Getting comfortable sleep during pregnancy can feel like an impossible challenge. As your body changes and your belly grows, positions that once felt natural become uncomfortable or even inadvisable. This guide walks you through safe and comfortable sleep positions for each stage of pregnancy, with practical tips for using pillows and body pillows to support restful sleep.
This article provides general information about sleep during pregnancy. Every pregnancy is different, and you should always discuss sleep positions and any concerns with your healthcare provider, particularly if you have a high-risk pregnancy or specific medical conditions.
First Trimester Sleep Positions
During the first trimester (weeks 1-12), you have the most flexibility in sleep positions. Your uterus is still relatively small and protected within the pelvic cavity, so there's no medical reason to avoid sleeping on your stomach or back if these positions are comfortable for you.
However, early pregnancy often brings its own sleep challenges:
- Fatigue: Increased progesterone levels can cause extreme tiredness
- Nausea: Morning sickness can strike at any time, including night
- Frequent urination: Hormonal changes increase bathroom trips
- Breast tenderness: Stomach sleeping may become uncomfortable
This is an excellent time to start transitioning to side sleeping if you're not already a side sleeper. Building the habit early makes the transition easier as your pregnancy progresses.
Second Trimester Adjustments
The second trimester (weeks 13-26) is often called the "honeymoon phase" of pregnancy, as nausea typically subsides and energy returns. However, your growing belly starts to affect comfortable sleep positions.
Why Back Sleeping Becomes Problematic
As your uterus grows, sleeping flat on your back can compress the inferior vena cava, the large vein that returns blood from your lower body to your heart. This compression can:
- Reduce blood flow to you and your baby
- Cause dizziness, shortness of breath, or nausea
- Lead to backaches and potentially worsen hemorrhoids
Most healthcare providers recommend transitioning away from back sleeping by the end of the second trimester, though some suggest making the change earlier.
Stomach Sleeping Considerations
While not harmful to your baby (who is well-protected by amniotic fluid), stomach sleeping typically becomes physically uncomfortable during the second trimester simply due to the size of your belly.
- Begin transitioning to side sleeping if you haven't already
- Start using pillows for support as your belly grows
- Listen to your body—discomfort is usually a signal to change positions
- Consider investing in a pregnancy pillow during this trimester
Third Trimester: The Side-Sleeping Phase
During the third trimester (weeks 27-40), side sleeping becomes essential. Research published in reputable medical journals suggests that sleeping on your side, particularly your left side, is the safest position during late pregnancy.
Why Left Side Is Often Recommended
Sleeping on your left side offers several benefits:
- Optimal blood flow: Keeps the uterus from pressing on the liver (which is on your right side)
- Better circulation: Improves blood flow to the heart, uterus, kidneys, and baby
- Reduced swelling: May help reduce swelling in legs, ankles, and feet
- Kidney function: Helps kidneys efficiently eliminate waste and fluids
That said, don't panic if you wake up on your right side or even on your back. Your body will usually alert you with discomfort before any position causes problems. The key is to start on your side when you go to sleep and return to side sleeping when you wake during the night.
If you keep rolling onto your back during the night, try placing a pillow behind your back to prevent this. Some women find wearing a sports bra to bed with a tennis ball tucked into the back helps them stay on their side.
Using Pillows for Pregnancy Sleep Support
Pillows are your best friends during pregnancy. Strategic pillow placement can dramatically improve comfort and help you maintain safe sleep positions.
Basic Pillow Positioning
Even with regular pillows, you can create a supportive sleep setup:
- Between your knees: Keeps hips aligned and reduces lower back strain
- Under your belly: Supports the weight of your growing bump
- Behind your back: Prevents rolling onto your back during sleep
- Under your head: Additional support if you experience heartburn (elevate slightly)
Pregnancy Body Pillows
Dedicated pregnancy pillows come in several shapes, each designed for different needs:
U-Shaped Pillows: These wrap around your entire body, supporting both front and back simultaneously. They're ideal if you tend to switch sides during the night, as the support follows you. However, they're large and take up significant bed space.
C-Shaped Pillows: These curve around your body, typically supporting your head, belly, and knees in one continuous pillow. They're more compact than U-shaped options but provide support on only one side.
Wedge Pillows: These smaller, triangular pillows can be placed under your belly or behind your back. They're versatile, affordable, and great for targeted support.
Full-Length Body Pillows: Straight body pillows can be hugged in front for belly support while keeping your spine aligned. They're the most versatile option and useful beyond pregnancy.
Common Sleep Challenges and Solutions
Heartburn and Acid Reflux
Pregnancy hormones relax the valve between your stomach and esophagus, making heartburn common. To manage nighttime heartburn:
- Elevate your upper body slightly using pillows or a wedge
- Avoid eating within 2-3 hours of bedtime
- Eat smaller, more frequent meals
- Avoid trigger foods (spicy, acidic, fatty foods)
Hip Pain
The weight of your belly and pregnancy hormones that loosen joints can cause significant hip pain. Solutions include:
- Use a firm pillow between your knees to keep hips aligned
- Consider a mattress topper for additional cushioning
- Try gentle prenatal yoga or stretching before bed
- Alternate which side you sleep on throughout the night
Shortness of Breath
As your uterus expands, it can press against your diaphragm, making breathing feel difficult. Propping yourself up with pillows to sleep in a semi-reclined position can help, while still maintaining a side-leaning position.
Contact your healthcare provider immediately if you experience severe shortness of breath, chest pain, sudden severe swelling, or if your baby's movements decrease significantly. These could indicate complications requiring medical attention.
Tips for Better Pregnancy Sleep
Beyond positioning, these general strategies can improve your sleep quality during pregnancy:
- Stay hydrated: But reduce fluids in the evening to minimise bathroom trips
- Establish a bedtime routine: Consistent wind-down habits signal your body it's time to sleep
- Keep your bedroom cool: Pregnancy can make you sleep hot; aim for 16-19°C
- Nap strategically: Short afternoon naps can help with fatigue without disrupting nighttime sleep
- Manage stress: Pregnancy anxiety is normal; consider relaxation techniques or counselling if needed
Preparing for Postpartum Sleep
While pregnancy sleep challenges are temporary, it's worth noting that your body pillow and sleep strategies will remain valuable after birth. Many women find body pillows helpful for comfortable breastfeeding positions, supporting their body during recovery, and creating safe co-sleeping boundaries.
The habits you build during pregnancy—like side sleeping and using supportive pillows—often become permanent improvements to your sleep quality long after your baby arrives.