Sleeping on Back During Pregnancy – Is It Harmful?

Sleeping on your back during pregnancy can become less safe, especially after 28 weeks, because the weight of the growing uterus may compress major blood vessels and reduce blood flow to you and your baby. Research reviewed by the UK’s National Institute for Health and Care Excellence (NICE) suggests that going to sleep on your back in late pregnancy is associated with a higher risk of stillbirth, although the overall risk remains low (1).

In this article, you’ll learn all about sleeping on back and pregnancy, including why your sleep position matters, when sleeping on back in pregnancy becomes a concern, what the latest medical evidence says, and practical tips for finding a safe and comfortable sleeping position throughout each trimester.

Can You Sleep on Your Back While Pregnant?

If you’re wondering, is it OK to sleep on your back during pregnancy? The answer depends on how far along you are. If you usually sleep on your back, it is generally considered safe during the first trimester. However, as your pregnancy progresses—especially after the second trimester—you may need to switch to a more comfortable sleeping position (2).

If you wake up on your back during the night, there’s no need to panic. Simply roll onto your side, preferably your left side, which is often recommended because it supports healthy blood flow to both you and your baby. The most important thing is the position you fall asleep in, not the one you occasionally wake up in.

Why Should You Avoid Sleeping on Your Back During Pregnancy?

Sleeping on your back especially during later stages of pregnancy can feel more and more uncomfortable because of the growing belly. Moreover, it may not be a good position for your baby. The harmful effects of sleeping on the back while pregnant are listed below:

• When a pregnant woman sleeps on her back, the weight of the enlarging uterus can pressurise the key blood vessels, adversely affecting the blood supply to the baby which means fewer nutrients and oxygen for the developing foetus (3).
• The restricted blood flow may also lead to low blood pressure that may cause you to feel giddy and faint. It is also called supine hypotension syndrome (4).
• Sleeping on your back during pregnancy can result in digestive issues like indigestion or heartburn.
• As the pregnancy progresses, some pregnant women may have trouble breathing properly or experience shortness of breath while sleeping on the back.
• Sleeping on your back during pregnancy can strain the back muscles resulting in backaches.

When Should You Stop Sleeping on Your Back During Pregnancy

Most experts recommend stopping sleeping on your back after 20 weeks of pregnancy (2). By this stage, your growing uterus is large enough that lying flat on your back may affect blood circulation.

Things to Consider If You Are Sleeping on Your Back During Pregnancy

If you absolutely cannot do without sleeping on your back in pregnancy, then pillows can be a real lifesaver for you. Pillows can make sleeping on the back comfortable during the first trimester of pregnancy.

• You can take the help of pillows to suitably support yourself and make sleeping on your back more comfortable during pregnancy.
• If you are troubled with indigestion at night, placing a pillow on the back of your head and upper part of the body may help (5).
• To ease back pain, you can try sliding a small pillow in the hollow of your back to support your back (6).
• To tackle shortness of breath, you can consider sleeping in a slightly raised position, using pillows for support (7). Alternatively, you can use a recliner.
• Some pregnant women may feel comfortable tucking a slim pillow under their abdomen for extra support.
• If you must sleep on your back, you can fashion the pillows in a way you are able to rest against the back pillow and find a conciliation position between back sleeping and side sleeping.

Can Sleeping on the Back Increase the Risk of Stillbirth?

There may be a distant link between the lying down position of the mother and the danger of stillbirth. Sleeping on the back, for an extended period of time, may be harmful to the growth of the foetus and in case of difficult pregnancies, it can further distress the foetus resulting in stillbirth in some cases (8). According to some studies, the foetus tends to be in a less active state when pregnant women sleep on their back. This sleep-like condition is usually attributed to low oxygen supply due to the horizontal position.

On the other hand, the foetus is likely to change into a more active mode when the position is switched to lying on the left side. The foetus’ heart rate may also reduce if the mother sleeps on the back. Reduced heart rate can hinder the growth of the foetus. But concrete scientific evidence is still lacking which can establish a direct correlation between sleeping on the back and the risk of stillbirth.

Safe and Comfortable Sleeping Positions While Pregnant

Sleeping comfortably during pregnancy can be a bit of a challenge, especially during the later stages of pregnancy. One of the most frequently asked questions by pregnant women is, “Which side should I sleep on?” Owing to the bodily changes during pregnancy, some sleeping positions may not be as comfortable as before. Experts generally don’t recommend lying on the back during pregnancy. It is important to bear in mind that it is quite common to have a few uncomfortable nights, as the pregnancy progresses. It is best to give your body a suitable time to adjust to a new position.

Some of the safe and comfortable sleeping positions during pregnancy can be:

• Sleeping on your left side, during all phases of pregnancy, is usually considered to be the best and safest sleeping position as it doesn’t interfere with the blood circulation and helps drive in more nutrients to the baby (9). But you should not sleep in one position throughout the night. You can alternate between the left and right sides when sleeping.
• When sleeping on the side, it may feel comfortable if you bend your knees and legs. This will help keep unnecessary pressure off the heart.
• After the first trimester, you can place a pillow under your belly while lying on one side. It will help support the weight of your expanding tummy. While sleeping on the side, putting a sturdy pillow underneath the top leg can aid in properly aligning the body and easing pressure off the lower leg and back.
• In the side position, placing a pillow at the back and in the front can enable you to bend forward or backwards comfortably.
• You can try and rest one leg over the other leg and tuck a thin pillow between the legs for support.
• You can also look for a pillow which is shaped like a wedge or an all-around body pillow, shaped like the letter C, for full body support during pregnancy.
• If you prefer sleeping on the stomach, it may be fine but only during the first trimester. Thereafter, the growing belly may not allow you to sleep comfortably in this position.

FAQs

1. Should I worry if I naturally roll over at night?

No. It’s normal to change positions while sleeping. If you wake up on your back, gently turn onto your side and go back to sleep. The occasional change in position is not usually a cause for concern.

2. Which sleeping position is considered safest during pregnancy?

Side sleeping is generally recommended, especially in the second and third trimesters. It supports better circulation and helps reduce pressure on the back and internal organs.

During pregnancy, it is important to choose sleeping positions which are not only comfortable but also beneficial for the baby’s health. While some pregnant women may prefer sleeping on the back even during pregnancy, it is advisable to try and practise sleeping on the left side instead. Pregnant women may also consult a doctor to discuss their options for comfortable sleeping positions during pregnancy.

Also Read:

Too Much Sleep while Pregnant
Right Side Sleeping in Pregnancy
Sleeping on Stomach during Pregnancy

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Sources References

1. National Institute for Health and Care Excellence – Maternal sleep position during pregnancy

2. Cleveland Clinic – Is It Really All That Bad To Sleep on Your Back While Pregnant?

3. Sleep Foundation – Pregnancy Sleep Positions

4. PubMed – Supine hypotensive syndrome

5. Cleveland Clinic – Will a Wedge Pillow Help My Acid Reflux?

6. Cleveland Clinic – Low Back Pain: Coping

7. Cleveland Clinic – Breathing Problems? Try These Sleep Positions

8. University of Utah Health – IS SLEEPING ON YOUR BACK DURING PREGNANCY RISKY? EXPERTS WEIGH IN

9. Stanford Medicine Children’s Health – Sleeping Positions During Pregnancy