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Are you exhausted in the first trimester of pregnancy? Feel like you could rest your head on the table during a work meeting and take a nap? Like you’re in a sleepy haze as you push your grocery cart down the aisles?

You can chalk it up to the extra demands on your body and a hormone called progesterone.

First-trimester exhaustion is well-documented. According to a 2023 Sleep Science study, more than 94% of women say they suffer from fatigue during pregnancy. The first trimester usually rates as the worst for sleepiness.

Fortunately, you likely won’t feel this exhausted throughout your pregnancy. Most women feel great after they hit their second trimester, which is why many call it the “golden trimester.” In the meantime, you can make simple changes to your daily routine to help you feel more energized.

Why Am I So Tired During the First Trimester?

As for what causes your extreme fatigue — pregnancy has your body working hard, even though your baby may have only grown to the size of a plum (or even a pea).

In the first trimester, your body makes a whole new organ — the placenta, which supports your baby’s growth throughout pregnancy. This placenta-building process lowers your blood pressure and blood sugar, causing first-trimester tiredness.

Meanwhile, your body produces a higher-than-normal level of progesterone. This hormone encourages your uterus to release nutrients and stimulates milk ducts to prepare to breastfeed. But progesterone can also signal brain transmitters that it’s time to switch off and sleep.

When Does Fatigue in Pregnancy End?

Though you continue to make high amounts of progesterone throughout your pregnancy, your body adjusts to it over time. So by the time you reach 10 to 13 weeks, progesterone no longer has the same sedating effect.

Another reason fatigue improves is that the placenta has fully formed by the end of the first trimester. This means your body’s resources aren’t going toward building the placenta.

Most women find that fatigue improves after the first trimester but then returns toward the end of the pregnancy. A kicking baby, a heavy tummy, and late pregnancy aches and pains can make it tough to get any shut-eye.

Though fatigue tends to lessen in the second trimester, you’re still supporting a growing pregnancy. So, you may continue to feel like you don’t have the same prepregnancy energy throughout your pregnancy.

How to Manage First-Trimester Exhaustion

Tips for dealing with extreme fatigue in the first trimester include getting serious about your bedtime routine, napping, exercising, and changing your diet.

Limit caffeine

When you’re feeling exhausted in the first trimester, you might want to brew a cup of hot java. But the American College of Obstetrics and Gynecologists (ACOG) says pregnant women shouldn’t exceed 200 milligrams (mg) of caffeine daily. That’s about the amount in a 12-ounce cup of average (not super-strong) coffee, so you may want to divide this across the day or try half-caf options.

The reason you need to limit caffeine? Studies have linked caffeine in high amounts to slower fetal growth and pregnancy loss.

Get some exercise

Though you may feel tempted to lie on the couch, exercising will give you a boost of energy that can last for hours afterward.

According to ACOG, exercise during pregnancy improves overall health and may reduce the risk of pregnancy complications. This doesn’t mean you need to do step aerobics — walking, swimming, and yoga release endorphins that boost mood and energy levels.

Take a nap

Lying down for 20 or 30 minutes when that afternoon slump hits can recharge you for the rest of the day. But experts warn that longer naps can make you feel groggier when you wake up. Plus, napping for more than 30 minutes can reduce your sleep schedule, making it tougher to fall asleep at night.

Eat smaller meals

Eating big meals can spike blood sugar, followed by an energy-zapping crash. For more energy, experts suggest trying five to six small meals daily instead of three large meals. As a bonus, this can help reduce nausea in the first trimester.

You should also try to eat more protein, fruit, vegetables, and whole grains. Fiber and protein help steady your blood sugar. Eat fewer simple carbs (like white bread, cookies, and sugary drinks) that cause your blood sugar to spike and then drop.

Stick to a good sleep routine

Getting enough sleep at night helps combat daytime fatigue. Try to go to bed at the same time every night. It’ll help you fall asleep faster.

If you struggle to fall asleep at night, keep the lights low and avoid screens one hour before bedtime. Do a calming activity, like reading, before bed. Getting enough exercise and exposure to daylight will also help your body settle in for sleep.

If you have pregnancy nausea at night, try eating crackers before bed. (Despite the name, morning sickness can hit throughout the day and night.)

Lighten your load

When you’re in the first trimester, you’re likely to find you can’t take on as much as you did prepregnancy. So don’t feel bad about asking family members to help out more.

See if you can outsource tasks, such as using a delivery service for buying groceries. You can also save some errands for when you have more energy in the second trimester.

When Should I Worry About First Trimester Fatigue?

Fatigue is most likely due to the effects of progesterone and the added demand on your body. But for cases of extreme fatigue, pregnancy may cause health issues such as:

• Anemia (low iron).
• Gestational diabetes.
• Prenatal depression.
• Thyroid problems.

One way to tell the difference between normal and abnormal pregnancy fatigue is whether you can push through it. If you’re falling asleep at your desk by accident or you’re too tired to drive safely, check in with your doctor or ob-gyn.

You should also see your health care provider if you have any worrying symptoms besides fatigue, which could signal other health problems. These may include weakness, frequent urination, pale skin, sudden weight changes, breathlessness, or irritability.

Despite the huge change pregnancy brings, you can’t blame every symptom on it. If you think something isn’t normal and concerns you, talk to your doctor about it.

In these circumstances, it’s OK to ask if they can run any tests to reassure you that your symptoms are within the realm of what to expect when you’re pregnant.

Editor's Note: This article was originally published on February 16, 2024, and was last reviewed on September 24, 2025.