Sleeping Positions During Pregnancy and How to Sleep After Giving Birth

There’s a lot to take in when you’re pregnant, and how you should be sleeping is one of the things people ask about most. The advice does change as you go along, and it’s simpler than it first looks. Here’s what’s recommended at each stage, what to do if you wake up on your back, and how to actually get comfortable. We’re here to help you sleep well through all of it.

Either side is fine, left or right. There’s no wrong one to pick.

The NHS advises going to sleep on your side, left or right, from 28 weeks onwards. It doesn’t express a preference between the two. What matters is that you’re on your side and not on your back.

You may have seen the left side sleeping being recommended specifically. Tommy’s states that this isn’t supported by good evidence, and that sleeping on your left hasn’t conclusively been shown to be safer than sleeping on your right.

The recommendation comes from NICE, which reviewed the evidence on maternal sleep position before making it. The NHS and Tommy’s both set out the reasoning in full, and Tommy’s ran a national campaign on it. Their Sleep On Side film is worth five minutes of anyone’s pregnancy.

We asked Dr Zoe Williams, our resident sleep expert and an NHS GP, what’s behind the advice.

Before 28 weeks, sleeping position is simply a question of comfort, so whatever gets you off to sleep is fine. From 28 weeks, it becomes a health recommendation. It’s the week that changes it, not the size of your bump, so it’s worth noting the date in your diary.

The advice covers every episode of sleep. Tommy lists this as going to sleep at night, settling back down after waking during the night, and taking daytime naps. Dr Zoe puts it the same way: “The advice is from 28 weeks, by which point you’ve got a bump anyway, so sleeping on your front is very difficult. The UK advice is to go to sleep on your side for every sleep, so at night and during naps.”

Front sleeping tends to sort itself out, as she notes: “Sleeping on your front isn’t necessarily dangerous. But once you’ve got the bump there, it’s not very possible.”

From 28 weeks, the advice is to go to sleep on your side instead of your back. Dr Zoe explains what sits behind it: “As pregnancy progresses, the increasing weight of the uterus can put pressure on major blood vessels when you’re lying flat on your back. This may reduce blood flow and oxygen reaching the baby, which is why going to sleep on your side is recommended from 28 weeks.”

Waking up on your back is a different matter, and it isn’t a problem. The NHS says so directly. Turn onto your side and settle back down.

The reason the guidance is framed around going to sleep comes down to what was actually studied. In Dr Zoe’s words: “It’s absolutely fine to sleep on either your left or right side during pregnancy. The important advice is that from 28 weeks, you should go to sleep on your side rather than your back. The research has primarily looked at the position women fall asleep in, rather than the position they remain in throughout the night.”

Nobody can control what their body does at three in the morning, and you’re not expected to. Plenty of women wake up on their backs at some point in pregnancy.

If it’s happening most nights, there’s one thing she suggests trying: “If you’re somebody who’s always rolling onto your back and you’re worried about it, placing a pillow behind your back can help.”

Lying on your back briefly while you’re awake is fine too. Midwife appointments, scans and a few minutes on the sofa aren’t what the advice is about.

If you’ve always slept on your front or your back, side sleeping takes some adjusting to. These tips may help:

• A pillow under your bump and one between your knees: It can help to take the strain off your lower back and hips.
• A pregnancy pillow if ordinary ones aren’t cutting it: These are long and usually horseshoe-shaped, wrapping around you to support bump, hips and back at once. They also stop you from rolling onto your back. Useful afterwards for propping your arm while feeding, too.
• A wedge pillow for propping yourself up: Sleeping slightly raised helps if heartburn is keeping you awake, and it’s still a side-sleeping position.
• Put a pillow behind your back: It won’t stop you from rolling over entirely, and it makes it uncomfortable enough that you’re less likely to stay there. Ordinary pillows and pregnancy pillows work equally well for this.
• Tie long hair in a low bun: A bun at the back of your head can make lying on your back uncomfortable, so you’re less likely to settle there.
• Start practising early: Getting used to it before 28 weeks makes the switch much easier than doing it overnight at exactly 28 weeks.
• Check what you’re lying on: A mattress that’s too firm puts pressure on your hip and shoulder when you’re on your side. Our comfort guide explains how to tell.

If you have pelvic girdle pain or SPD, side sleeping can be genuinely painful, and this advice is much harder to follow. Tommy’s suggests a pillow under your bump and between your legs, and keeping your knees together as you turn over. They also encourage you to ask your midwife for a physiotherapy referral if you haven’t already.

Sleep is disrupted throughout, and what disrupts it can change:

1. First trimester: Position isn’t a safety issue yet. What wakes you is hormonal change, nausea and needing the loo. The Life-ON study found that a third of women reported poor sleep quality at this early stage, and daytime sleepiness actually peaks here.

2. Second trimester: Often the easiest stretch. Your bump is growing, and there’s more pressure on your bladder, and this is when many women first feel the baby move, which tends to be liveliest in the evening. A good time to get into the habit of side sleeping.

3. Third trimester: The 28-week threshold falls at the start of it, so side sleeping becomes the rule rather than a preference. Life-ON found that 46% of women reported poor sleep quality at this stage, with heartburn, restless legs and simply not being able to get comfortable all contributing.

Our guide to pregnancy insomnia covers what helps with each of those.

The position guidance applies only during pregnancy.

If you’ve had stitches or a caesarean and something doesn’t feel right, your midwife would rather you asked.

What helps more than position is everything around the sleep itself:

• Sleep when the baby sleeps, and plan for it properly: This advice is easy to give and hard to follow, which is why a postnatal plan matters. Work out in advance who’s around and when, especially for the week your partner returns to work.
• Have the numbers to hand: Write down who you can ring at four in the morning, before you need to.
• Share the nights: Our guide on how dads can help with night feeds covers ways to split them.
• Put visitors to work: Visiting time is an extra pair of hands, not an audience. Let people wash up.
• Nap short and early when you can: Our guide to daytime napping covers how long.
• Say something if it isn’t lifting: Exhaustion is expected. Feeling persistently low, anxious or detached is worth raising with your health visitor or GP.