Stillbirth: Popular Questions on Safe Sleep During Pregnancy, Answered

Stillbirth: Popular Questions on Safe Sleep During Pregnancy, Answered

What do you do if you went to sleep in a side position, but woke up in the middle of the night and found that you have been sleeping on your back? Would your partner who is more like an octopus and has a tendency to thrash his limbs around in sleep, affect your baby in any way?

Pregnancy is wondrous time, full of excitement and a bit of nervousness, and also many questions. One of the questions many pregnant women have is related to sleep positions during pregnancy. If you are pregnant, you may have heard that certain sleep positions during pregnancy are recommended over others to ensure a safe pregnancy.

Certain sleep positions during pregnancy (during the last trimester) may even be linked to stillbirth. Let’s get a better understanding about safe sleep positions in pregnancy and which ones you should try to avoid. We also answer some of the most common questions related to safe sleep during pregnancy, so that you can have peace of mind. 

But first:

Why should you avoid sleeping on your back during late pregnancy? 

According to research, sleeping on your back during the third trimester (after 28 weeks of pregnancy) increases your risk of stillbirth.

The advice to all pregnant women is to always go to sleep on your side, regardless of the episode of sleep you intend to have: going to sleep at night, returning to sleep after any night awakenings, and any naps taken during the day.

However, mums, don’t be alarmed at this word of caution. Your risk of stillbirth is low, with 1 in 200 babies being stillborn in uncomplicated pregnancies, with going to sleep on your side further lowering that risk.

But what do you do if you went to sleep in a side position, but woke up in the middle of the night and found that you have been sleeping on your back? Does this affect your baby in any way? What about a partner who is prone to tossing and turning in his sleep; would your baby be affected if a blow lands on your tummy perhaps? 

We at theAsianparent have curated a list of answers to popular questions that we get on our community platform all the time, regarding safe sleep during pregnancy, in order to help you lessen your risk of stillbirth. 

sleeping positions during pregnancy

Side sleeping positions during pregnancy lowers your risk of stillbirth. Photo: iStock

Sleep positions during pregnancy: Your questions answered

What do I do if I constantly find myself waking up on my back during the night?

You did your research, bought a few sleeping aids and practised safe measures to make sure you sleep on your side. But despite all that, you suddenly wake up in the middle of the night and you find yourself on your back.

Should you worry?

Short answer, no.

According to research published in the medical journal The Lancet, the position you go to sleep in is the one that’s held the longest during your sleep, and if you went to sleep on your side it is likely that you have not been sleeping supine long enough to harm your baby.

Further, a large pregnancy bump is more likely to wake you up if you are on your back. Many women report to being either woken up with a kick from their babies, or an uncomfortable sensation even in deep sleep. These responses were recorded in a question asked on theAsianParent community, about waking up in the middle of the night to find that you have rolled onto your back. 

The golden rule here is to always go to sleep on your side. If you still find yourself waking up in the middle of the night on your back, do not fret; simply roll back on your side and carry on sleeping!

Please refer to our article on tips to ensure you are sleeping on your side, at least for the most part of the night, which can be found here.

How much sleep do I really need when I am pregnant?

With heavy uteruses, frequent trips to the loo and cramps in your legs, buttocks (ouch!) and other areas that you never thought were possible to cramp up, quality sleep during pregnancy can be as evasive.

And with all the advice around that we should be getting as much sleep as possible, from “sleeping for two” to “enjoying it when you can” we often find ourselves contemplating how much easier that is said than done.

However, we need to endeavour to get in our daily snoozes. According to Dr Kathy Lee, a professor of nursing at the University of California San Francisco who carried out an important study on how sleep affects late pregnancy and delivery and labour outcomes, it is important that mothers-to-be spend at least 8 hours in bed each night so they can get at least 7 hours of sleep.”

Based on the study, first-time mothers who got less than 6 hours of sleep at night were 4.5 times more likely to have a C-section and their average length of labour was 10 hours or longer compared with first-time mothers who slept 7 hours or more.

Lee noted that a pregnant woman needed the extra rest and that “they can’t keep going on the same amount of sleep they got before becoming pregnant.”

Further, another expert on the matter – Dr. Grace Pien, an assistant professor of medicine at the Johns Hopkins University School of Medicine –  notes that “pregnant women who are not getting enough sleep, less than 5 or 6 hours of sleep a night, probably are at increased risk for things like gestational diabetes, and potentially for things like preeclampsia.”

Here a few tips you can practice to ensure that you get enough sleep during pregnancy:

  • Go to bed earlier than usual
  • Try to slot in a daytime nap, and rest as much as you can during the day
  • Go for a stroll in the late afternoon or early evening
  • You should already be limiting your intake of caffeine during pregnancy, but try to avoid tea and coffee before bedtime, in particular 
  • Create a mood for relaxation before bedtime, by taking a long bath, reading, listening to soothing music, watching TV or perhaps getting a family member to give you a backrub
  • Avoid nighttime cramps that can interfere with your sleep by stretching your calf muscles, being active during the day and drinking plenty of fluids. Try to incorporate foods high in magnesium such as whole-grain bread and pasta, beans, nuts, seeds and dried fruit, into your diet as low levels of magnesium is often a marker for leg cramps. You may talk to your gynaecologist about taking a magnesium supplement as well. 

But what if I am sleeping too much?

While many of us are being reminded to sleep all we can during pregnancy, is there any such thing as getting excessive rest? And will this be potentially problematic to you and your baby? 

In a study that was published in the medical journal Birth, research suggests that excessive, undisturbed sleep may pose a problem as well and may be linked to late stillbirth. Too much sleep (more than 10 hours a night at a stretch) can also increase your risk for developing preeclampsia, making you twice as likely to have it.

According to Louise O’Brien, research associate professor in the neurology sleep disorders center and in obstetrics and gynecology at the University of Michigan, one of the authors of the study, “there’s been a lot of public attention paid to sleep deprivation and its impact on health, but not as much to lengthy — perhaps too much — sleep, especially when it comes to pregnancy.”

The findings of the study reported that nearly 30 percent of those who had stillbirths had long sessions of sleep in the last month of pregnancy compared with only 16 percent of women with live-born babies.

O’Brien further noted that one of the significant reasons for this could be a change in sleeping patterns during pregnancy, as opposed to when a woman is not pregnant.

“Given that a similar proportion of women in the stillbirth and live-birth group were long sleepers before pregnancy, but during pregnancy the stillbirth group had a significant increase in the proportion of women having long sleep, it would appear that it could be the change in sleep duration during pregnancy that is important,” she noted. “Being a lifelong long sleeper versus a pregnancy-associated long sleeper could be the difference.”

“Women often worry when they wake up several times during the night when they are pregnant, but it may be protective in this case,” she noted.

According to O’Brien, blood pressure reaches its lowest point during sleep but surges upon awakening, leading to temporary spikes in levels. “These short-lived rises in blood pressure may prevent extended periods of low blood pressure, which has been linked to fetal growth problems, preterm birth and stillbirth”, she noted. 

If you feel that you may be sleeping for extended periods of time, for more than 9 hours in a row, it would be best to set periodic alarms to try and shake up your sleep pattern to avoid the potential dangers of stillbirth. 


sleeping positions during pregnancy

Should you be concerned if your partner flails his limbs during sleep and it lands on your pregnant belly? Photo: iStock

I’m afraid my sleeping partner will land his arms or legs on my pregnant belly accidentally: Sleep positions during pregnancy and other questions

While this can be scary and painful to you, it is extremely unlikely to hurt the baby as your foetus is protected within many other facets such as bones, muscles, Fascia (strong connective tissue that holds muscles together), in addition to the uterus with its thick and strong muscles.

Any blunt force delivered accidentally in sleep to your belly has to pass through all these insulating layers to reach the baby where he/she is further protected by the amniotic fluid that acts as a buffer of sorts.

While bad falls onto the abdomen or buttocks, car accidents or severe trauma can cause the placenta to be dislodged from the uterus in a condition called an abruption, a sleepy arm or leg to the belly by accident is not likely to cause any harm. 

Try sleeping with a pillow lodged in between your partner or a toddler who co-sleeps with you, if this is something that is bothering you.

What if I roll out of bed in my sleep? 

While your baby is deep-set in your womb and protected within a heavily cushioned environment, a fall does have the potential of causing harm to you and the foetus you are carrying. 

Visit your gynaecologist, and watch out for the following signs that could signal a potential problem:

  • Any vaginal bleeding, or fluid leakage 
  • Uterine contractions or labour pains
  • Severe abdominal pain
  • Feeling lightheaded or experiencing dizziness
  • Shortness of breath
  • A decrease in your baby’s movements 
Stillbirth: Popular Questions on Safe Sleep During Pregnancy, Answered

Creating a “wall” or a fort at the edge of the bed may help in preventing any falls during sleep. Photo: iStock

Reduce your risk of falling out of bed during pregnancy, particularly if this has happened to you previously, by positioning your bed against a wall and taking the side adjacent to the wall, or by trying to create a “barrier” at the edge of the bed with a pregnancy pillow or common bolster pillow. 

What other questions do you have regarding safe sleep during pregnancy? Do let us know in the comments below if we have left out any concerns on the matter that you may be worried about. 

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