Can Pregnant Women Sleep on Their Back? The Pros, Cons, and Safety Tips

Sleeping comfortably can be a challenge during pregnancy. Many women find that sleeping on the back is no longer possible or comfortable with a growing baby bump. But is back sleeping safe during pregnancy? Here is a thorough guide examining whether pregnant women can sleep on their back, the potential risks, tips to sleep safely and comfortably, and the best sleeping positions for expectant mothers.


Sleep is vital during pregnancy to support the health of both mother and baby. However, finding a comfortable sleeping position can be difficult with a growing belly and a shifting center of gravity. Many pregnant women naturally gravitate towards sleeping on the side rather than the back. But some women may prefer sleeping on the back or find themselves waking up in this position.

This comprehensive guide will cover whether back sleeping during pregnancy is safe, the potential risks, pros and cons, tips for sleeping comfortably on the back, and the best sleeping positions recommended by experts. Key insights include:

  • Sleeping fully on the back after the first trimester may increase risks like backaches, hemorrhoids, low blood pressure, decreased circulation, and impaired fetal oxygen flow.
  • Using pillows to prop up the upper body and head 30-45 degrees while back sleeping can help mitigate risks.
  • Sleeping on the left side is often considered the optimal position during pregnancy by maximizing blood flow and circulation.
  • Finding comfortable, supportive pregnancy pillows and mattresses helps accommodate a changing body.
  • Practicing good sleep hygiene helps ensure restful sleep in the best position for you and baby.

Continue reading for an in-depth examination of whether pregnant women can safely sleep on their back and tips to sleep comfortably during pregnancy.

The Potential Risks of Back Sleeping During Pregnancy

Sleeping fully flat on the back during pregnancy may increase the risk of adverse health effects for expectant mothers. Here are some of the potential risks associated with back sleeping while pregnant:

Impaired Fetal Circulation and Oxygen Flow

One of the primary concerns with back sleeping during pregnancy is that the weight of the uterus and baby on the inferior vena cava can restrict blood flow to the fetus. The inferior vena cava is the large vein that carries deoxygenated blood from the lower body to the heart. When a pregnant woman lies flat on her back, especially after 20 weeks, the uterus may compress this vein which can limit blood circulation and oxygen delivery to the baby.

Lower Blood Pressure

Similarly, the expanding uterus can compress the abdominal aorta when lying on the back. The abdominal aorta is the large artery that carries oxygenated blood from the heart to the lower body. Compression of this major vessel can result in lower maternal blood pressure, which may also impair blood flow to the fetus.


Sleeping on the back can exacerbate back pain issues during pregnancy. The added weight on the spine, back muscles, and discs can lead to extra pressure and discomfort. This may contribute to lower back pain that many women experience as the belly grows.

Poor Circulation in the Legs

Lying flat on the back may also cause the inferior vena cava to compress leg veins, resulting in poor circulation, leg cramps, and swelling. The extra pressure on the back from the weight of the uterus reduces normal blood flow returning from the lower body while back sleeping.


Similarly, the pressure of the uterus on the inferior vena cava can restrict blood flow from the anus area when lying on the back. This can potentially contribute to or worsen hemorrhoids during pregnancy.

Sleep Apnea

Pregnant women are also more prone to snoring and sleep apnea when sleeping on the back, especially in the third trimester. The added weight on the airways and chest while lying flat on the back increases airway obstruction and diminishes air intake.


Sleeping fully flat on the back can make heartburn and acid reflux worse during pregnancy. Lying down flat puts more pressure on the stomach and LES valve, allowing stomach acid to back up into the esophagus. Elevating the head and torso helps prevent reflux symptoms.

Stillbirth Concerns

A few studies have linked back sleeping later in pregnancy to a higher rate of stillbirths. However, the direct evidence is still inconclusive and debated. Regardless, most experts recommend side sleeping as the optimal position during pregnancy.

While these risks are concerning, sleeping partially inclined on the back or with pillows under one side may help mitigate these issues. Let’s examine some of the potential benefits of back sleeping during pregnancy.

The Pros and Cons of Back Sleeping While Pregnant

Here is an overview of some of the key pros and cons associated with sleeping on the back during pregnancy:


  • May feel comfortable, especially in early pregnancy before the belly grows significantly
  • Can help alleviate side/hip pain by providing variation in sleep position
  • Allows the spine to rest in a neutral alignment
  • May help elevate the head to minimize heartburn
  • Places no pressure on the abdomen as it expands


  • Uterus may compress inferior vena cava after 20 weeks, restricting fetal blood flow
  • Could contribute to lower blood pressure
  • May worsen back pain as belly grows
  • Can restrict circulation in legs, causing swelling
  • May aggravate hemorrhoids
  • Increases risk of sleep apnea and snoring
  • Potentially associated with higher rate of stillbirth (inconclusive)
  • Can make heartburn/reflux worse when lying completely flat

The takeaway is that a modified back sleeping position with the upper body elevated appears to be low risk during early and mid-pregnancy. But most experts recommend switching to side sleeping as the belly grows to reduce the risks. Using supportive pillows to prop up the back and head is key to making this position safer.

Tips for Sleeping Comfortably and Safely on the Back While Pregnant

Here are some tips to help pregnant women sleep as comfortably and safely as possible on the back:

  • Use pillows to prop up at an angle – Placing pillows under the back, head, and knees helps take pressure off the abdomen and improve alignment when back sleeping. An incline of 30-45 degrees is optimal.
  • Try a pregnancy pillow – C-shaped and wedge pillows support the back, belly, and head for a side-to-back sleeping position.
  • Sleep on the left side before moving to back – Begin by sleeping on the left, then use pillows to transition to a propped up back position once comfortable.
  • Avoid flat back sleeping in third trimester – Side sleeping is recommended as the belly grows.

Practice Good Sleep Hygiene

Following good sleep hygiene practices can help ensure better quality sleep during pregnancy[1]:

  • Keep a consistent sleep schedule by going to bed and waking up at the same time daily, even on weekends
  • Make sure your bedroom is cool, quiet, and dark
  • Avoid screen time and bright lights before bed
  • Limit caffeine intake to early in the day
  • Avoid large meals, spicy foods, and alcohol before bedtime
  • Get regular exercise and daylight exposure
  • Establish a relaxing pre-bed routine like taking a bath or reading

Watch Your Diet

Your diet can impact sleep, so make sure to[2]:

  • Eat a balanced diet with plenty of fruits, vegetables, lean protein, and whole grains
  • Stay hydrated by drinking enough water during the day
  • Limit sugary and fatty foods before bedtime
  • Avoid spicy foods that can cause heartburn
  • Restrict caffeine intake to early in the day
  • Avoid alcohol which can disrupt sleep

Invest in Pregnancy Pillows

Special pregnancy pillows can help support your body in comfort[3]:

  • Full-length body pillows allow side-lying with knees bent and spine aligned
  • Wedge pillows under the back or belly support the weight of the uterus
  • C-shaped pillows are versatile for side-sleeping and elevating the head
  • Travel pillows are great for neck support and preventing back sleeping

Choose the Right Mattress

Your mattress greatly impacts sleep comfort during pregnancy:

  • Memory foam contours to the body and relieves pressure points
  • Latex mattresses provide cushioning and are responsive
  • Innerspring mattresses can be too firm without pressure relief
  • Adjustable air beds allow customizing sleep position

Talk to Your Doctor

Discuss any persistent sleep issues with your obstetrician:

  • They can provide positioning aids if needed
  • Physical therapy may help alleviate back pain
  • Sleep medications are typically not recommended
  • Sleep studies can check for apnea if severe snoring develops

The key is finding what works best for your sleep comfort and supports a healthy pregnancy. Pay attention to your body, stick to good sleep habits, and don’t hesitate to ask your doctor for guidance.

Frequently Asked Questions

Is it bad to sleep on your back while pregnant?

Sleeping fully flat on the back after 20 weeks of pregnancy can increase risks like backaches, hemorrhoids, and impaired circulation. But sleeping propped up at an incline of 30-45 degrees with pillows under the back and head can help make back sleeping safer.

What week should you stop sleeping on your back while pregnant?

Most experts recommend switching from back to side sleeping around 20 weeks pregnant as the uterus expands. But always listen to your body – if back sleeping becomes uncomfortable or causes symptoms earlier, it’s best to stop.

What side is best to sleep on when pregnant?

Sleeping on the left side is typically recommended as the optimal position during pregnancy. It maximizes blood flow and circulation by preventing the uterus from pressing on the liver. The right side is second best.

What helps pregnant women sleep at night?

Ways to help pregnant women sleep better include sticking to a routine, limiting fluids before bedtime, using pregnancy pillows, finding a comfortable mattress, and avoiding back sleeping in the third trimester.

When pregnant, how many hours of sleep are needed?

Most pregnant women need at least 8 to 9 hours of quality sleep per night to allow proper rest and recovery. Lack of sleep during pregnancy has been associated with increased risks of preeclampsia, preterm birth, and depression.