Overview

Feeling exhausted during pregnancy is common, but it can still be frustrating and challenging to manage. This episode explores why fatigue happens during pregnancy and how hormonal changes, physical demands, sleep disruptions, and emotional stress play a role. Learn to tell when tiredness is normal and when you should bring it up with your doctor. Hear about easy interventions and tools to combat fatigue. Plus, get practical tips to help you avoid feeling overwhelmed with the mental and emotional demands of pregnancy and preparing for a new baby.

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Hi Vanessa,

I’m currently 32 weeks pregnant, and I just wanted to say how much I appreciate your podcast. It’s been such a helpful resource! I have a question that I’m hoping you can cover. Lately, I’ve been feeling so exhausted all the time. It’s not the same kind of tired I felt in the first trimester. It feels like I’m running on empty even when I get a full night’s sleep. I work full-time, and by the time I get home, I barely have the energy to make dinner or even do simple chores. Even on weekends, I feel like I need multiple naps just to function.

I’m trying to stay active because I know it’s good for me, but sometimes even going for a short walk feels like a huge accomplishment. I keep wondering if this level of fatigue is normal at this stage or if it’s something I should be concerned about.

I also feel a little guilty because there’s so much I wanted to get done before the baby arrives, and right now just getting through the day feels like all I can do. Is it normal to feel completely drained during the third trimester? How can I tell if this is just a normal part of late pregnancy or if it’s something I should bring up with my doctor? I would also love any advice you have for managing exhaustion while still trying to prepare for the baby and keep up with life in general.

Thank you so much!

Best,
Rachel

Rachel, thank you for sharing your questions. Fatigue is very common, especially in the third trimester. Struggling with your energy levels can be very challenging, especially when juggling work and preparing for a new baby, on top of all the challenges of being pregnant.

Why Third Trimester Fatigue Happens

Many factors contribute to fatigue during pregnancy. Fatigue in the first trimester is primarily due to hormonal changes and the body’s adjustment to pregnancy. By the third trimester, additional challenges arise, including increased physical demands and disruptions to sleep. In the final months of pregnancy, you are in the home stretch of preparing for your baby’s arrival, from setting up the nursery to creating your birth plan. If you are working, you also balance your usual job responsibilities and possibly additional tasks to prepare for maternity leave. All of these factors add up and can leave you feeling incredibly exhausted.

Hormonal Changes

Hormones drive nearly everything during pregnancy. While they are essential, they can also have some downsides.

In the first trimester, there is a massive surge in progesterone, which is the primary driver of early fatigue. Progesterone levels stay high throughout pregnancy, and while this hormone helps maintain your pregnancy, it also acts as a natural sedative. It can make you feel more relaxed but also more tired.

Relaxin, another important pregnancy hormone, loosens your ligaments to prepare your body for labor. While this is necessary for birth, the downside is that the physical toll from relaxed ligaments can cause general discomfort and make it harder to get good sleep, leaving you more tired during the day.

Prolactin levels begin rising in the third trimester. This hormone is key in preparing your body to produce milk but can also impact your metabolism and energy levels.

Toward the end of pregnancy, cortisol, often referred to as the stress hormone, also increases. Although cortisol can provide short bursts of energy, sustained high levels over time can leave you feeling more exhausted or burned out.

Physical Demands

The physical demands of building a baby increase as your pregnancy progresses. As your body works harder, the more energy you consume, the more you feel fatigue. By the end of the third trimester, most expecting moms will gain between 25 and 35 pounds or more. This extra weight, combined with your growing uterus, puts additional stress on your body. Common symptoms like lower extremity swelling and back pain have become more frequent in the last few months. Carrying extra weight, adapting to new physical stresses, and meeting increased energy needs all add up. The result is that the physical demands of pregnancy are a major contributor to third-trimester fatigue.

Sleep Challenges

Many issues in the third trimester can negatively impact your sleep. Getting into a comfortable position becomes more challenging as your belly grows. Nasal congestion and snoring are common and can disrupt sleep. About 24% of expecting mothers experience restless leg syndrome. This neurological disorder causes uncomfortable sensations in the legs, which are more common at night and most frequent in the third trimester. You may also experience leg cramps, which are often painful and tend to happen in the middle of the night. Plus, frequent trips to the bathroom, vivid or strange dreams, and anxiety about labor can all contribute to disrupted sleep. Even if you are technically getting a full eight hours of sleep, poor sleep quality can leave you feeling tired during the day.

On the bright side, you can use many evidence-based and straightforward strategies to improve both the quantity and quality of your sleep. For more in-depth information, see the episodes on evidence-based tips to improve your sleep and troubleshooting sleep issues during pregnancy.

Emotional Load

While much of the fatigue you experience during pregnancy can be attributed to physical changes, it is also essential to recognize that emotional and mental demands can significantly affect your energy levels. Even when you are physically at rest, your brain requires substantial energy to function. Most of this energy is spent maintaining basic functions like nerve signaling, processing sensory information, thinking, memory, and regulating body systems. Even if you are simply lying in bed, about one-fifth of all the energy your body uses at rest goes toward brain function.

During pregnancy, your brain is working overtime cognitively and emotionally, which can make the energy drain feel even more intense. You are planning and preparing for a major life change, processing new information about pregnancy, birth, and parenting, not to mention managing a wide range of emotions and anxieties. This added cognitive and emotional load makes your brain work even harder, contributing to the overwhelming sense of fatigue many expecting mothers feel.

Is This Level of Exhaustion Normal?

Rachel, you asked, how can I tell if this is just a normal part of late pregnancy or if it’s something you should bring up with my doctor? In most cases, feeling exhausted in the third trimester is entirely normal. However, there is never a downside to mentioning any symptoms you are experiencing to your doctor. The last thing you want to do is brush off concerns that could be important for your care.

Fatigue alone isn’t usually a concern unless it is sudden and extreme, feels overwhelming, or is accompanied by other symptoms like dizziness, shortness of breath, headaches, heart palpitations, or significant swelling. Some medical conditions can cause fatigue. If that is the case, it is essential to identify and treat the underlying issue. Common causes could include low iron levels, leading to anemia, thyroid problems, blood pressure concerns, or sleep apnea. If an underlying condition contributes to your fatigue, addressing it can make a big difference in how you feel.

Managing Exhaustion in the Third Trimester

While many of the causes of fatigue during pregnancy are unchangeable, there are steps you can take to better manage exhaustion. Like many things in pregnancy, one intervention alone may not make a dramatic difference, but there is real value in stacking small strategies together to create a bigger impact.

Prioritize Rest

Your body experiences more changes during pregnancy than at any other time in your life. Listening to your body and respecting the need to slow down is important. While it may be easier said than done, now is the time to prioritize rest. Once your baby arrives, there will be many things you simply cannot say no to, like feeding your baby in the middle of the night, so it is important to rest while you can.

Make Tasks Manageable

There are so many things to do to prepare for a new baby, and your to-do list can quickly become overwhelming. Try breaking tasks into smaller, more manageable steps. Rather than trying to set up the entire nursery in one weekend, focus on completing one task at a time, like assembling the crib or setting up the baby monitor. It is also okay to accept that you may not be able to do everything you originally planned.

Set Realistic Expectations

You may need to evaluate your expectations and make sure they are realistic. It is easy to put off tasks until the weekend if you are working but be honest about what you can realistically accomplish. Set the bar lower. It is better to check everything off your to-do list and feel accomplished, with the option to do more, rather than feeling like you failed to meet impossible expectations.

Prioritize Your Mental Health

Also remember that mentally and emotionally preparing for your baby is just as important as getting the nursery organized. If you spend the last few months or weeks of pregnancy sprinting to finish everything and end up completely exhausted and drained by the time your baby arrives, that’s not ideal. You are better off taking it easy, conserving your energy, and feeling rested and ready when you go into labor.

Tips for Managing Energy Levels

There are basic building blocks of your health that together can significantly impact your energy levels.

Optimize Your Sleep

One of the most important ways to manage fatigue is to prioritize sleep. Surveys show that sleep duration decreases in the third trimester, with most expecting mothers averaging between 6.6 and 7.8 hours of sleep per night. The good news is that you can use many simple strategies to improve the quality and quantity of your sleep.

Maximizing your exposure to natural light in the morning can help regulate your sleep-wake cycle. Minimizing bright and blue light exposure after sunset supports your body’s natural melatonin production. This includes reducing screen time in the evenings. A consistent sleep schedule, even on weekends, can also make a significant difference. Using different types of pillows to find a comfortable position as your belly grows can help you sleep more soundly and wake up less frequently at night.

Take Naps

Naps can also help compensate for lost sleep, but the timing and length of naps matter. A TED talk from Dr. Matt Walker explains that humans are hardwired to experience a drop in alertness between 1:00 and 4:00 p.m., making this window ideal for napping. While naps can offer benefits, they can also disrupt nighttime sleep if not timed properly. Dr. Walker advises avoiding naps if you already struggle to sleep at night. If you are able to nap without affecting your nighttime sleep, a short 20-minute nap earlier in the afternoon can be helpful.

Exercise

Staying active during pregnancy has many benefits, including helping to boost your energy levels. Even gentle movement like walking can support better sleep and make a noticeable difference in how you feel. As your pregnancy progresses, exercise may feel more challenging, and you may need to slow down or modify your routine. If a short walk feels like enough, that’s perfectly fine. Movement doesn’t have to be intense or long to be valuable. Listening to your body is key. Some days, you may feel up for more activity, and others may need extra rest. Focus on consistency rather than intensity.

Stay Hydrated

Dehydration can worsen fatigue, and staying hydrated is especially important during pregnancy. Your body needs extra water to support increased nutrient demands, digestion, amniotic fluid production, and increased blood volume. You also lose more water through urination, breathing, and sweating due to changes in metabolism and circulation during pregnancy. Plus, dehydration can make common pregnancy symptoms like Braxton Hicks contractions, constipation, swelling, and migraines worse.

The American College of Obstetricians and Gynecologists recommends drinking 64–96 ounces (about 2–3 liters) of water each day. A simple way to check your hydration is to look at the color of your urine. If it is a light yellow shade, it is a good sign you are getting enough water.

Eat Healthy Whole Foods

What you eat plays a significant role in maintaining your energy levels during pregnancy. Focusing on healthy whole foods helps provide steady energy. Eating a variety of nutrient-dense foods can also help prevent common issues like low iron levels or vitamin deficiencies, which can contribute to fatigue. Keeping your blood sugar stable throughout the day is key. Large meals or foods high in sugar can cause spikes and crashes in blood sugar, leaving you even more tired. Pay attention to how certain foods impact your energy levels and adjust your diet to focus on foods that fuel your body.

Ask for Help

One way to manage your energy that is often overlooked is to ask for help and outsource when you can. It’s easy to feel like you have to do everything yourself. During pregnancy, it is essential to recognize your limits and scale back when needed. If your daily to-do list feels overwhelming, take a step back and prioritize what truly needs to get done. Look for tasks you can delegate to your partner, friends, or family. Whether it’s asking someone to help with household chores, grocery shopping, or setting up baby gear, letting others chip in can free up your time and energy for rest and self-care.

Managing Guilt

Rachel, the last thing I want to touch on is managing the guilt of feeling like you’re not getting enough done. It’s essential to remind yourself that you are growing a human and preparing your home and life for a brand-new family member. Try to step back and see the bigger picture. In a few months, you won’t look back and care whether every little thing was finished perfectly, whether you worked out every single day, or whether you woke up every morning feeling rested. What will matter is that you nurtured, grew, and brought a new life into the world. Be kind to yourself in these final weeks. Give yourself permission to rest, to slow down, and to let go of the pressure to do it all.

Additional Resources:

• Third Trimester Overview
• Strategies to Feel Less Overwhelmed During Pregnancy
• Evidence-Based Tips To Improve Your Sleep
• Troubleshooting Sleep Issues During Pregnancy

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