By the third trimester, your growing belly and shifting hormones can turn a good night’s sleep into a nightly challenge. Between physical discomfort, frequent bathroom trips, and the mental load of preparing for baby’s arrival, it’s no wonder many expectant mothers feel exhausted.
The good news? There are ways to get better rest, even in these final months. Let’s walk through the best sleeping positions, how to use pillows effectively, and ways to minimize reflux so you can sleep more soundly.
The Best Sleeping Positions for Late Pregnancy
Why left-side sleeping is recommended:
As your uterus expands, it can put pressure on major blood vessels—especially the inferior vena cava, which runs along your spine and returns blood to your heart. Sleeping on your back in the third trimester can compress this vein, potentially reducing blood flow to your placenta and baby. That’s why we recommend left-side sleeping whenever possible.
Sleeping on your left side also optimizes kidney function and improves circulation, helping reduce swelling in your feet and ankles. Some women find right-side sleeping comfortable too—and that’s okay in moderation—but aim to favor the left when you can.
What about back or stomach sleeping?
Back sleeping isn’t dangerous for every mom, every night—but if you’re consistently flat on your back, especially late in pregnancy, it can lower blood pressure and make you feel dizzy, short of breath, or nauseous. Stomach sleeping is usually no longer an option by this stage due to the size of your baby bump.
Pillows in Your Third Trimester
Why pillows matter so much:
Pillows aren’t just for comfort, they’re tools for body alignment. As your center of gravity shifts and ligaments loosen (thanks to the hormone relaxin), your lower back, hips, and pelvis can become sore or unstable.
Pillow strategies to try:
- Between the knees: Helps align your hips and lower back, reducing strain on your pelvis and sacroiliac joints.
- Under your belly: Provides gentle support for your bump and reduces pull on your lower back.
- Behind your back: Prevents rolling onto your back and can ease upper back strain.
- Elevated head and shoulders: Especially helpful if you’re battling heartburn or snoring. Elevating your torso slightly can improve breathing and digestion.
Pregnancy pillows (U-shaped or C-shaped) combine these supports into one large pillow, but you can achieve the same results with a few well-placed regular pillows if preferred.
Managing Reflux and Heartburn at Night
Why reflux gets worse in late pregnancy:
As baby grows, your uterus pushes your stomach upward, leaving less room for digestion and increasing the chances that acid will flow back into your esophagus, especially when you’re lying down. At the same time, progesterone relaxes the valve between your stomach and esophagus, making reflux more likely.
Tips to minimize nighttime heartburn:
- Elevate your upper body: Use a wedge pillow or elevate the head of your bed by 4–6 inches. Gravity helps keep stomach acid where it belongs.
- Eat earlier: Avoid meals or snacks 2–3 hours before bedtime. A full stomach is more likely to trigger reflux.
- Avoid trigger foods: Spicy, fried, and acidic foods (like citrus and tomato-based dishes) can make heartburn worse.
- Stay upright after eating: Even a gentle walk after dinner can aid digestion.
- Talk to your provider: If you’re still struggling, safe antacids or medications can be prescribed to help reduce acid production and protect your esophagus.
Bonus Tips for Better Sleep in the Third Trimester
- Stay cool: Hormonal changes can make you feel warmer at night. Keep your room cool and use breathable, cotton sheets and pajamas.
- Limit fluids late in the day: To minimize bathroom trips, stay hydrated during the day and taper off fluids a few hours before bed.
- Keep a calm bedtime routine: Your body needs signals to wind down. Gentle stretching, reading, or a warm (not hot) bath can help shift your body into sleep mode.
- Nap smart: Short naps earlier in the day can help you recharge without interfering with nighttime sleep.
When to Call Your Doctor
Trouble sleeping is common—but if you’re feeling dizzy, short of breath, noticing a sudden increase in swelling, or experiencing consistent back pain at night, reach out. These could be signs of something more serious like high blood pressure or preterm labor, and we want to be sure everything is progressing safely.
You Deserve Rest
This is a season of preparation and anticipation—but your rest still matters. Quality sleep helps you recover, balance your mood, and prepare physically for labor and delivery.
At Northwest Family Clinics, we’re here to support you through every twist, turn, and pillow pile of the third trimester. If you need help managing discomfort or sleep changes, reach out. We’ll help you feel more rested—and ready.