It's completely normal for your pregnant self to be concerned about your sleeping positions. Naturally, mothers-to-be are cautious about changing positions while asleep and take necessary measures to not put the baby at risk.
Sleeping on your back while pregnant becomes a concern in late pregnancy, when your growing uterus may affect blood circulation. Generally, it is recommended for you to sleep on your left or right side from 28 weeks until birth. Before 28 weeks, there is no evidence suggesting association between sleep position and adverse pregnancy outcomes.
This guide will steer you through adopting a safer starting position and knowing what to do if you wake up in an uncomfortable position. Once you understand the correct sleeping positions during pregnancy, why back sleeping becomes a concern, when to adjust your sleeping position, and how to rest comfortably on your side, you can make informed choices without adding unnecessary stress to your bedtime routine.
Quick Answer: Is It Safe to Sleep on Your Back While Pregnant?
After 28 weeks of pregnancy, it is best to start every sleep on your side rather than your back. Both the left and right sides are safe options. Sleeping on your back later in pregnancy is not recommended as it may compress major blood vessels and affect blood flow to your baby. If you wake up on your back, don't panic. Roll onto either side and go back to sleep, simple!
Key Takeaways
- From 28 weeks onward start every sleep, including naps, on your left or right side.
- Left or right side, both are suitable; you do not need to sleep exclusively on your left.
- Waking up on your back is common and not a reason to panic. Turn onto your side and settle back to sleep.
- Back sleeping matters because in later pregnancy, the weight of the uterus compresses major blood vessels, potentially affecting circulation.
- Use pillows between your knees, under your abdomen, or behind your back to help maintain a side-sleeping position and improved comfort.
Is It Safe to Sleep on Your Back During Each Trimester?
Your sleeping preferences may change as your bump grows. Here is how the guidance differs throughout pregnancy.
| Trimester | Is Back Sleeping Safe? | Key Recommendation |
|---|---|---|
| First Trimester (Weeks 1–12) | Yes | Sleep in whichever position feels comfortable, including on your back. |
| Second Trimester (Weeks 13–27) | Generally Acceptable | Acceptable, but start practicing side sleeping as your bump grows and pressure increases around week 20. |
| Third Trimester (Weeks 28+) | Not Recommended | Start every sleep (including naps) on your left or right side to protect blood circulation. |
The First Trimester: Can You Sleep on Your Back When Pregnant in the First Trimester?
During the first trimester, it's absolutely ok for you to sleep in whichever position feels comfortable, including on your back. Current evidence has not established the same association between back sleeping and adverse pregnancy outcomes before 28 weeks that researchers have observed in late pregnancy. [1]
You do not need to change your usual sleeping position just because you are pregnant. If you are a back sleeper, you may continue sleeping comfortably in this position during early pregnancy unless your healthcare provider advises otherwise.
The Second Trimester: Can you sleep on your back at 17 weeks or later?
Sleeping on your back during the second trimester is generally considered acceptable, although comfort may change as your bump grows. Some people begin experiencing discomfort when lying flat as pregnancy progresses as it puts weight of the uterus on spine and back muscles. [3]
If lying on your back makes you feel dizzy, nauseated, weak, or breathless it's better to switch to a more comfortable position. You may also begin practicing side sleeping before the third trimester, it will make you more comfortable with the transition.
Note: You cannot control every movement you make while asleep, but you have the option of choosing a comfortable settling position.
Around 20 weeks, your growing uterus may begin pressing on major blood vessels when you lie flat on your back, sometimes causing dizziness, nausea, or lightheadedness. From 28 weeks, the recommendation is to start every sleep on your left or right side to help protect blood flow to your baby.
If you’re between 20 and 27 weeks, use this time to get comfortable with side sleeping without worrying about every movement you make. If you wake up on your back, simply roll onto your side and settle back to sleep.
The Third Trimester: When Should You Stop Sleeping on Your Back?
You should start avoiding going to sleep on your back at 28 weeks of pregnancy. It is recommended that from this point until birth, it's best if you settle into sleep on either your left or right side. [1, 2] Primarily this is recommended to avoid pressure on your blood vessels after 28 weeks as compression may lead to stillbirth.
There is no need to treat 28 weeks as a sudden point at which every moment spent on your back becomes dangerous. Instead, use it as a clear milestone for changing your sleep routine. If you are approaching the third trimester, start experimenting with pillows and side sleeping now.
The Main Concern: Why Can't You Sleep on Your Back While Pregnant?
The main concern with sleeping on your back during pregnancy is the potential effect on blood circulation as your uterus becomes heavier. Around 20 weeks (5 months) your uterus grows, lying flat on your back puts pressure on two major blood vessels: the aorta, which carries blood away from your heart, and the inferior vena cava, which returns blood from your lower body to your heart.
Compression of the Inferior Vena Cava
The inferior vena cava is a major blood vessel that carries blood from the lower part of your body back to your heart. When you lie flat on your back in late pregnancy, the growing uterus may compress this vessel. Pressure on nearby blood vessels may also affect circulation. Reduced blood return to the heart causes your blood pressure to drop, potentially leading to dizziness, nausea, sweating, weakness, or a feeling of faintness.
Adequate Supply to the Uterus and Placenta
The aorta, another major blood vessel, may also experience pressure. Changes in maternal circulation may also affect the blood flow supplying the uterus and placenta. The placenta provides oxygen and nutrients to your developing baby, so maintaining adequate circulation is important.
A healthy pregnancy is a combination of multiple factors which is why experts cannot put a finger on one factor that may put the pregnancy at risk. However, in this case, an expanding uterus pushing against the blood flow may put you and your developing fetus at risk with inadequate blood supply.
What Does the Research Say?
Research involving five studies found that going to sleep on your back after 28 weeks was linked to higher odds of late stillbirth, while sleeping on either side showed similar results.
Although the research cannot prove that back sleeping directly causes stillbirth, it supports the advice to start every sleep on your left or right side from 28 weeks until birth.
Key Takeaway: The practical message is to adopt a safer sleeping habit without assuming that an accidental change in position means something has gone wrong.
What If You Wake Up on Your Back While Pregnant?
If you wake up lying on your back during pregnancy, calmly roll onto either side and return to sleep. You do not need to stay awake worrying about your position or repeatedly check whether you have rolled over. The recommendation focuses on the position in which you start sleeping, not on remaining perfectly still all night.
Moreover, if you are concerned about how often you wake up on your back, try placing a pillow behind you to make rolling fully onto your back less likely. A pillow between your knees or beneath your abdomen may also make sleeping more comfortable.
Note: Speak with your healthcare provider if you have specific concerns about your pregnancy or have received individualized instructions about sleeping positions.
Best Sleeping Positions for Pregnancy
As a mother-to-be, when you read up on healthy pregnancy, you often come across on getting good sleep. How will you be able to get sound sleep if you are worried about rolling on your back all night? Well, it is smart to be cautious which is why below are some sleeping practices that you may try and see if they work for you.
Left or Right, You're Alright
The best sleep position during pregnancy is SOS (sleep on your side). Generally OB/Gyns advise pregnant women to sleep on their left side since your inferior vena cava is on your right.
Sleeping on your left side supports blood flow to the placenta, helping deliver oxygen and nutrients to your baby. Healthy circulation may further help manage swelling in your legs and feet and reduce discomfort associated with varicose veins and hemorrhoids during pregnancy (both are normal conditions during pregnancy).
Evidence today shows either side is fine and safe for you and your baby. So get comfortable, snuggle up and slide into that sound sleep.
Give Your Belly a Break
Sleeping on your tummy is absolutely fine during your first trimester, but as the baby bump grows, naturally you won't feel comfortable in this position. Don’t worry about getting off your tummy, your body will let you know when it's time to give up sleeping on your stomach.
A Little Lift Goes a Long Way
Once you cross the 20 week milestone, it's fine if you find yourself on your back for a brief spell but not the entire night. Prop yourself with a pillow for support and to keep your blood flowing. Even if you are inclined on a 20-30 degree angle, that would work in relieving pressure on your inferior vena cava and aorta. Generally, your body will signal you with an uncomfortable position with difficulty in breathing or a racing heartbeat. Pay attention to the signals!
BONUS Sleeping Position
If back pain or pelvic discomfort makes side sleeping difficult, a few well-placed pillows may help you get comfortable. This is especially useful if you have Symphysis Pubis Dysfunction (SPD) / Pelvic Girdle Pain (PGP). Try this three-point cushioning method:
- Under your belly: Place a thin pillow or small wedge beneath your bump to support its weight and reduce pulling on your lower back.
- Between your knees and ankles: Keep both knees and ankles supported and aligned to help prevent your hips from twisting while you sleep.
- Behind your back: Place a pillow along your back to make side sleeping more comfortable and discourage you from rolling fully onto your back.
The 20-30° Incline Hack
A wedge pillow may help you adjust gradually by supporting a side-lying position. You may tilt the upper body or elevate one hip by 20–30° to reduce pressure on the inferior vena cava (IVC).
More Ways to Get a Better Night’s Sleep During Pregnancy
If you are struggling to get comfortable at night, a few simple changes to your daily routine will help you relax and sleep more soundly during pregnancy. Try these tips!
- Cut Back on Caffeine in the Afternoon: If you love your afternoon coffee or tea, try switching to a caffeine-free drink after 3 p.m. to help your body wind down before bedtime.
- Stay Hydrated Throughout the Day: Keep sipping water during the day to stay hydrated. However, try drinking less in the couple of hours before bedtime to reduce those nighttime bathroom trips.
- Make Time for Gentle Exercise: A 30-minute walk or another pregnancy-safe activity will help you sleep better. Aim to finish exercising at least four hours before bedtime, and follow your healthcare provider’s advice about suitable activities.
- Treat Yourself to a Relaxing Bedtime Ritual: A warm bath, a gentle foot massage, or a soothing shoulder massage to ease tension and prepare you for sleep.
- Create Your Own Sleep Sanctuary: Keep your room cool, dark, and quiet, and consider using blackout curtains or a white noise machine if needed.
When Should You Contact Your Healthcare Provider?
Waking up on your back is not, by itself, usually a reason to seek emergency care. However, contact your healthcare provider if you experience repeated dizziness or positional discomfort, especially if it affects your ability to rest or happens when you are not lying on your back.
Seek urgent medical assessment for severe or persistent breathing difficulty, chest pain, fainting, or other serious or sudden symptoms. If your baby's movements become reduced or change from their usual pattern, contact your maternity team promptly rather than waiting until the next day.
If you have a high-risk pregnancy, a condition that affects circulation, or specific instructions from your obstetric team, ask whether you need additional precautions.
A Little Self-Care to Help You Relax During Pregnancy
Pregnancy brings plenty of worries, and finding time to relax is just as important as getting comfortable at bedtime. Gentle relaxation routines, such as slow breathing, a warm bath, or a soothing massage that's appropriate for pregnancy, may help you unwind before sleep. As a mom who is preparing for labor and postpartum recovery, the Perineal Massage and Pelvic Floor Wand is worth exploring. It is designed for perineal massage and pelvic-floor care.
Note: Keep in mind that this type of wand is not a treatment for pregnancy anxiety or a way to prevent problems associated with back sleeping. If you are unsure whether perineal massage is appropriate for you, ask your maternity care provider before using it.
Prepare Your Baby's Sleep Space Before Birth
As you get ready to welcome your little one, preparing the nursery in advance makes those first few weeks at home easier. A bedside bassinet with adjustable height, such as the Grownsy Baby Bassinet, keeps your baby's sleep space close to your bed for convenient nighttime care. Its adjustable height may also help reduce the need to bend deeply when reaching for your baby, which is particularly helpful for some parents recovering from a C-section.
When choosing a bassinet, make sure it meets applicable safety standards and follow the manufacturer's instructions. Your baby should sleep on their back on a firm, flat, separate sleep surface without pillows, loose blankets, or other soft items.
The Bottom Line
Generally, you may sleep in a comfortable position during early pregnancy, but from 28 weeks until birth, start every sleep on either your left or right side. Research links going to sleep on the back in late pregnancy with increased odds of stillbirth, although it cannot predict an individual outcome. If you wake up on your back, calmly turn onto your side and return to sleep. Use pillows to make sleeping easier and explore our tips for sleeping comfortably during pregnancy. Contact your healthcare provider if you have persistent symptoms or concerns.
References
[1] Kember AJ, Gilad N, Hobson SR. Sleeping posture in pregnancy. Canadian Medical Association Journal. 2025;197. https://pmc.ncbi.nlm.nih.gov/articles/PMC12187203/
[2] Cronin RS, Li M, Thompson JMD, et al. An Individual Participant Data Meta-analysis of Maternal Going-to-Sleep Position, Interactions with Fetal Vulnerability, and the Risk of Late Stillbirth. EClinicalMedicine. 2019;10:49–57. https://pmc.ncbi.nlm.nih.gov/articles/PMC6543252/
[3] American College of Obstetricians and Gynecologists. Can I Sleep on My Back When I'm Pregnant? https://www.acog.org/womens-health/experts-and-stories/ask-acog/can-i-sleep-on-my-back-when-im-pregnant/
[4] Cleveland Clinic. Is It Really All That Bad To Sleep on Your Back While Pregnant? https://health.clevelandclinic.org/exactly-how-bad-is-it-to-sleep-on-your-back-when-youre-pregnant/
[5] UPMC HealthBeat. Is It Bad to Sleep on Your Back While Pregnant? https://share.upmc.com/2025/02/sleeping-on-back-while-pregnant/
[6] Tommy's. Sleep Position in Pregnancy Q&A. https://www.tommys.org/pregnancy-information/im-pregnant/sleep-side/sleep-position-pregnancy-qa/
[7] American Pregnancy Association. Best Sleeping Positions While Pregnant. https://americanpregnancy.org/pregnancy/sleeping-positions-while-pregnant/
