Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes accompanied by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.

This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30+ extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.

To help with symptoms in the first trimester, you can work on minimizing the effects of nausea and vomiting of pregnancy by eating several small meals or snacks throughout the day and adding vitamin B6 twice a day if you haven’t already. Naps sometimes feel like a good idea, but they often have the opposite effect than what you desire. Napping can interfere with your ability to get good rest at night and this can create a vicious cycle. Going for a walk or getting some exercise is probably a better idea and will improve your nighttime sleep.

Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you are still allowed to have up to 350 mg of caffeine per day; so don’t feel too bad about having that cup of coffee in the morning or maybe after lunch.

Many pregnant women need to work on maximizing their sleep hygiene. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don’t make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattresses with their rounder bellies and hips. Try adding an extra layer of egg crate or a foam topper to your mattress and make sure you have a long pillow that you can hug with your legs. A hot shower about an hour before you go to sleep can also make a huge difference.

Also, be sure to empty your bladder right before you go to sleep and if you find that you are waking up to pee several times a night, you might need to restrict water intake for two to three hours before going to sleep.

In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.

If you are occasionally tired or having a difficult time getting to sleep, tossing and turning, etc. an antihistamine like Unisom SleepTabs or Benadryl can be a safe option for moms to help with sleep. We recommend trying healthy sleeping habits before resorting to medications. Finally, if you are snoring a lot, you might have sleep apnea. A sleep study and treatment for this can be life-changing! Don’t hesitate to talk to your doctor about a sleep study while you’re pregnant.