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Exhausted expectations Prenatal Care

Exhausted expectations

Fatigue and depleted energy are common during the first trimester. Use these strategies to stay awake.

Your pregnancy test comes back positive, and you feel on top of the world. But then fatigue strikes. Although you’ve likely read about it (along with cravings, morning sickness and all the other early pregnancy symptoms), you probably weren’t prepared for just how tired you’d really be.

It’s common for women to experience fatigue during the first trimester, and some fight it throughout their entire pregnancies. Growing a human being is a serious undertaking, so it should come as no surprise that pregnancy can really take it out of you.

“The weeks at the end of the first and the beginning of the second trimester will always be known as the time of ‘bone- crushing fatigue’ in the tale of my pregnancy,” says JulieAnn Lawson, mother of one in Seattle, who had trouble staying awake throughout the day early on in her pregnancy and found herself nodding off in work meetings.

If, like Lawson, you’re trying to figure out how to simultaneously grow a baby and get through the day without that extra cup of coffee, rest assured there are ways to cope.

A real buzz kill
To a certain extent, fatigue is simply something you have to deal with during the first trimester. There’s no surefire way to bypass it all together, and you should expect to operate at a lower energy level for a while.

However, there is a difference between typical pregnancy fatigue and the kind that may indicate that something is off. “The first element is persistence of the fatigue after 12-13 weeks gestation,” advises Roger W. Harms, MD, specialist in the OB/GYN department at the Mayo Clinic in Minnesota and medical editor of The Mayo Clinic Guide to a Healthy Pregnancy. “Most normal pregnancy fatigue improves dramatically by then.” If yours hasn’t, it’s a good idea to talk with your doctor.

“The most common cause [of persistent fatigue] would likely be iron deficiency anemia due to a failure to keep up with the iron demands of the pregnancy,” explains Harms. Thyroid status could also be a factor, he adds. “Hypothyroidism is common in younger women and a very important consideration to protect baby’s health.”

Emotional health can play a role in how you’re feeling, too. “In some cases depression masquerades as simple fatigue,” explains Harms. “If you aren’t doing much because you don’t really care to, that might be depression. If you aren’t doing much, but you really want to, that is fatigue.”

Keep up
So how can you cope, especially if you’re working or have older children who need your care? There’s good and bad news when it comes to pregnancy fatigue. The good news: Things often get better after the first trimester. The bad news: You’re still going to have to deal with it in the meantime. However, that doesn’t mean you’re totally helpless.

Eating a balanced diet can positively impact the way you feel. “Some practices that help include eating regularly and avoiding simple sugars that can lead to blood sugar slumps,” says Margaret Dow, MD, an OB/GYN at Mayo Clinic in Minnesota. “Caffeine in small amounts is not contraindicated, and unsweetened coffee or tea may provide a small boost early in the day. Smaller, more frequent meals can help keep blood sugar levels steady, too.”

And don’t forget the value of exercise. “Moderate activity can improve sleep, help with many of the common musculoskeletal pains of pregnancy and increase energy levels,” says Dow. “Even just a short 10-15 minute walk makes a difference.” Current guidelines recommend expectant women without complications participate in moderate exercise for at least 30 minutes most days of the week. Plus, notes Dow, “For added motivation, there is emerging data that exercise in pregnancy improves cognitive function in offspring, too.”

Working woes
Whether you’re dozing off at your desk or struggling to keep up with the boundless energy of an older child, you’re not alone.

“There were times I almost couldn’t fight my eyes open,” says Lawson. “I would drift off in meetings and have to focus on breathing deeply just to stay awake.” Accept the reality, and get help with kids and work responsibilities, Harms recommends.

See if there’s a place at work where you can rest or take brief naps. In some cases, sharing the news of your pregnancy a little earlier than you’d planned allows bosses and co-workers to be more understanding because they know the reason behind your fatigue.

Once Lawson told her colleagues she was pregnant, she was able to rest assured people didn’t think she was just lazy or irresponsible. She was also able to use the designated nursing room for a catnap without interruption from colleagues.

If you have older children to take care of, recruit help from family or friends to take some of the pressure off. Ask your partner or a relative take your child to the park or on another active outing, so they can release some energy and you can get some rest. If your budget allows, consider hiring a nanny or mother’s helper. The fatigue won’t last forever, so you’d only need to factor in the expense short-term.

If outside help isn’t an option, try keeping playtime low-key. While you may not have enough energy for games of tag or hopscotch, you can still connect in other ways such as reading books, building puzzles or working on a low-mess art project. And if you need to resort to some screen time here and there to buy yourself a break, don’t beat yourself up about it. You’ll be back to feeling like yourself soon enough.

In the moment, temporary can feel like an eternity, but before you know it, you’ll be holding your brand-new baby—and she’ll be here to stay.