Aims To identify the course of maternal fatigue during the first 6 months postpartum and to determine factors associated with it. Design A prospective cohort study. Methods Women (N = 2,697) in 13 Japanese hospitals provided longitudinal data using self‐report questionnaires at five time points. Maternal fatigue was assessed using the Postnatal Accumulated Fatigue Scale. We focused on the effect of maternal age and parity on the course of maternal fatigue and used a mixed between/within‐subjects analysis of variance. Factors associated with maternal fatigue were analysed using stepwise multiple regression. Results In the 6‐month postpartum period, the level of fatigue was highest at 1 month and significantly decreased from 1–4 months postpartum. Primiparas showed a significantly higher level of fatigue than multiparas during hospital stay and their levels of fatigue more closely approximated the 1‐month peak. Multiparas showed significantly higher levels of fatigue than younger primiparas at 6‐month postpartum. Factors associated with maternal fatigue included satisfaction with sleep, concerns about child‐rearing, satisfaction with social support, financial burden and meal times per day.
