Why you can’t sleep on your back.


It’s on our checklist, every patient, at 20 weeks: no more sleeping on your back.

Even for people who don’t usually sleep on their back, in pregnancy, especially towards the end, it can be such a comfortable position.

So what’s the deal?

When lying flat on your back in pregnancy, there’s a point at which the uterus is large enough and heavy enough to compress your Vena Cava.   This is the large blood vessel that returns blood to the heart from your lower body.  This compression affects the amount of circulating blood and can affect (poorly) the fetal heart rate.

While most pregnancies do well, there is good data to show in women with unexplained stillbirths, that the majority of women were sleeping on their back the night before.  While this doesn’t mean back sleeping directly caused all of these stillbirths, it does suggest that when a baby may be under some other stress, the compression of the vena cava exacerbates the fetal stress and increases the risk of stillbirth.

What to do?
Work on finding comfortable positions to sleep in on your sides.  This is optimized with a collection of pillows, small ones, large ones, body pillows, pregnancy pillows, wedge pillows, whatever you need to get comfortable.

If you wake up on your back, don’t panic, but reposition yourself and try to tuck a pillow behind your back so it’s not possible for you to fall flat on your back one you’ve fallen asleep again.

And then remember, pregnancy is limited and very soon you’ll be able to meet your baby and be able to sleep on your back again!


El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems.   Drs. Amy TengErika Balassiano, and Pooja Gupta, all members of AAGL (American Association of Gynecologic Laparoscopy) are highly trained and experienced in the field of Minimally Invasive Gynecgologic Surgery.   Dr. Erika Balassiano is also completed a Minimally Invasive Gynecologic Surgery Fellowship, under the supervision of world-renowned Dr. Camran Nezhat.


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