Plenty of women experience extreme fatigue during pregnancy. It is perfectly normal to feel tired when you are pregnant as your body undergoes many changes at this period . But, you are not obliged to put up with the symptoms as there are many ways to manage and reduce fatigue while pregnant.
Is fatigue an early sign of pregnancy?
It is considered one of the earliest pregnancy symptoms , along with cramping, dizziness, nausea and headache, often occurring even before you notice a missed period. Fatigue, often accompanied by sleepiness and irritability, is common during the third trimester as well.
What causes pregnancy fatigue?
The numerous body changes occurring during the first weeks of pregnancy (for supporting the growing fetus) are the principal causes behind fatigue during first trimester. The increasing hormone (progesterone) levels and the rising blood circulation make the organs and systems in your body work harder . It naturally puts lots of stress on your body, leading to constant fatigue. It is also quite common for the symptom to aggravate after eating a meal.
Insomnia or lack of sleep often causes constant fatigue during the last trimester  (after the 28th week). Symptoms like heartburn and the increased urination during the night as well as the huge baby bump are some of the common causes preventing you from getting a good night’s sleep during later pregnancy.
Other causes may include carrying twins, being stressed about becoming a mother as well as underlying conditions like chronic or pregnancy-induced anemia and vitamin D deficiency .
Treatment of fatigue in pregnancy
Although more common in early and late stages of pregnancy, it is not uncommon to experience signs of fatigue in the second trimester. Listening to your body’s need for rest is the best treatment for the symptom in pregnancy. Here are some tips for preventing and managing chronic fatigue while carrying:
- Drinking plenty of fluids to avoid dehydration 
- Getting as much rest as possible
- Taking a few power naps throughout the day, especially during the afternoon, to compensate for the lost sleep at night 
- Going easy on household chores, asking for help from your partner, friends and other family members
- Taking short breaks to avoid stress at workplace
- Including plenty of iron and protein rich foods, like sea foods, poultry, red meat, whole grain breads and leafy vegetables, in your daily diet to prevent anemia 
- Avoiding caffeine and junk foods 
- Going for a short walk every day or joining a pregnancy fitness class can boost your energy levels, reducing fatigue 
- Going to bed early every night and trying to get 7 hours’ sleep
Consulting your doctor regarding possible remedies for fatigue relief at home is recommended in case of severe fatigue.
How long does fatigue last during pregnancy?
In most cases, the symptom subsides during late first trimester and second trimester, coming back again during the last weeks of pregnancy . However, some women may remain fatigued throughout all the three trimesters.
When to call the doctor?
- Fatigue associated with extreme hunger and thirst (might indicate gestational diabetes) 
- Severe fatigue that refuses to get any better with rest 
- Excessive fatigue associated with symptoms like fever, sore throat or swollen glands 
- Extreme tiredness along with nausea, vomiting, tender breasts and increased urination (might indicate an ectopic pregnancy) 
- The symptom associated with extreme stress and/or depression
Your doctor might order certain exams and tests to confirm the diagnosis of any underlying conditions.
Fatigue ICD-9 and ICD-10 Codes
The ICD-9 code used for indicating fatigue is 780.7 , while its ICD-10 code is R53 .
- http://apps.who.int/classifications/icd10/browse/2010/en#/R53 [/ref]