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It was surprising to me how nerve-racking pregnancy felt from the start. That first pregnancy, during those very early weeks, my human chorionic gonadotropin (a hormone commonly referred to as hCG) levels were low. Apparently this is the sign that the pregnancy might not be viable, and my doctor told me to prepare myself for that. So, I spent those first few weeks waiting and obsessing between each blood draw.
When I finally saw her little heartbeat fluttering on the ultrasound screen, I breathed a sigh of relief. Even so, knowing things were going well didn’t relieve me of my obsessing about keeping her healthy while she grew. I worried about what I ate and just about every other decision I made. I slept poorly for weeks, tossing and turning, dreaming about losing the pregnancy well into my second trimester.
When it comes to sleep during pregnancy, there is plenty to talk about. Being sleepless is par for the course during pregnancies; some women, like me, are anxious about their baby. Others have heartburn or general discomfort keeping them awake at night. Here’s what you need to know about sleeping safely, comfortably, and soundly from the time of your positive pregnancy test until your baby’s birth.
The Safest Sleep Position for Pregnancy
Good sleep during pregnancy is about so much more than simply getting a good night’s rest. For expecting moms, it’s important to understand the research around safe sleeping practices. The right sleep position during pregnancy protects the health of both mom and baby.
As a newly pregnant mom, I was told more than once to sleep on my left side. It wasn’t really explained why, but you better believe I was following the rule. It wasn’t until my second pregnancy that I really understood why sleeping on your left side is important—and that there are some exceptions to this rule.
“Laying on your left side provides optimal blood flow to your uterus which in turn gives it to your baby,” explains Paige Rowland, CNM, from the Department of Obstetrics and Gynecology at Einstein Medical Center.
More specifically, this sleeping position plays a role in maintaining optimal blood flow because of the location of a major artery in the body.
“That displaces the uterus off a major vessel in the body called the vena cava,” explains G. Thomas Ruiz, OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “It allows for better return of blood flow to the heart and, with better return of blood flow to the heart, [it] allows you to better perfuse the placenta.”
As it turns out, all of my obsessing about my proper sleep positions early on was unnecessary. Since sleeping on your left side is about displacing the weight of the growing baby off of your vena cava, this isn’t something moms need to concern themselves until around six months, according to Rowland. At this point, the baby, and the uterus, are just becoming large enough to place significant pressure on that artery.
Because the liver is located on the right side, sleeping on the left side is ideal to avoid the pressure of the uterus on this organ. However, if sleeping on your left side isn’t comfortable, there are other options to choose from.
The main recommendation across the board is that women avoid sleeping flat on their backs. And women who are most comfortable on their back can use pillows to prop themselves up in bed, displacing the weight of the uterus. And they can sleep on their right sides.
Falling Asleep When Dealing You’re Dealing with Discomfort
Once you’re sleeping safely, you can start to address the pregnancy symptoms that tend to keep you from dozing off or staying asleep all night. As your baby grows and your body changes, it’s pretty normal to experience some discomfort while trying to get some rest. Many moms report spending much of their night tossing and turning or walking around the house, especially as they reach the end of their pregnancy.
“I never sleep well pregnant,” confesses Chaunie Brusie, mom of four. “By my last pregnancies, I just learned to stop fighting it. I tend to wake up at least twice a night when I’m pregnant and just would think of it as training for those nighttime feedings.”
Moms who find themselves struggling to get comfortable at night can try a few different tactics for catching some shut-eye. First, Rowland suggests using a body pillow between your legs and to support your belly. If that doesn’t working, try moving around some or sleeping in a recliner or propped up on the couch.
Getting Rest When You’re Dealing with Insomnia
For moms of many like Brusie, insomnia during pregnancy is something they’ve come to expect. Some moms tell me that after experiencing insomnia in their last pregnancies, they stopped trying to fix their sleeplessness and started learning to live with it. I can identify. In my own pregnancies, there were many nights when I never got into bed, assuming I’d have to fall asleep on the couch in the early morning hours.
Gretchen Bossio, a mother of four, scheduled a midday nap everyday in hopes of catching up. Brusie simply gave up, distracting herself with social media when she couldn’t sleep. Personally, I took to propping up both my swollen feet and my heartburn-ridden abdomen on the loveseat each night, where I would replay Almost Famous until I finally dozed off for the night.
Experiences like these are incredibly common. Between 66 and 94 percent of women report experiencing problems sleeping during their pregnancy, according to research published in the journal Obstetric Medicine. As early as 10 weeks, moms-to-be may notice they’re having trouble winding down or tossing and turning, and these symptoms often worsen as the pregnancy progresses.
As it turns out, you don’t have to suffer through insomnia. Whether it’s anxiety or pregnancy hormones keeping you awake, there is medication you can take, an old faithful, that is very safe and effective for managing prenatal insomnia.
“One of the safest things is … Benadryl,” says Ruiz. “It’s an antihistamine, and at 25mg dosage, most people get really drowsy. You can take 50mg and it doesn’t hurt the baby. It’s non-addictive.”
For his patients experiencing insomnia, Ruiz recommends taking 25 to 50 mg of Benadryl 30 minutes before bed. This allows the medicine to take effect, so they’re feeling good and drowsy when they’re ready to go to sleep.
Outside of medication, there are also practices moms can embrace to help ease their anxiety so they can wind down more easily before bed. These can be tried before medication or used in combination with medication. Don’t give up: Try a few different things before you pull out your smartphone and give up on sleep for the night.
“Start with a little meditation,” says Rowland. “Every time you lay down to go to sleep … visualize that everything will go well. Think about your baby’s fingers and toes and how amazing your body is for growing this little one. We are constantly being bombarded with more things to be worried about—take this time, every night, to visualize the good.”
Additionally, Rowland recommends magnesium, like the brand Natural Calm, to mothers-to-be dealing with anxiety. Magnesium is a supplement that is safe for use during pregnancy.
Dozing Off When You’re Facing Killer Heartburn
Heartburn during pregnancy is incredibly common, with between 17 and 45 percent of expecting moms reporting this uncomfortable gastrointestinal symptom, according to research published in the journal Clinical Evidence.
Heartburn is typically the worst late in the pregnancy, when the growing uterus actually pushes up on the stomach, forcing acid into the esophagus. One of the big keys to dealing with heartburn is prevention. If you’re dealing with heartburn, Rowland advises avoiding eating and drinking for at least 30 minutes before laying down.
“The second trick is to not lie flat on your bed; use a few pillows or those fancy wedge pillows to prop up the upper half of your body,” she adds. “Make sure you are avoiding spicy and acidic foods, and [eat] several smaller meals and not three big meals.”
If these initial steps don’t work, Ruiz recommends over-the-counter medication, starting with Tums.
“Women very rarely get enough calcium during their pregnancy,” says Ruiz. “So, whenever you feel heartburn you can take a Tums, one or two of those every four hours.”
Tums are typically really helpful in reducing heartburn, but if that doesn’t work, Ruiz also recommends over-the-counter heartburn medication like Pepcid AC. However, he does warn that mothers should avoid Prilosec. The U.S. Food & Drug Administration is still unsure of whether it can harm your unborn child.
Ultimately, moms should feel confident advocating for themselves and their baby during their pregnancy. If you feel the symptoms of your pregnancy have become abnormally disruptive to your sleep, don’t be afraid to talk to your doctor. Together, you can brainstorm about whatever it is that is keeping you awake, whether it be anxiety over the future, back pain, or heartburn, so that you can get the rest you need.