Best sleeping position during pregnancy

Finding a comfortable sleeping position can become harder as pregnancy progresses, especially once your bump grows and your usual position no longer feels quite right.

The key guidance is simple: after 28 weeks of pregnancy, the safest position to go to sleep is on your side, either left or right. This applies when you first go to bed, when you return to sleep after waking during the night and when you have a daytime nap.

If you wake up on your back, you do not need to panic. Simply turn onto your side before settling back to sleep.

Why is side sleeping recommended after 28 weeks?

NHS England advises going to sleep on your side rather than your back after 28 weeks of pregnancy.

Research has found an association between going to sleep on your back in later pregnancy and an increased risk of stillbirth. Tommy’s explains that this finding has been seen across several studies.

One possible explanation is that, when you lie flat on your back later in pregnancy, the weight of the baby and uterus can put pressure on major blood vessels. This may affect blood flow to the placenta and baby.

The advice is about the position you go to sleep in, including when returning to sleep after waking, rather than expecting you to control your position throughout the night.

Is the left side better than the right?

You may have heard that pregnant people should always sleep on their left side. Current guidance is less restrictive than that.

Tommy’s states that good research has not shown that sleeping on the left side is safer than sleeping on the right.

That means you can choose whichever side feels more comfortable. You can also change sides during the night.

For some people, having permission to switch between sides makes sleep much easier, particularly if one hip becomes sore or uncomfortable.

What if you wake up on your back?

Waking on your back can feel worrying once you know the side-sleeping guidance, but it is not a reason to panic.

NHS England and Tommy’s advise that if you wake on your back, you can simply turn onto your side and settle back to sleep.

You cannot consciously control every movement your body makes while you are asleep. The research and guidance focus on the position in which you settle to sleep.

The same applies if you wake during the night to use the toilet. When you return to bed, settle onto either side again.

Does side sleeping matter for naps too?

Yes. After 28 weeks, the guidance applies to any episode of sleep.

That includes:

going to sleep at night
returning to sleep after waking during the night
daytime naps

If you occasionally fall asleep on the sofa or take an afternoon nap, try to settle onto your side in the same way you would at bedtime.

Can you sleep on your stomach during pregnancy?

Sleeping on your stomach in early pregnancy is generally fine if it is comfortable.

Tommy’s explains that as your bump grows, stomach sleeping will usually become uncomfortable naturally. If you happen to wake on your stomach later in pregnancy, turn onto your side.

There is no need to force yourself away from a comfortable stomach position early in pregnancy simply because you expect it to become impractical later.

What about sleeping on your back earlier in pregnancy?

The specific NHS England advice to go to sleep on your side applies after 28 weeks.

As pregnancy progresses, lying flat on your back may also become physically uncomfortable. Some people feel light-headed or unwell in that position.

If lying on your back makes you feel faint, dizzy or uncomfortable, change position. If you are concerned about symptoms or unsure what is appropriate for your pregnancy, speak to your midwife or maternity team.

How can you make side sleeping more comfortable?

Side sleeping is not automatically comfortable just because it is recommended.

A few strategically placed pillows can make a significant difference. Tommy’s suggests using a pillow to support your bump and another between your legs. A pillow behind your back may also help you stay comfortably supported on your side.

You do not need to buy a specialist pregnancy pillow unless you want one. Tommy’s notes that ordinary pillows can work well too.

Try different arrangements rather than assuming there is one correct setup. Some people prefer a firm pillow between their knees, while others like support underneath the bump or behind their back.

Your needs may also change as your pregnancy progresses.

What if side sleeping causes hip or pelvic pain?

Side sleeping can be difficult if you have pelvic girdle pain, hip pain or back pain.

Tommy’s suggests placing a pillow underneath your bump and between your legs to make side sleeping more comfortable. Keeping your knees together when turning over in bed may also help people experiencing pelvic girdle pain.

If pain is making sleep difficult, speak to your midwife. They can advise you about appropriate support and may be able to refer you for physiotherapy.

You do not need to spend every night struggling with significant pain simply because you have been told to sleep on your side.

Do you need a pregnancy pillow?

No. A pregnancy pillow is an option, not a requirement.

Long pregnancy pillows can support several areas of the body at once, which some people find comfortable. Others prefer two or three ordinary pillows because they can move them independently.

The useful part is the support rather than the shape or price of the pillow.

You might try placing:

one pillow between your knees
one underneath or alongside your bump
one behind your back for support

If your current pillows already help you settle comfortably on your side, there is no need to replace them.

What if you cannot get comfortable on either side?

Late-pregnancy sleep can be frustrating. Your bump may feel heavy, your hips may ache and changing position can take much more effort than it used to.

Experiment with pillows and switch between your left and right sides as needed. You do not have to remain on one particular side all night.

If pain, breathlessness, heartburn or another pregnancy symptom is repeatedly preventing you from sleeping, speak to your midwife or GP. Addressing the symptom itself may be more useful than endlessly rearranging your pillows.

When to get professional advice

Speak to your midwife or maternity team if pain or another pregnancy symptom is making it difficult to sleep, or if you are worried about your sleeping position because of a medical condition or complication affecting your pregnancy.

Contact your maternity service promptly if you experience vaginal bleeding, watery or unusual discharge, symptoms that may suggest pre-eclampsia, significant itching or another symptom that concerns you. NHS England advises pregnant people not to wait when these symptoms occur.

If your baby’s movements have slowed, become weaker, changed from their usual pattern or stopped once you normally feel movement, contact your maternity unit immediately. Do not wait until the next day or your next routine appointment.

If you have an urgent medical problem and are unsure where to get help, contact NHS 111. Call 999 for a life-threatening emergency.