Extreme fatigue when pregnant: what to know

Pregnancy changes can increase sleepiness, especially early on, while later discomfort, frequent urination and interrupted sleep may drain energy. Fatigue can also accompany anaemia, when the blood carries less oxygen, or dehydration from poor intake, vomiting, heat or illness. Mood changes, low appetite, breathlessness, palpitations, fever or new swelling add useful clues. Conditions such as Coeliac Disease, COVID-19 or Chronic Kidney Disease can also cause marked tiredness, although fatigue alone cannot identify a cause.

Rest when possible and accept practical help. Eat regular meals and snacks containing iron-rich foods and protein, drink fluids steadily, and rise slowly if you feel light-headed. Gentle activity may help if your maternity clinician has said it is suitable. Keep a brief record of sleep, food and fluid intake, vomiting, bleeding, fever and when the fatigue began. Do not start iron, herbal products or other medicines without checking pregnancy safety with a clinician.

Contact your maternity team promptly if fatigue is worsening, stops you managing normal activities, or comes with dizziness, fainting, breathlessness at rest, chest pain, racing heartbeat, heavy bleeding, severe headache, fever, persistent vomiting or reduced fetal movement later in pregnancy. Seek urgent help for collapse, severe breathing difficulty, confusion or inability to keep fluids down.

Could anaemia or another medical problem explain this level of fatigue? Do I need blood or urine tests? Which foods, supplements and medicines are appropriate for my stage of pregnancy? What symptoms should prompt same-day maternity advice?