First trimester fatigue

When I fell pregnant I was prepared for so-called “morning sickness”, but nobody warned me about the fatigue. And what fatigue it was! It came on at about six weeks and finally lifted just before thirteen weeks. I felt as though I had the “flu” for all this time, and developed a newfound empathy for patients who suffer from Chronic Fatigue Syndrome. I felt unwell and sedated for most of the first trimester.

Like everything else, “hormones” are blamed, namely progesterone, which does make a woman more placid and drowsy than usual. Apparently the body takes three months to adjust to higher levels of hormones, which is why doctors often tell women that their Pill side effects may disappear after three months of use.

Blood sugar levels also tend to fall during the first trimester, which I believe exacerbates the fatigue (and led to me never leaving the house without a peanut butter sandwich in my handbag for those two-hourly hypoglycemic attacks). Something else is happening that your body hasn’t done for a long time – it’s building a whole new organ “from scratch”. The placenta, which is the connection between you and your baby, starts to form in the first days after conception, and is completed pretty much by the thirteenth week.

There were days I could barely drag myself out of bed, even after marathon 10-12 hour sleeps (I often passed out on the couch by about 8:30pm – my poor husband had little of a social life in those weeks!) The fatigue was overwhelming, worse as the day wore on, and over the weekend I seemed to spend all of my time sleeping – and yet woke up feeling no better. I remember crying one morning during the tenth week as I woke up to my fourth day of terrible fatigue. My obstetrician called it “my version of morning sickness” – not that I was spared the nausea, mind you, just that the fatigue was much more prominent than the nausea.

As I bumbled along in first trimester, I learned a few things that helped (sometimes):

• I needed to eat every 2 or 3 hours, without fail. Low-GI carbohydrates (I went through loaves of wholegrain bread and craved pasta) plus protein helped the most.
• The support from V was immensely helpful. He told me to take it easy, never complained when I fell asleep during dinner, put up with my lacklustre cooking efforts (if I made the effort that night), and twice I woke up after having put laundry in the washing machine and falling asleep, to see him put the laundry out in the middle of the night. Your partner needs to honour the immense work your body is doing on your baby’s behalf.
• Gentle exercise helped – a lot. Swimming was wonderful as I felt buoyant and wasn’t worried about passing out. Always have a snack before and after exercising.
• Overdoing the exercise and exertion resulted in days of awful fatigue. I went surfing on a cold day at 7 weeks and the experience was just too intense. The following week was one of the worst weeks.
• Take your antenatal vitamins religiously.
• Take it easy and remember “this too shall pass”. For the vast majority of women, they feel “normal” again by 14-16 weeks. I remember gradually feeling like myself again during the thirteenth week, and voila! One morning I woke up and said to V, “I’m Back!”

Your body is doing a huge job – creating a new organ AND a new human being. Your baby is fully formed by 12 weeks – with ears and nose and fingers and toes and everything in its place. Your body did this from a microscopic sperm and egg. Respect the enormity of what it sets out to achieve in those first three months and good luck!