Fatigue

It’s not uncommon for women to be tired in the first few weeks of pregnancy.  Growing a person is hard work!  Most women find it helpful to take a nap and/or go to bed a little earlier than usual.  Sometimes “tiredness” is more severe and turns into  “fatigue.” Women with extreme tiredness or fatigue, feel like their energy level is so low, and their exhaustion so extreme that they are not able to enjoy life.

Frisco Midwifery has created this resource to help you understand what’s going on with your pregnancy, and offer you some evidence-based options to help you manage fatigue.  

What causes fatigue?

Fatigue can be caused by a number of things.  Your midwife will explore the whole range of possible causes and help you come up with a care plan to help you feel rested and healthy.

Anemia:  The most likely cause of fatigue is anemia.  In the first 28-weeks of pregnancy, your blood volume is increasing faster than your body can create red blood cells.  As a result, the concentration of oxygen/iron carrying red blood cells in your blood is lower.  Less oxygen, less iron, more tiredness.

Insomnia:  Many women wake frequently at night to void.  The growing uterus applies pressure to the urinary tract during the daytime when the pregnant woman is more “upright”.  That reduces the amount of urine that passes into the bladder.  At night time, the body compensates by allowing more fluids to be processed at night.

Other women wake frequently at night because of joint pain.  As your pregnancy advances, a hormone called “relaxin” softens connective tissues causing joint and muscle pain. 

Getting to sleep, or going back to sleep is difficult for some women who feel like their mind is “racing”.  If wakefulness is the cause of fatigue, the solution will include both pain management and relaxation strategies.

Nutrition:  Your body is working hard to grow a full human.  The baby will draw the resources he/she needs.  If you are not getting adequate nutrition, your baby will call “dibs” on the available energy, and you will feel more tired.

Infection:  Sickness in general makes people feel exhausted.  During pregnancy, your immune system is a little lower so your body won’t attack your baby.  That leaves moms at greater risk to catch infections.  

Hormone issues:  During pregnancy, thyroid imbalance and insulin resistance are fairly common.  

What can be done?

Anemia:  Your midwife will draw your blood to determine if you are anemic.  If your red blood cells are too diluted, your midwife will recommend iron supplements and nutritional responses to help your body make more blood. 

• Hematinic is a blood-building supplement that many find effective.

• Chlorophyll can also be taken to build blood.

Insomnia:  Evidence-based options for helping avoid / treat insomnia include 

• Turning off “blue screens” at dinnertime and avoid looking at them for 2-hours before bedtime.

• Use a guided relaxation or meditation app like “Insight Timer” , “Calm” or “Sleep well” available in the App store

• Take a nap daily.  Hire a postpartum doula or babysitter to help at your house while you nap if needed.

• Negotiate with your husband/partner to be responsible for getting up with other children at least 1 night per week to give you a continuous night of sleep.

• Address issues of discomfort or distractions that may be contributing to wakefulness. 

• Pursue chiropractic care to relieve aches and pains and balance the neurological system to support sleep.

• Take your calcium supplement at bedtime.

• Drink hot tea like “sleepy time” or chamomile tea at night.

• Take a hot bath, with Epsom salts, at night.

Nutrition:  Your midwife will give you a nutritional assessment.  Your protein intake should be at least 80-grams daily; carbohydrates should be limited.  Your diet should include multiple servings of vegetables, and fewer servings of fruits, grains, and carbohydrates.

Infection:  Your midwife will draw labs and collect a urine specimen to culture for UTI.  If you have a urinary tract infection, your midwife will refer you to her consulting physician or your family physician for antibiotics.

Hormone Issues:  Your midwife will do a series of lab tests including thyroid labs.  If your thyroid is not functioning properly, she will refer you to an endocrinologist for further support and medication.

Call your Midwife if:  

• You do not experience any relief from the remedies above

• Your fatigue interferes with your functioning

• You are concerned for your safety or the safety of others.

Summary

o    Nutrition / Diet

·       80 grams of protein daily

·       ½ your body weight in water daily

·       Small frequent snacks every hour

o    Therapies

·       Chiropractic care

·       Acupuncture

·      Massage

o    Lifestyle / Exercise

·       Prenatal yoga

·       Daily light exercise

·       Daily relaxation and meditation

·      Adequate sleep / rest

o    Relaxation / Meditation

·       Guided imagery apps

·       Essential Oils for sleep

o   Stress Away by Young Living

o   Tranquil by Young Living

·       Essential Oils for pain

o   PanAway

o   Deep Relief

·       Chiropractic

·       Acupuncture