When to stop lying on back while pregnant

Is Back Sleeping Harmful When Pregnant? – Cleveland Clinic

Since the moment you saw those two, bliss-inducing pink lines on your pregnancy test, you’ve been painstakingly conscientious to do nothing that would harm your baby.

You’ve kicked your latte habit. You take your prenatal every evening like clockwork. And you don’t change the kitty litter. (Heck, who are we kidding? Someone else can do that one permanently!)

But then ― without even meaning to ― you woke up and had a groggy (and panicked!) realization: You were sleeping on your back. After all, every single pregnancy book you’ve read has advised against it. But how bad is it really?

The why behind the warnings

As your uterus gets larger (usually by the time you’re 20 weeks ― that’s five months ― along), it’s big enough that it lies on top of your inferior vena cava, if you’re lying on your back, explains Ob/Gyn Salena Zanotti, MD.

“This big blood vessel is what brings blood flow back to your heart,” Dr. Zanotti explains. “So the thought is if you have anything large that’s pushing against the blood flow return, you’ll have less blood flow to your heart. That means you’ll have less blood flow to yourself and the baby.”

So what can this actually do?

Researchers in New Zealand found that there was a potential increased risk of stillbirth for those who slept the entire night on their back. But Dr. Zanotti says these and similar studies were small, not randomized and shouldn’t be taken as definite proof.

For instance, the studies looked at those who spent all night on their backs and never got up to go to the bathroom. “But most people don’t sleep the entire night without getting up at that point in pregnancy ― even if they wish they could,” Dr. Zanotti says.

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Plus, she adds, there are many factors involved in pregnancy, so it’s really hard to say one thing causes stillbirths or other problems. “A lot of people who are back sleepers may be snorers or have sleep apnea. That’s where these studies are faulted because you can’t weed out all those things.”

Quantifying it is the tricky part

Dr. Zanotti reassures expectant mothers not to stress if they accidentally find themselves on their backs for a brief spell.

“We do know that short periods of time ― even if you were on your back for an hour or two ― probably do no harm to your child,” she says. “The hard part is we can’t really quantify exactly how much is ‘safe time’ and what it really does.”

When they’re far along in their pregnancies, they’ll get light-headed or not feel right if they’re on their backs for long periods of time, Dr. Zanotti notes.

“Often times, your body is going to tell you something isn’t right and that will make you move around,” she says. “So if you’re on your back and having a little trouble breathing or maybe your heart is beating faster, it’s your body’s way of saying you need to roll over on your side. Listen to your body.”

The best advice if you’re expecting

So what’s an already uncomfy expectant mother to do? After 20 weeks of pregnancy, try not to spend the entire night on your back, Dr. Zanotti advises. She suggests putting a pillow between your back and the mattress as insurance. That way, even if you do roll over, you’re on a bit of a tilt.

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“As long as you’re not flat on your back, you’re going to be fine,” she says. “Even if you can be on a 20- to 30-degree angle, that’s going to relieve any potential pressure on your inferior vena cava. I think most people, even if they were back sleepers, can be comfortable sleeping with just that bit of an angle.”

While it’s sensible to be cautious, Dr. Zanotti says it’s also important to comfort those who already have enough on their minds.

“I’ve had patients who’ve woken up on their back and they’re worried they’re going to cause their child brain damage. That has not been shown,” she says. “We don’t see a higher risk of autism or developmental disorders in those who’ve slept on their back for a little bit.”

And left side vs. right side?

Traditionally, Ob/Gyns have advised pregnant people to sleep on their left side. That’s because your inferior vena cava is on your right. “The thinking was that if you slept on your right side, you could potentially compress the blood flow,” Dr. Zanotti says.

But today, the evidence shows that if you’re truly on your side, you’re still going to get good blood flow. So most experts tell people it’s OK to sleep on either side.

“The left side’s ideal,” she says. “If you like your left side, absolutely wonderful. But if you’re a right-sided sleeper, you’re fine that way too.”

Sleep position in pregnancy Q&A

Tommy's PregnancyHub

In the third trimester of pregnancy going to sleep on your side has been shown to help prevent stillbirth.

In the third trimester our advice is to go sleep on your side because research has shown that this is safer for baby. This includes night sleep and day time naps.

Can I sleep on my back during pregnancy?

Research has shown that in the third trimester (after 28 weeks of pregnancy) going to sleep on your back increases your risk of stillbirth. As the link has now been shown in four separate research trials, our advice is to go to sleep on your side in the third trimester because it is safer for your baby. The advice relates to any episode of sleep, including:

going to sleep at night
returning to sleep after any night wakenings
day time naps.

We don’t want you to become anxious about this. If your pregnancy is uncomplicated your risk of stillbirth is low (1 in 200 babies are stillborn). Going to sleep on your side will make it even lower.

How reliable is the research?

The research linking going to sleep on your back to stillbirth is very reliable. Four case control research studies (in which information from women who have had a stillbirth is compared with information from women who have not) have been carried out into maternal sleep position and stillbirth and all have shown that there is a link.

What if I wake up on my back during the night?

The research has been focused on position going to sleep, not position during the night. If you wake up on your back, just settle back to sleep on your side.

We cannot control our position when we are asleep and a large bump is likely to be uncomfortable enough to prevent you from being on your back for long during the night. We also know that the position we go to sleep in is the position we spend the longest amount of time in during the night.

What could cause the increased risk of stillbirth?

Sleep position in the third trimester is important because if you are on your back the combined weight of baby and womb puts pressure on other organs in your body.

Researchers do not know for certain what exactly is causing the increased risk of stillbirth, but we already know the following, which could play a part :

When sleeping/lying on your back the baby and womb put pressure on the main blood vessels that supply the uterus and this can restrict blood flow/oxygen to the baby.
Further recent studies have shown that when a woman lies on her back in late pregnancy (compared to lying on side) the baby is less active and has changes in heart-rate patterns. This is thought to be due to lower oxygen levels in the baby when the mother lies on her back.

Does it make a difference which side I sleep on in pregnancy?

There are many websites that tell you that the left side is best to sleep on during pregnancy. This is for the following reasons:

One of the smaller research studies, from Auckland, New Zealand, showed that women who sleep on their left side on the last night of pregnancy halved their risk of stillbirth compared to those who slept on their right. However, the same finding has not been seen in any other trial (there have been three other published research studies since then).
Sleeping on your left has been shown to help your kidneys to get rid of waste products and fluids from your body.

Therefore, while sleeping on your left side has not conclusively been shown to reduce your risk against sleeping on your right, there are reasons that you might choose to do so.

Tips for sleeping on your side in pregnancy

Put pillows behind you to prevent falling on your back. It won’t prevent you being on your back for certain but is likely to make it more uncomfortable.
If you have long hair, try tying it in a low bun, which may make it uncomfortable to sleep on your back for any length of time.
If you wake up for any reason during the night, check your position and go back to sleep on your side.
If you are likely to nap during the day pay the same attention to sleep position during the day as you would during the night.

If you're finding sleeping on your side difficult because of SPD/PGP, try these tips.

In the early days of pregnancy it is fine to sleep on your stomach. Your bump will not start showing until the second trimester and sleeping on your stomach is unlikely to be uncomfortable. In the third trimester, you will have a large bump and it is very unlikely that you would choose this position. However, if you do wake up on your stomach, don’t worry, just roll onto your side.

Heazell AEP, Li M, Budd J, Thompson JMD, Stacey T, Cronin RS, Martin B, Roberts D, Mitchell EA, McCowan LME. Association between maternal sleep practices and late stillbirth – findings from a stillbirth case-control study. BJOG2017; https://doi.org/10.1111/1471-0528.14967.

Stacey T1, Thompson JM, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LM.
Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ. 2011 Jun 14;342:d3403. doi: 10.1136/bmj.d3403.

Gordon A1, Raynes-Greenow C, Bond D, Morris J, Rawlinson W, Jeffery H. Sleep position, fetal growth restriction, and late-pregnancy stillbirth: the Sydney stillbirth study. Obstet Gynecol. 2015 Feb;125(2):347-55. doi: 10.1097/AOG.0000000000000627.

Lesley ME, McCowan LME, Thompson JMD, Cronin RS et al (2017) Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PLOS One https://doi.org/10.1371/journal.pone.0179396

Jeffreys RM, Stepanchak W, Lopez B, Hardis J, Clapp JF, 3rd. Uterine blood flow during supine rest and exercise after 28 weeks of gestation. BJOG : an international journal of obstetrics and gynaecology. 2006 Nov;113(11):1239-47

Khatib N, Weiner Z, Beloosesky R, Vitner D, Thaler I. The effect of maternal supine position on umbilical and cerebral blood flow indices. European journal of obstetrics, gynecology, and reproductive biology. 2014 Apr;175:112-4.

Stone PR, Burgess W, McIntyre JP, Gunn AJ, Lear CA, Bennet L, et al. Effect of maternal position on fetal behavioural state and heart rate variability in healthy late gestation pregnancy. The Journal of Physiology. 2017 Feb 15;595(4):1213-21.

Murray I, Hassall J. 2014. Change and adaptation in pregnancy. In: Marshall J, Raynor M. eds. Myles Textbook for Midwives. 16th ed. Edinburgh: Churchill Livingstone, 143-177

Is it possible to sleep on your stomach during pregnancy

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Many girls like to sleep on their stomachs, moreover, many of them can fall asleep only in this position. When planning a future pregnancy, many people have reasonable questions about whether it is possible for pregnant women to sleep in this position and for how long can this be done? Obstetrician-gynecologist EMC Olga Panfilova answers these and other questions.

Can I sleep on my stomach in the first trimester?

Of course, for good health and mood, a calm and complete rest at night is very important. This is especially true for a woman who is expecting a baby, because it is she who often has problems with sleep, not least related to the positions that she usually takes in a dream. Including the posture on the stomach. However, in the early stages of pregnancy, you can safely continue to do this. The uterus is still so small and, moreover, so well protected by the bones of the pubis, that this position of the body is not capable of causing any harm to the developing baby. If the usual posture began to cause you discomfort, then most likely this is due to the so-called inflection of the uterus, which occurs due to the fact that the tissues of this organ soften, especially in the isthmus zone. Another cause of inconvenience may be the mammary glands, which begin to gradually increase in size, become painful. If you're having similar problems, it's time to find more comfortable sleeping positions, such as trying to fall asleep lying on your back. And even better already in the early stages to accustom yourself to sleep on your side. You will definitely appreciate the benefits of the newly acquired habit later, when your stomach has reached such a size that even the very thought of trying to sleep on it seems ridiculous.

Can I sleep on my stomach in the second trimester?

In the second trimester of pregnancy, the expectant mother can already boast of a voluminous belly, which means that the baby inside has grown up. And even though it is reliably protected by the fetal membranes, amniotic fluid, the muscles of the uterus and the press, laying on the stomach, you still put pressure on the baby. And just imagining that you are lying on your child, you are unlikely to be able to sleep peacefully. At this stage of pregnancy, you can still sleep on your back, but it is best to lie on your side, so you arrange your stomach as comfortably as possible.

Can I sleep on my stomach in the third trimester?

In the third trimester of pregnancy, sleeping on the back of the expectant mother is no longer recommended. The growing uterus puts extra pressure on the blood vessels behind the abdomen. When you lie on your back, this pressure interferes with the normal circulation of blood that should flow to your baby from the lower part of your body. You yourself can feel how uncomfortable this position is by noticing that it becomes difficult for you to breathe when you lie on your back.

The only acceptable sleeping position at this stage of pregnancy is the side position. To improve blood circulation, it is better to raise your legs a little: when you lie on your side, place a pillow under your upper leg. To facilitate the work of the kidneys and improve the outflow of bile, it is optimal to sleep on the left side. But if you are worried about discomfort in the region of the heart, it is better to roll over to the right. Many women claim that special pillows for pregnant women bring great relief, providing the most comfortable position for the whole body during sleep.

Detailed answers to the most burning questions during pregnancy you can get within the framework of the School of Moms EMC

How to sleep during pregnancy

It is difficult to overestimate the role of sleep in the life of every person. A complete healthy rest allows you to fully restore the functioning of the nervous system, relieve stress, improve performance and increase activity. Chronic sleep deprivation is the cause of many diseases. What can we say about a woman who is at the stage of bearing a baby. During this period, more than ever, she needs a healthy, long and full sleep. However, unfortunately, it is during this period that one can only dream of a restful sleep.

As soon as a woman finds out about her new situation, she has to give up a lot for the sake of the health of her unborn baby. And you need to give up not only bad habits: alcohol, cigarettes, coffee, but also from a comfortable sleep.

The cause of insomnia can be :

Anxiety;
Frequent urination;
Fears and phobias before a new stage of one's life;
Nervousness and irritability;
Digestive disorder;
Toxicosis;
Physical indisposition;
Uncomfortable posture.

During the period of bearing a child, the female body experiences an extraordinary load, especially in the last trimester. The need for more sleep increases, because the body expends much more energy. Therefore, healthy sleep and pregnancy are inextricably linked.

As soon as a woman finds out about her new position, she has to give up a lot for the sake of the health of her unborn baby. And you need to give up not only bad habits: alcohol, cigarettes, coffee, but also from a comfortable sleep.

Let's try to figure out how to sleep during pregnancy, so as not only not to harm the health of your unborn baby, but to sleep well.

Looking for a comfortable sleeping position

Each person has his own favorite position, in which it is easy to fall asleep and sleep. Many do not imagine a comfortable rest on their backs, accustomed to sleeping on their stomachs. This habit will have to be sacrificed, as it is unsafe for the normal development of the fetus. If in the first three months of pregnancy a woman can still sleep in the position in which she is used to and feels comfortable, then after the first trimester the growing belly will not allow her to lie safely in this position. Despite the natural protection of the baby in the form of amniotic fluid, there is a high probability of injuring the baby in a dream, squeezing it. But what is the right way to sleep during pregnancy?

Back position

Even if you are used to sleeping in a Spartan position, on your back, with your arms spread wide, from the 28th week you will have to radically change your lifestyle. The fact is that as the fetus grows, the load on the intestines and vena cava will increase significantly, blocking the access of oxygen to the baby.

If you sleep on your back during pregnancy, you may experience the following problems:

Dizziness;
Nausea;
Convulsions;
Numb limbs;
Pressure reduction;
Hemorrhoids;
Heaviness of breathing.

If you feel these symptoms or the baby gives persistent signals, you need to urgently change your position, so squeezing the vena cava is fraught not only with poor health for the mother, but also with a lack of oxygen supply to the fetus.

Stomach position

One of the most beloved positions for many people, which allows you to quickly fall asleep while hugging a pillow. Many women, as soon as they find out about the change in their lives, are interested in the question, is it possible to sleep on your stomach during pregnancy? Doctors recommend abandoning this position already in the first weeks, even before the enlarged belly makes it impossible to fall asleep peacefully.

If you are afraid during sleep, without controlling your movements, to arbitrarily roll over on your stomach, you can put a large pillow that does not allow you to change position.

Side position

In order to normalize your sleep and not harm the health of the baby, experts recommend sleeping on your side during pregnancy. And if at first this option seems unacceptable to many, after the second trimester, lying on your side is the only possible one. But here the question arises, on which side to sleep in order to ensure the safety of the fetus?

Sleeping on the right side can cause squeezing of the kidney, which can have dire consequences. The ideal posture is lying on the left side. Thus, you not only do not injure the unborn baby, but also improve blood flow along with oxygen to the placenta.

But one should not ignore the individual characteristics of each organism and the position of the fetus in the uterus. When the baby is in a transverse position, choose the side where the baby's head is. And with a breech presentation, doctors recommend changing the position several times a night.

If you still cannot improve your sleep, you feel unwell and you are tormented by insomnia, then it is better to consult a specialist. A good gynecologist will analyze the situation and help solve the problem. If necessary, he will prescribe a safe sedative that stabilizes the emotional state and helps to fall asleep calmly, resting and restoring the nervous system in a dream.