How to not sleep on your back during pregnancy

Sleeping on your side is the best position for you and your baby during pregnancy, especially once you're more than halfway through your pregnancy.

Sleeping on your side places the least pressure on your veins and internal organs. This ensures the best blood flow to the uterus, which means your baby will get maximum nutrients and oxygen. Good circulation also helps you by reducing potential swelling, varicose veins in your legs, and hemorrhoids.

I'm not a side sleeper. How can I make the switch to sleeping on my side?

If you're used to sleeping on your back or tummy, you might try to make the transition to your side early in your pregnancy, while sleeping in general isn't uncomfortable. As you get bigger, you can:

• Use pillows under your belly, between your legs, and behind your back
• Lean back against a pillow while on your side
• Lie in a half-sitting position, propped up against some pillows, which can be helpful if you suffer from heartburn.

Is one side better than the other for sleeping during pregnancy?

Some caregivers will suggest that you sleep on your left side in particular, because it's thought that blood flow is better to the heart, uterus, kidney, and baby when you're on your left side. Sleeping on your left side also keeps pressure off your big vein (inferior vena cava), which brings blood from your legs back up to your heart and keeps your circulation going.

But there's no scientific evidence that the left is better than the right. So feel free to shift from side to side.

Is it safe to sleep on my back during pregnancy?

If you typically sleep on your back (supine), it's safe to continue doing so through the first trimester. But as your uterus gets heavier around mid-pregnancy, it's best to choose another position.

That's because lying on your back allows your growing uterus to compress the inferior vena cava (mentioned above), which could theoretically interfere with the flow of blood and nutrients to the placenta and developing baby. It can also result in decreased blood flow for you, which may cause dizziness, shortness of breath, or a fast heart rate. Back sleeping can also contribute to the circulation problems mentioned above (varicose veins, hemorrhoids, swelling) as well as muscle aches and pains and snoring, which can lead to sleep apnea as you put on weight.

Don't be alarmed if you go to sleep on your side and wake up flat on your back. It happens all the time and shouldn't have any serious adverse effect on your baby's health. Just shift your position and go back to sleep.

Is it safe to sleep on my stomach during pregnancy?

Yes. Tender breasts and a growing belly may soon make sleeping on your stomach uncomfortable, but you can sleep face down for as long as it suits you.

If you're used to sleeping on your stomach and want to continue, try using a donut-shaped pillow to support your growing belly. Some women find this allows them to sleep comfortably on their stomach well into the third trimester.

How to sleep when pregnant

Even after you find a comfortable sleeping position (and the perfect pregnancy pillows to make it work), good sleep may be hard to get. Pregnancy symptoms like the constant need to pee, nausea, heartburn, and restless legs can make it hard to sleep well when you're pregnant. But there are plenty of sleep strategies to try, too. Cut down on caffeine, drink more fluids in the morning and less at night, have a light snack before bedtime, and use relaxation techniques like yoga, stretching, and deep breathing. Establish a soothing bedtime routine and try to go to bed and get up at around the same time every day. If nothing seems to help, ask your provider about safe sleep medications during pregnancy.

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As your belly grows, sleeping on your back may not be good for you. It puts the weight of your uterus on your spine and back muscles. In the second and third trimesters, lying on your back may compress a major blood vessel that takes blood to your uterus, making you feel dizzy and possibly reducing blood flow to your fetus.

Sleeping on your side during your second and third trimesters may be best. Keep one or both knees bent. It may help to place a pillow between your knees and another under your belly. You also can try a full-length body pillow for support.

Published: January 2021

Last reviewed: January 2021

Topics

Pregnancy During Pregnancy Health and Safety During Pregnancy Sleep

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Pregnancy can be exhausting. Plus, you need sleep now more than ever. But finding a comfortable position can be a challenge, especially when you are plagued with concerns over which positions are safe and which should be avoided.

If you are a back sleeper, you may have heard that sleeping on your back is a pregnancy no-no. Naturally, you may be concerned, especially if you wake to find that you have spent most of the night on your back.

Turns out, back sleeping is fine during the first and second trimesters. But during the third trimester, it increases your risk of having a stillbirth and other problems, so it is best to choose another position.

"Sleeping on your back during pregnancy should be avoided in the third trimester to avoid compression of the vein that returns blood to the heart," says Kim Langdon, MD, an Ohio-based OB/GYN with more than 20 years of experience.

Previous studies indicated that sleeping on your back during pregnancy puts you at risk of preeclampsia and your baby at risk of low birth weight, reduced fetal growth, and stillbirth. However, the latest research says that sleep position is not an issue during the first 28 weeks of pregnancy.

When the baby, placenta, and uterine fluid grow heavier, sleep position becomes an important consideration. As you get closer to the third trimester, this weight may compress important blood vessels, leading to problems like low birth weight, preeclampsia, reduced fetal growth, and stillbirth.

The weight of the contents of your uterus is what determines when back sleeping becomes unsafe. This may vary from person to person, so you should always talk with your healthcare provider to understand exactly when and whether back sleeping is safe for you and your specific pregnancy.

Around 28 weeks gestation, choose a sleeping position other than supine. But if you do wake up on your back, just resettle yourself on your side or stomach.

Every pregnancy is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about sleeping on your back while pregnant

Back sleeping during the first 28 weeks of pregnancy will not likely impact your baby. After about 28 weeks, sleeping on your back may increase the baby's risk of being born at low birth weight due to reduced fetal growth, or stillbirth.

Lying on your back during pregnancy becomes problematic when your uterus becomes heavier, around 28 weeks. The contents of your uterus, which includes your baby, the placenta, and amniotic fluid, make up about a third of your pregnancy weight gain.

When you lie in the supine position, the weight of your uterus falls upon a vein called the inferior vena cava. The inferior vena cava returns blood from the abdomen to the heart. Compressing this vein may lead to low birth weight, preeclampsia, reduced fetal growth, and stillbirth.

There are a few risks to be aware of when it comes to sleeping on your back later on in pregnancy. Here are some of the risks associated with sleeping in a supine position.

Too much pressure on the vena cava may increase your risk of developing preeclampsia, high blood pressure during pregnancy. With preeclampsia, you may experience headaches or abdominal pain, and your baby is at risk of preterm delivery or stillbirth.

Sleeping on your back past 30 weeks gestation can compress the inferior vena cava, potentially restricting blood flow, leading to reduced fetal growth. Reduced fetal growth also may result in low birth weight, which is defined as less than 5 pounds, 8 ounces. Babies born at low birth weight face increased risks, including breathing problems and jaundice.

Studies found a threefold increase in stillbirth risk when pregnant people slept on their back after 28 weeks gestation. Back sleeping increases the risk of fetal growth restriction and fetal stress, both of which contribute to the risk of stillbirth. If comorbidities are present, these factors further increase the risk of stillbirth.

If you prefer to sleep in the supine position, it is fine to resume doing so after you give birth. When you deliver your baby and placenta, the vast majority of the weight in your uterus exits your body. Then, you no longer have the issue of compressing the vena cava to worry about. And once your baby is dozing in a bassinet, your sleeping position will not affect their development.

Back sleeping is no longer safe after 28 weeks gestation, but there are a few other comfortable positions for you to safely doze in.

Sleeping on your stomach does not put pressure on any major blood vessels and is considered safe for your baby. Using a donut pillow like a Boppy may help you rest comfortably in this position.

If you sleep best on your back, sleeping almost on your back but not quite might be your most comfortable option towards the third trimester.

"A good position for sleeping while pregnant is what the medical community calls the lateral decubitus position," notes Alan Lindemann, MD, an obstetrician and maternal mortality expert and co-author of “Modern Medicine: What You’re Dying to Know,” a consumer action guide about how to navigate the United States healthcare system. "This position is halfway between flat on your back and totally on your side."

Pillows and bolsters may help you get into this position and stay in it while you sleep. When reclining in the lateral decubitus position, you can be on either side.

"The important point is to not be fully on your side or fully on your back," explains Dr. Lindemann.

After 28 weeks gestation, sleeping on your right side may have similar risks to sleeping on your back because this position can compress the aorta, a major artery. Sleeping on your left side is a safe alternative.

Sleeping on your back during pregnancy is safe during the first two trimesters. During the third trimester, it is best to avoid back sleeping because it has been associated with some risks to both you and your baby.

If you wake to find yourself sleeping on your back, simply reposition yourself. You also can place a pregnancy pillow behind your back to keep you from rolling into that position. Talk to a healthcare provider if you have any questions or concerns about sleep positions during pregnancy.