EXHAUSTION DURING PREGNANCY

There is a reason – and it’s not just you

It’s no secret that pregnant women are tired women. And if you’re feeling like you just can’t go on – at work, at home, or wherever you may be trying to function – know that you’re not alone. Exhaustion during pregnancy is completely normal.

YOU’RE WORKING HARD, MOM

“Physiologically, there are a lot of good reasons why you might be tired when pregnant,” says gynae Dr Philip Zinn at the Kingsbury Hospital in Cape Town. “A baby’s prime purpose is to command the resources of its mother, and the mother comes second. It does this by making sure that it gets preference for circulation, preference for oxygen and preference in terms of nutritional requirements. Every heartbeat, every enzyme action, every cell that’s growing (at a very fast rate) in your baby, comes from your energy,” he says.

UNDER PRESSURE

Blood pressure plays a big role in fatigue when pregnant. You’re not able to adjust your blood pressure as quickly as when you’re not pregnant and when you fall pregnant, your blood pressure drops. Low blood pressure is a natural state of pregnancy. Once you get to your second trimester, it goes down to its lowest point and while it starts to pick up through the pregnancy, it still remains, on average, low. “The hormones of pregnancy and the need to shed extra heat actually cause blood vessels to dilate and remain dilated even when the blood pressure is too low for you. “This is why when you’re lying down and you stand up too quickly, your blood pressure doesn’t equalise fast enough and you might feel faint and fall over,” says Dr Zinn.

MATTERS OF THE HEART

Haemoglobin is the iron-containing pigment of the red

blood that transports oxygen from your lungs to the rest of your body. Its levels also drop during pregnancy because your blood is diluted, and the thinner blood circulates more easily through the placenta. “What’s more, the baby has a different kind of haemoglobin which will grab oxygen from the mother even if the mother’s levels are low – yet another reason your baby is tiring you out,” explains Dr Zinn. “As a result of the greater oxygen demands your heart has to work more vigorously during pregnancy and your reserves are prioritised for your baby. All of this is tiring,” he says.

THOSE HORMONES!

Not only is your sleep disturbed when you’re pregnant because you’re uncomfortable (in the third trimester), it’s disturbed all the way through pregnancy because of high oestrogen levels that act as a stimulant. “High oestrogen levels make you more sensitive to all stimuli and deep sleep is a thing of the past. Perhaps this is why – once you have your baby – you might wake up to your baby’s cries while your partner sleeps peacefully all night long. The point is, you’re attuned to sleep lighter and as a result, end up tired in the morning,” says Dr Zinn.

WHEN IS IT AT ITS WORST?

According to Dr Zinn, many women feel fine in their first trimester, but there are a lot of physiological changes and increased energy demands that affect how you feel. If you’re used to running around but are also suffering from nausea and painful breasts and with a lower blood pressure, you’ll probably be feeling very tired. Most notably, it’s a stark contrast to how you felt before. “In the second trimester, your blood pressure drops even further and if you were able to relax in your first trimester, you will feel more tired in your second trimester when your blood pressure is at its lowest (around 16 weeks or so), and you might want to sleep all the time,” he says. From about the 18-to-20week mark, you will most likely feel a renewed energy. “And 20 to 28 weeks is a nice time for all sorts of reasons – one of the main reasons is having the reassurance that everything is okay with the baby and the pleasure of feeling baby move.” The weight of the pregnancy is more manageable at this time. The anxiety of the first and second trimesters can be quite significant and there are lots of psychological buoyancy effects that might give you more energy. “As the third trimester advances, mechanics will of course take over. Everything will start to creak, your centre of gravity shifts, your muscles and ligaments start to take strain and you’re constantly carrying a baby in front of you,” says Dr Zinn, explaining that your body needs more energy to deal with aches and pains.

OTHER REASONS FOR EXHAUSTION

One of the most common pathological reasons Dr Zinn sees for exhaustion during pregnancy are the common illnesses that everyone else gets. “When you’re pregnant, your immune system is compromised and you’re more vulnerable to coughs and colds. You may also not recover fully from a cold before the next one comes along,” he says. He also stresses that social issues – for example, demands at work, other family members, and the inability to be able to just go and lie down when you’re tired – can leave you feeling exhausted. “Stress can and does have a physiological effect on the body, leaving it tired.” Lastly, he believes that society doesn’t have empathy for pregnant women. Not only are they expected to carry on at the same pace as before (even though they are functioning for two), but women work until 38 weeks, exercise as before and carry on at the same pace. No wonder you are exhausted.