Just how dangerous is it to sleep on your back when pregnant?

Pregnant woman uses pillow to sleep on side comfortably

As pregnancy progresses, sleep becomes a little, well, uncomfortable. You may have heard the recommendation to avoid sleeping on your back while pregnant, but why? It’s challenging enough to get rest and now we’re taking away a whole sleep position?

Like so many things in prenatal life, there’s quite a bit to unpack with this one:

What is the recommendation for sleeping positions in pregnancy?

The standard recommendation is to avoid sleeping on your back from about the midway point of pregnancy and on. Some experts take it even further and say that it’s best to sleep on your left side. This is one of those even more extra recommendations that can cause more stress than necessary – it’s hard enough to suddenly become a side sleeper if you were used to back.

Why is this recommendation made?

Throughout your pregnancy, your uterus is expanding greatly – by the end it will have expanded to 500 times its size! When you lie on your back it can place pressure on your inferior vena cava, which carries blood back to your heart. Any pressure pushing against this blood vessel could result in a lesser blood flow for yourself and the baby.

Some studies have indicated an increase in instances of still birth when pregnant people from about 20 weeks+ began sleep on their backs – but a lot of these studies are problematic. They are asking people who have experienced loss to reflect back on behaviours they may have engaged in. Not only would it be hard to remember exactly how we slept five months ago, but there is a lot of emotional trauma that may play into how these memories are recalled.

All in all, medical perspectives vary because the scientific data isn't conclusively there yet. So what does end up happening is what we seem to do best: we scare pregnant people. You’re already doing so much – growing a human is no easy feat. When you need sleep the most, the last thing you should do is spend time worrying about whether to sacrifice your physical comfort and ability to do so.

Bottom line to back sleep during pregnancy

If you stopped reading right here, this is the one take away we want for you: this issue is literally not something that should keep you up at night with worry. Simply begin your night sleep on your side, and no there is no need to panic if you wake up and find you've migrated to your back. 

Almost no one lies completely still all night long. If you’ve woken up, that’s probably your body’s way of letting you know it’s time to shift (and go pee, if we’re being real here). Your mental and emotional well-being, and your ability to get that much-needed restorative sleep is important. As always, YOU matter in this equation.

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