Best and worst sleeping positions during pregnancy

Sleeping during pregnancy can be a bit of a conundrum: you’re exhausted and your body and mind crave more sleep. However, whether it’s the pregnancy hormones, heartburn, and cramps keeping you awake or the discomfort that comes with a growing belly… You just can’t seem to consistently get that shut-eye. Cool, thanks, biology!
You’re not alone. According to the American Pregnancy Association [1], 78% of pregnant women have insomnia while sleeping. This is supported by numerous research studies conducted globally.
Turns out, there are certain sleeping positions that can ease discomfort and promote better sleep. One of the best sleeping positions includes side lying with a pillow and wedge supports to support the spine, hips, and knees in a neutral position. However, there are no hard and fast rules regarding pregnancy pillow use. There will be individual variations with the comfort level and what works best for you.
We do know that sleeping posture can affect the duration and quality of sleep, as poor spinal and hip alignment can lead to increased achiness and pain which will interrupt those sweet dreams like a smack in the face.
IN THIS ARTICLE:
Can you hurt the baby in the womb while sleeping?
Best positions to sleep during pregnancy
Worst sleep positions in pregnancy
Pregnancy sleeping positions FAQ
Can you hurt the baby in the womb while sleeping?
Many physicians recommend sleeping on the left side during pregnancy, as this places less pressure on the blood vessels supplying the uterus. This advice is largely based on a small sample study [2] where women who reported that they did not sleep on their left side had a greater incidence of poor health outcomes for their baby.
Solely sleeping on the left side can be troublesome to moms who are not accustomed to sleeping on their sides – not to mention that when sleeping, we’re not always conscious about what position we wind up in!
A study published in the journal of Obstetrics and Gynecology [3] found that back sleeping in early to mid-pregnancy (up to 29 weeks), there was no greater risk of adverse reactions between mothers who sleep on their left side and those who slept on their right or on their backs.
Now, the research is less clear regarding 3rd-trimester sleeping positions. To be safe, side-sleeping in the 3rd trimester is recommended to promote a reduced risk of complications for your baby.
Best positions to sleep during pregnancy
Position 1: Pillow between legs
A long regular pillow or a pregnancy pillow between the upper thighs creates space in the pelvis and hips. This tends to work quite well for the 1st and 2nd trimesters.

Position 2: Pillow cradling back and front.
A ‘C’ or ‘U’ shaped pregnancy pillow to support the head, neck, and spine, and create alignment and space in the pelvis and hips. This can really ease the pain and discomfort associated with 3rd-trimester sleep.

Position 3: Pillow supporting back
If you are a back sleeper, using a pillow wedge behind your back or using a C or U pregnancy pillow may help prevent you from rolling over and encourage the new habit of side sleeping.

Worst sleep positions in pregnancy
Position 1: Lying on your stomach after the 1st trimester
Prefer to sleep on your tummy? While there’s no evidence to support that stomach sleeping during pregnancy is dangerous, it can be increasingly uncomfortable as the baby grows and the abdomen stretches.
Position 2: Flat-Back lying for long periods of time
One small study out of New Zealand [4] found that back sleeping may be associated with an increased risk of stillbirth. However, the study was small and of low-quality evidence. Most obstetricians suggest that most pregnant people in their 2nd or 3rd trimester will naturally feel strange after too long sleeping in a completely flat position and shift. Even sleeping on a slight incline versus flat on the back was associated with little risk to the pregnancy.
Takeaway
With the right support (pun intended!), it is possible to find comfort in sleeping during pregnancy. Pregnancy pillows or wedges are often recommended by physicians and physical therapists/occupational therapists to help reduce back, hip, and pelvic pain commonly associated with the later stages of pregnancy. It seems that the safest position during pregnancy for sleeping is lying on your left side.
Pregnancy sleeping positions FAQ
Q: How many hours should a pregnant woman sleep?
A:
Pregnant women should aim for between 7 - 10 hours of sleep per night. A study by Kathy Lee[5], a professor of nursing at the University of California - San Francisco, found that women who slept less than 6 hours of sleep per night were 4.5 times more likely to have a C-section and their average length of labor was 10 hours or longer compared with first-time mothers who slept 7 hours or more.
Q: Does baby sleep in the womb when mother sleeps?
A:
Little is known about sleep and early fetal development, but most child development experts agree that a fetus sleeps a lot - up to 95% of the time by the end of pregnancy.
Q: Why does it hurt to turn over in bed while pregnant?
A:
It can be common to experience back pain and aches during pregnancy, mostly due to the increased pressure on the low back with a growing belly. Turning can elicit nerve compression and muscle soreness.
Q: What happens if you accidentally sleep on your back while pregnant?
A:
While there is no definitive risk of back sleeping, it is generally recommended that to promote optimal circulation and minimize compression of major arteries supplying the baby, moms sleep on their left side. Most obstetricians will agree that pregnant mothers tend to move a lot due to discomfort in their sleep and if they wake up on their backs, even after a few hours, it likely poses little risk to the fetus.
Note: The content on this site is for informational purposes only and should not replace medical advice from your doctor, pediatrician, or medical professional. If you have questions or concerns, you should contact a medical professional.
5 Sources
American Pregnancy Association (2023). Pregnancy Insomnia: Snooze or Lose! https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/insomnia-during-pregnancy/
Thompson, et al. (2011). Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ. https://www.bmj.com/content/342/bmj.d3403
Silver, et al. (2019). Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes. Obstetrics and gynecology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768734/
Thompson, et al. (2011). Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ. https://www.bmj.com/content/342/bmj.d3403
Lee, K. & Gay, C. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. https://www.ajog.org/article/S0002-9378(04)00574-5/fulltext