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

Your Pregnancy - - Talking Point - YP BY TORI HOFF­MAN

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.


“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.


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.


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.


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.


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.


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.

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