In short: The best sleeping position during pregnancy is on the left side, especially after 16-20 weeks. Sleeping on your back is undesirable after this period, as the uterus presses on the inferior vena cava. A special pillow for pregnant women helps to ensure comfort and correct body position.
Why does sleep change during pregnancy?
Pregnancy changes everything, including the quality of sleep. High levels of progesterone in the first trimester cause daytime sleepiness, but paradoxically impair the quality of night's sleep. A growing abdomen, frequent urination, heartburn, back pain , and fetal movements at night all disrupt normal sleep.
According to studies, more than 75% of pregnant women notice sleep disorders in at least one trimester. Sleep disorders in pregnancy are associated with an increased risk of gestational diabetes, preeclampsia, and prolonged labor. Therefore, a good night's sleep is not a whim, but a medical necessity.
The best sleeping position during pregnancy
Doctors recommend sleeping on the left side, especially starting from the second trimester. The reason is physiological: the inferior vena cava (a large vessel that carries blood from the lower half of the body to the heart) passes to the right of the spine. When a pregnant woman lies on her back, the uterus presses on her, disrupting the venous return to the heart and reducing the blood supply to the fetus.
Sleeping on the left side improves blood flow through the placenta, reduces pressure on the spine and internal organs, and reduces swelling of the legs.
Is it possible to sleep on the right side? Yes, especially if you fall asleep well in this position. The right side is not as preferable as the left, but it is incomparably better than the back with long terms. In sleep, we still change position – don't panic if you wake up on the wrong side.
Why you can't sleep on your back after 16-20 weeks
Sleeping strictly on the back after 20 weeks is undesirable due to compression of the inferior vena cava. Consequences for the mother: low blood pressure, dizziness, a feeling of shortness of breath, sometimes loss of consciousness. For the fetus: decreased uteroplacental blood flow.
In the first trimester (up to 12-16 weeks), the uterus is still small and does not press on the vessels - you can sleep on your back. But from the 16th week, it is worth gradually accustoming yourself to the lateral position.
What to do if you wake up on your back? Just roll over on your side. The body gives signals long before real harm occurs – therefore, if you feel discomfort, you yourself will want to change your position.
Pillow for pregnant women: do you need it
A special pillow for pregnant women is one of the best investments in the second half of pregnancy. It helps:
Support the abdomen and do not let it "pull" on the mattress.
Relieve the load on the spine and hip joints.
Mechanically limit the flip on the back - the pillow does not allow you to fully lie on your back.
Reduce the severity of heartburn when lifting the headboard.
Support the abdomen and do not let it "pull" on the mattress.
Relieve the load on the spine and hip joints.
Mechanically limit the flip on the back - the pillow does not allow you to fully lie on your back.
Reduce the severity of heartburn when lifting the headboard.
Options: U-shaped pillow (covers the body on both sides), C-shaped (supports the abdomen and back), wedge pillow (placed under the abdomen or back). The choice depends on the preference and size of the bed.
Common sleep problems during pregnancy
Frequent trips to the toilet at night. To reduce nocturnia, try not to drink a lot of fluids 1-2 hours before bedtime. But don't limit your drinking during the day – adequate water intake is important during pregnancy.
Leg cramps. They are typical for the second and third trimester. Causes: deficiency of magnesium, calcium, circulatory disorders. Before going to bed, do a slight stretch of the calf muscles. If cramps are frequent and severe, discuss magnesium supplements with your doctor.
Restless legs syndrome. Unpleasant sensations in the legs ("goosebumps", the desire to move the legs), which increase at rest and at night. It occurs in 20-26% of pregnant women. Associated with iron and folic acid deficiency. It is treated with the correction of deficiencies and moderate physical activity.
Heartburn at night. Do not eat 2-3 hours before bedtime. Sleep with your head raised (15-20 cm). Nocturnal heartburn is described in more detail in the article Heartburn during pregnancy.
Anxiety and insomnia. Restless thoughts about pregnancy, childbirth, and the unborn child prevent you from falling asleep. Relaxation techniques, limiting screens an hour before bedtime, and rituals of falling asleep help. For more information, see the article Anxiety and fears during pregnancy.
Practical Tips for Better Sleep
Maintain a regular sleep routine by going to bed and getting up at the same time.
The temperature in the bedroom is 18-20°C - optimal for sleep.
Avoid screens (phone, TV) 30-60 minutes before bedtime.
Light evening walks, warm showers or baths help to relax.
A daytime nap of 20-30 minutes in the first trimester is acceptable; in the third, try not to sleep after 15:00 so as not to disturb the night's sleep.
Do not take sleeping pills without a doctor's prescription - most of them are contraindicated during pregnancy.
The temperature in the bedroom is 18-20°C - optimal for sleep.
Avoid screens (phone, TV) 30-60 minutes before bedtime.
Light evening walks, warm showers or baths help to relax.
A daytime nap of 20-30 minutes in the first trimester is acceptable; in the third, try not to sleep after 15:00 so as not to disturb the night's sleep.
Do not take sleeping pills without a doctor's prescription - most of them are contraindicated during pregnancy.
Sleep in the third trimester
The third trimester is the most difficult to sleep. A large abdomen restricts postures, the urge to go to the toilet becomes more frequent, and fetal movements can be felt at night. Some women notice that the lateral position also becomes uncomfortable over time - use pillows under the abdomen and between the knees.
Closer to the 36-38th week, some women paradoxically improve their sleep: the abdomen "drops" a little, the pressure on the diaphragm decreases, and it becomes easier to breathe. Others, on the contrary, suffer from an increased urge to go to the toilet due to the pressure of the head on the bladder.
When to see a doctor
See a doctor if:
You suffer from severe insomnia (you cannot sleep for several nights in a row).
At night, severe shortness of breath appears in the lying position.
You or your partner notice that your breathing stops during sleep (apnea).
Restless legs syndrome severely disrupts sleep.
At night, abdominal pain, bloody discharge, and decreased fetal movements appear.
You suffer from severe insomnia (you cannot sleep for several nights in a row).
At night, severe shortness of breath appears in the lying position.
You or your partner notice that your breathing stops during sleep (apnea).
Restless legs syndrome severely disrupts sleep.
At night, abdominal pain, bloody discharge, and decreased fetal movements appear.
Frequently Asked Questions
Is it dangerous to accidentally roll over on your back in your sleep?
No. The body gives signals of discomfort long before the onset of a critical decrease in blood flow – you will simply wake up or instinctively roll over. There is no need to worry about one accidental rollover - it is important to try to fall asleep on your side.
Is it possible to sleep on your stomach during pregnancy?
In the first trimester – yes, if you feel so comfortable. The uterus is still small and protected by the pubic bone. Starting from the second trimester, lying on your stomach simply will not be possible physically due to the size of the uterus.
Conclusion
The left side is the best sleeping position during pregnancy after 16-20 weeks. Use a pillow for pregnant women, maintain a regimen, eliminate the causes of sleep disorders (heartburn, cramps, anxiety). Good sleep is important for both the health of the mother and the normal development of the fetus. In case of serious disorders, do not self-medicate, consult a doctor.
Bibliography
- Warland J, Dorrian J, Morrison JL, O'Brien LM. Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Med Rev. 2018;41:197-219. https://pubmed.ncbi.nlm.nih.gov/29910051/
- ACOG Committee Opinion No. 650. Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015. https://pubmed.ncbi.nlm.nih.gov/26595585/
- Hutchison BL, et al. Maternal sleep position: A systematic review. Aust N Z J Obstet Gynaecol. 2019. https://pubmed.ncbi.nlm.nih.gov/30793297/
- NICE. Antenatal care. NICE Guideline NG201, 2021. https://www.nice.org.uk/guidance/ng201
- Ministry of Health of the Russian Federation. Clinical recommendations: Normal pregnancy. Ministry of Health of the Russian Federation, 2023. https://cr.minzdrav.gov.ru/
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.
