To sleep on my back at 37 weeks pregnant

[Usernamqwerty]

Am 37+4 with second baby.

I usually sleep on my back but have been sleeping on my side for the past few months as I understand it's better for the baby to reduce the risk of stillbirth.

However I have been waking up with awful pains in my lower back and glutes (left buttock) which actually make me cry when I try and get out of bed in the morning. It's getting out of bed which is the worst and I then hobble around all day (have had to hold onto walls to walk) and really struggling to look after my toddler son 😕.

A physio has given me some stretching exercises and I have a pregnancy support belt which are helping a bit, but we have both agreed that the issue is caused / aggravated by sleeping on my side...

Would it be ok at this stage to go back to sleeping on my back? I really don't think I can take much more of this and it is really starting to get me down. Am dreading going into labour while having back/glute spasms, it would just be horrendous 😩.

Thanks for reading x

Could someone lend you a pregnancy pillow? Or try putting a normal pillow between your knees, that can help too.
Personally I couldn’t have slept on my back at that stage as it made me very short of breath.

The risk of you sleeping on your back is that it could put pressure on your inferior vena cava, the vein that brings blood to the heart from the lower part of the body. This could cause your blood pressure to drop.

Sometimes putting a pillow between your knees and even bending your knees is very helpful.

Sorry op but it is not a good idea at all. If you really have to do it then make sure you have stacks of pillows under your head so you aren't flat.I agree with the above though about pillows between your legs etc. I doubt that sleeping on your back will actually be any more comfortable anyway!

I sleep on my back, however I have 5 pillows and am virtually sitting! I cannot stay on my side and can't breath properly. It's so hard the last few weeks.

Wouldn’t worry OP. This is one of those things that is recommended because of a small amount of ropey evidence that suggests it may be an issue, unfortunately like so many things pregnancy related... (don’t even get me started on listeria). If it’s comfortable it’s highly unlikely to be a problem.

It does increase the risk so no one can really tell you if it will be okay - the bigger your baby, the heavier it is and the more chance of it constricting blood flow when you lie back. What you're describing sounds like sciatica so, sadly, I don't think it would help much anyway. My sympathies, back pain is awful - hopefully not long to go until your baby arrives though

Why at ‘this stage’ ? The last couple of months are the most risky for stillbirth increased by laying on your back. I know how hard it is, been there done that. But it’s just not worth the risk surely? Short term pain is so much better than the alternative.

I'm hazy about the details now, but when that research hit the news I remember thinking that the methodology wasn't particularly convincing.

You have my sympathy OP. I had similar to you and it was so uncomfortable. My belly was huge too. Really don't sleep on your back tho. It's not recommended and to be honest the odd time I woke up in this position I felt ill afterwards. Not sure it will do either of you any good. Get yourself a huge pregnancy pillow off ebay to straddle whilst on your side. Mine got such a hammering it was actually flat by the time baby came! Did help a bit tho.

What my midwife said, and I don't know whether it's true or not, is that if you are comfortable lying on your back then you can sleep on your back. She said that you'll know if the baby is squashing the big vein because you'll feel faint and dizzy when you try. I have always been a side sleeper but when I was pregnant I was only really comfortable on my back. In the end I kind of wedged myself with a combination of pregnancy pillows so that if I rolled backwards in my sleep I ended up only half on my back if you see what I mean. But it might be worth asking your midwife or consultant about this because my midwife was excellent and very evidence based and her view basically was that if you can sleep on your back comfortably without feeling dizzy then the vena cava isn't squashed.

Is there a reclining chair you can borrow? I find the semi reclined position really comfortable.

The risk as pointed out above is of caval compression by the weight of the uterus. Essentially the vein is squashed by the uterus and because less blood gets back to the heart less blood gets pumped forward by the heart. This means there is less blood (and therefore oxygen) getting to both your vital bits (especially brain) and the baby. This becomes problematic usually after about 20 weeks and is why some women faint & some bumps get distressed when you lie on your back. It is also why we put a lateral tilt on the operating table when we're doing c-sections, why we resuscitate pregnant women with a wedge underneath and why, when babies become distressed in labour, midwives may tell women to lie on their side. If you don't feel unwell lying on your back your baby may be ok, but they also may not and at home, without monitoring you probably wouldn't know....not sure I'd want to test it!

I slept with a pillow under my bump, behind me and between my legs and found that helped with sciatica.

I wouldn’t. Sleeping on your back causes aorto-caval compression (well demonstrated with MRI) which reduces placental perfusion. You should either be on your side or semi supine (half sitting, pillows under knees to support lower back) to reduce this.

It’s why when you have a Caesar the table is on a left tilt until the baby is born. The alternative is on your back with pillows under your left hip to tilt you just enough you just enough to reduce the pressure on the vena cava.

The methodology used in these studies is appropriate for this kind of research and four studies have now demonstrated an association. Whilst you can't say definitively that the association equals one thing causing another, the fact that it's been seen in a number of studies with different populations, and the fact that there is a very plausible biological explanation for it (i.e. compression of the vena cava), means it's worth paying attention to. This is exactly the same research methodology that discovered an association between babies sleeping on their front and SIDS - and the advice would be the same - most babies that sleep on their front will be fine but it is associated with an increased risk and you have no way of knowing if your baby will be the one that is fine or the one that is not. So most women sleeping on their back will be fine, but it does appear to increase the risk and no one can tell you whether you'll be the 'one' or not.

And the poster who said their midwife is telling women they'll be fine as long as they feel fine - that's not supported by any evidence whatsoever and that midwife should stop saying it. Quite aside from the evidence, this is about position during sleep - how will you know if you're feeling fine when you're not conscious?

Thanks so much for all your advice. Greatly appreciated 😙.

Yes I sleep with the duvet folded up between my legs which helps (have never gotten on with normal / pregnancy pillows there).

Thanks for the sciatica suggestion. I have heard of that but don't know much about it. I'll look it up xx