Extreme tiredness in pregnancy: causes and next steps

Pregnancy changes sleep, circulation, metabolism and the effort required for ordinary activity. Nausea, pain, stress and interrupted sleep can add to exhaustion. Fatigue may also occur with anaemia, thyroid problems, infection, low mood or other health concerns. Breathlessness with light activity, paleness, dizziness, fainting, racing heartbeat or unusual weakness should be mentioned to a clinician.

Tell your midwife, obstetrician or family doctor if tiredness is persistent, worsening or stopping you from eating, working, moving safely or caring for yourself. Keep a note of sleep, food and fluid intake, dizziness, breathlessness and medicines. Rest when possible, accept practical help, eat regular nourishing meals and drink fluids. If tests suggest iron deficiency, iron therapy may be discussed; use it only as directed because excess iron can also cause problems.

Seek urgent help for fainting, severe breathlessness, chest pain, confusion, heavy bleeding, severe dehydration, a high fever or sudden profound weakness. Contact your maternity team promptly if fatigue comes with severe headache, vision changes, marked swelling or reduced baby movements. Emergency symptoms should be assessed immediately rather than explained as ordinary pregnancy tiredness.

Could anaemia, thyroid disease, infection or low mood explain my fatigue? Do I need blood tests? Is iron therapy suitable for me, and how should it be taken? Which warning signs should prompt same-day care? How can I pace activity safely?