Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes a company by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.

This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30 extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.

What can you do? In the first trimester, work on minimizing the effects of nausea and vomiting of pregnancy. Keep your energy up by eating several small meals or snacks throughout the day and try adding vitamin B6 if you haven’t already. Naps sometimes feel like a good idea, but they often have the opposite effect then what you desire. Napping can interfere with your ability to get good rest at night and create a vicious cycle. Going for a walk for getting some exercise is probably a better idea and will improve your nighttime sleep.

Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you were still allowed to have up to 350 mg of caffeine today; so don’t feel too badly about having that cup of coffee in the morning or maybe after lunch.

Many pregnant women need to work on maximizing their sleep habits. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don’t make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattress with their rounder bellies and hips. Try adding an extra layer of egg crate or a phone topper to your mattress and make sure you have a long pillow that you can hug with your legs.

Also, be sure to empty your bladder right before you go to sleep and if you find that you are awakening to pee several times a night, you might need to restrict water intake for 2-3 hours before going to sleep.

In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.