common during pregnancy, as your energy levels typically drop. Reasons you might feel fatigued during the second trimester of your pregnancy include anemia or sleep disorders, such as insomnia.

You might also have difficulty sleeping during the second semester when the fetus is growing and pushing against your bladder. This can cause the frequent urge to urinate at night, which can disrupt your sleep quality and leave you feeling tired the next day.

If you regularly feel fatigued throughout your pregnancy, consider speaking with a healthcare professional. They can help identify whether an underlying health condition may be the cause.

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