Sleeping Positions: Sleeping Pregnant Comfortably and Healthily

It’s not always easy to get comfortable when you’re pregnant and trying to sleep. Learn which sleeping positions are healthier for you and your developing baby.

During pregnancy, a woman’s body goes through a plethora of changes. An ever-expanding abdomen, back pain, heartburn, insomnia, and shortness of breath can make getting enough rest a real challenge.

Dr. DiLeo answers questions about which sleeping positions are best, which to avoid, and how to get as comfortable as possible while trying to catch some much-needed rest.

Is it really healthiest to sleep on my left side and not my back? Why?

Sleeping on the left side is best for you and the baby—and it’s all a matter of anatomy.

As the baby grows, the abdomen has to harbor an ever-increasing uterus. The heavier uterus rests flat on the inferior vena cava—the main vein just on the right side of your spine that drains the entire lower half of the body.

When the vena cava is compressed, much like stepping on a garden hose, flow towards the heart is obstructed and drainage of the lower half of the body becomes sluggish. Not only does this increase the swelling of your ankles, feet, and legs, but it also impacts hemorrhoids (ouch!). And decreased return of blood flow to the heart will cause hypotension (lowered blood pressure) down the line and result in diminished arterial blood flow to the uterus, placenta, and baby.

Sometimes this hypotension is evident when a woman has an ultrasound, during which she lies flat. One of the symptoms of hypotension is nausea that accompanies light-headedness.

All of this makes lying on the back the worst possible sleeping position in the third trimester of pregnancy. Lying on the right side is better than lying on your back, but lying on your left side is the best of all, because this is the position which will have the least amount of weight upon the vena cava.

I’m only a few weeks pregnant. Can I still sleep on my stomach?

The size of the uterus is the determining factor as to whether it can compress your vena cava, causing dizziness when you’re flat on your back, or whether your baby gets cramped when you sleep on your belly.

In early pregnancy, any sleeping position is fine. Your uterus isn’t big enough to rise out of the pelvis and become an abdominal organ before 12 weeks, so there’s really no chance of “crushing” your baby. As your pregnancy progresses, you will likely get uncomfortable enough to want to change your sleeping position, but for the record, lie on your left side after 12 weeks. The right side is OK too, but the left side is better. And again, lying on your back later in pregnancy is the worst position.

I’m not used to sleeping on my side! How am I supposed to get comfortable?

For many pregnant women, side sleeping is uncomfortable. The answer? Pillows. Lots of them. You don’t have to spend a fortune on fancy pillows—any old pillows will do.

Begin by lying on your side (ideally, your left side) with your top leg crossed over the bottom one. Tuck a pillow under your head, tuck another pillow under your belly, yet another one between your knees, and, if you want to, hug one. You might even want to stuff a fifth one behind your back. These pillows will help you support your body—even when you’re nearing the end of pregnancy.

Yes, you’ll probably roll around in the night and end up on your back again. As soon as you wake up (or your loving partner wakes you up), turn over and reassemble the arrangement.

You’ll soon get used to this sleeping position, and it will give you something else to look forward to once you’ve delivered—sleeping comfortably on your back, belly, or even left side!

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