What are you trying to fix in bed?
- Getting used to side sleeping
- A mattress that's dipped
- Pillows everywhere
- Feeling too hot
- Heartburn when I lie down
Go to sleep on your side from 28 weeks, and don't panic if you wake on your back
From 28 weeks, settle to sleep on either side, and turn back onto your side if you wake on your back. The NHS guidance on sleep in pregnancy says: "The safest position to go to sleep is on your side, either left or right.2 Research suggests that, after 28 weeks, falling asleep on your back can double the risk of stillbirth. This may be to do with the flow of blood and oxygen to the baby." "Do not worry if you wake up on your back, you can turn over and go to sleep again on your side."
The evidence comes from studies that found a link, rather than trials. In its rationale for sleep-position advice, NICE acknowledges some uncertainty because the studies were relatively small and their design made it difficult to assume sleep position caused the outcomes. On balance, the committee agreed the evidence was strong enough to advise pregnant women to try to avoid going to sleep on their back after 28 weeks.3
Either side appears equally safe in Cronin and colleagues' 2019 analysis, which pooled data from five case-control studies.
Tommy's, the pregnancy charity, says the left side has not conclusively been shown to be better than the right.1 Its advice applies when you first go to sleep, when you return to sleep after waking in the night, and during daytime naps.4 Choose whichever side feels comfortable when you settle.
Earlier in pregnancy, position does not matter in the same way. Tommy's says it is fine to sleep on your stomach in the early days. As your bump grows, pillows under it and between your legs may help you get comfortable on your side.
Replace a dipped mattress, but adjust a sound one first
A lasting dip is a good reason to replace your mattress now. If the surface is level and you feel supported, try changing the pillows and cushioning before buying a whole bed. Judge its condition by the sag and how you feel when you wake. Its age alone is a poor reason to spend money.
Honestly, keeping a sound mattress is a perfectly respectable shopping decision, even if it makes for a less exciting delivery. Spend where you notice a difference. A full replacement makes sense when the support has gone, while a smaller comfort buy is easier to justify when the mattress underneath still does its job.
A topper changes the surface, and a long pillow reduces the clutter
A topper is useful when a sound mattress feels too firm, because it adds cushioning above the existing surface. It follows any dip underneath, though. Browse mattress toppers for extra softness only if the mattress beneath is level and supportive.
One long pregnancy pillow can be a lovely comfort buy if you're forever gathering loose pillows back into place. There's a point at which making the bed becomes soft-furnishing admin, and I'm very happy to reduce that. Ordinary pillows are also a sensible first try, especially if you already have enough to experiment without spending anything.
The cat would regard a long pillow as an excellent purchase for entirely selfish reasons. For you, the less glamorous details matter more: check that the cover comes off for washing and that the pillow fits alongside whoever shares your bed. Leave yourself usable room to move.
The NHS suggests supporting your bump with pillows and putting a pillow between your knees. Tommy's also suggests pillows behind you to make rolling onto your back less likely, while acknowledging that they won't prevent it for certain. It says regular pillows and pregnancy pillows are equally effective at keeping you off your back.
For your head, choose a pillow that fills the gap between your head and the mattress when you're on your side. Too much height tips your head upwards, while too little lets it drop towards the bed. Compare pillows with the mattress underneath in mind, because you'll sink further into a softer surface.
The NHS advice on back pain in pregnancy asks for a mattress that supports you properly.7 It also suggests putting hardboard under a soft mattress to make it firmer if necessary. It gives no firmness level. If your backache is very painful, speak to your GP or midwife, who may refer you to an obstetric physiotherapist.
Buy enough give for your hips and shoulders
If you're replacing the mattress, start with a soft-medium to medium feel over pocket springs, or a hybrid with pocket springs beneath foam or latex. That's where I would begin for side-sleeping comfort: your hips and shoulders need to sink a little without your middle dropping deeply into the bed. Our side-sleeper mattresses are the relevant comparison.
Firmness is a comfort choice. When trying a mattress in a shop, spend a full ten minutes lying on your side so you can notice whether you feel squeezed at the shoulder or hip. If you sink so far that changing sides takes effort, try something more responsive. Buy for how you expect to sleep after pregnancy too, because you'll be using the mattress for much longer.
I like latex for its springy feel and the ease of changing position. Deep memory foam gives a slower, more enveloping feel, and I find a thick memory-foam topper warm. Pocket springs with a shallower comfort layer are a useful middle ground if you like cushioning but dislike feeling stuck.
A supportive edge and a sensible bed height also make getting in and out easier. Check that you can sit with your feet flat on the floor and that the edge doesn't collapse heavily beneath you. Include the mattress depth when checking the finished height of the bed.
Before ordering, check how a comfort return works, including collection charges and whether you'll receive a refund or an exchange. The paperwork is a dull companion to bed shopping, but an exchange-only arrangement matters if you dislike every alternative. Save the terms with your order confirmation so you have the wording you bought under.
Cool the bedding, raise your head for heartburn and make turning easier
You can adjust heat, heartburn comfort and ease of movement separately, without replacing the whole bed. Start with the problem that's actually keeping you awake. Buying every bedroom accessory at once is how you end up with a cupboard full of things you used until Thursday.
A cooler room and lighter bedding come first
Feeling hot and sweaty during pregnancy can be down to hormonal changes and increased blood supply, according to Tommy's advice on getting more sleep.5 It suggests keeping the bedroom as cool as possible, perhaps with an electric fan, and using loose bedclothes in natural fibres such as cotton.
Start around 18C if that feels comfortable, then adjust the duvet before turning up the heating. Separate duvets are a very civilised answer when your partner prefers a warmer bed. You can keep a lighter covering without negotiating the entire room temperature. For sheets, cotton is a straightforward option alongside the cooler-room advice.
My view on mattresses is simple: memory foam runs warm, and a sprung mattress with breathable fillings is the better direction if you already overheat. Compare mattresses for hot sleepers if you're replacing yours anyway. A thick foam topper adds another enclosing layer, so take that into account before using one to soften the bed.
Head-and-shoulder support can help with heartburn
Propping up your head and shoulders can help with night-time heartburn. The NHS guidance on heartburn in pregnancy says this can stop stomach acid coming up while you sleep.6 It also says avoiding food within 3 hours of bedtime can help, and sleeping on your left side may help heartburn.
An adjustable base is an expensive way to raise the head end, and I think it's overpriced for most people buying for these months. No health body recommends an adjustable bed for pregnancy. From 28 weeks, you still go to sleep on your side, even with your head raised. If heartburn is your main concern, our acid-reflux guide covers that separate comfort question.
Support between your legs can help when turning hurts
Pregnancy-related pelvic girdle pain can make turning over in bed painful, according to the NHS guidance on pelvic pain.8 It suggests a pillow between your legs for extra support in bed. Tommy's says keeping your knees together when turning over can help reduce pelvic pain.
A very soft mattress is harder to turn on because you have to lift yourself out of the hollow before changing position. For comfort, I prefer a surface that cushions you but responds promptly as you move. If it hurts to turn over in bed, contact your midwife or GP.
What to avoid
Avoid these arrangements when you're setting up the bed. Some concern how you settle to sleep, while others concern whether the surface is comfortable and easy to move on.
- Settling to sleep on your back from 28 weeks. The side-sleeping advice also applies to naps and returning to sleep after waking in the night.
- Treating a pregnancy pillow or wedge as a safety product. A pregnancy pillow is a comfort buy. Tommy's says ordinary pillows are equally effective at keeping you off your back, and neither prevents back sleeping for certain.
- Putting a topper over a dipped mattress. The topper follows the dip, so you still have the uneven surface underneath.
- A very soft mattress you sink deeply into when turning is already difficult. Moving out of that hollow takes more effort. I also avoid fixed pillow-tops and euro-tops because you can't remove the cushioning layer if it softens too much.
- Using a raised head end as a reason to settle on your back in late pregnancy. Stacked pillows and adjustable bases do not change the advice to go to sleep on your side from 28 weeks.
When to call your midwife or doctor
NHS guidance on your baby's movements says to call your midwife or maternity unit immediately if your baby is moving less than usual, you cannot feel your baby moving anymore, or there is a change to your baby's usual pattern of movements. Do not wait until the next day: call immediately, even if it's the middle of the night.
NHS guidance on tiredness and sleep problems in pregnancy says if lack of sleep is bothering you, talk to your partner, a friend, doctor or midwife. Occasionally, sleeplessness (when accompanied by other symptoms) can be a sign of depression. If you have any of the other symptoms of depression, such as feeling hopeless and losing interest in the things you used to enjoy, speak to your doctor or midwife. There is treatment that can help.
NHS guidance on pelvic pain in pregnancy says to call your midwife or GP if you have pelvic pain and it's hard for you to move around, it hurts to get out of a car or turn over in bed, or it's painful going up or down stairs.
NHS guidance on back pain in pregnancy says to contact your GP or midwife urgently if you have back pain and you are in your second or third trimester (this could be a sign of early labour); also have a fever, bleeding from your vagina or pain when you pee; or have pain in one or more of your sides (under your ribs). Call 999 or go to A&E if you have back pain and you lose feeling in one or both of your legs, your bum, or your genitals.
Replacing yours? Three side-sleeping builds on this list
The mattresses below are WantMattress's own picks, chosen from published specifications and retailer information.
If your mattress is sound, try pillows and a topper first. These three are for someone replacing anyway and choosing for years of side sleeping, so take time over the feel you prefer. Where there's a choice of tension, choose it on purpose.
Quilted silk, cashgora and British wool give the Apex its cushioning, with more wool layers beneath. Simba lists a viscose cover, three layers of pocketed Aerocoil microsprings separated by wool, and a zoned base of pocketed steel springs with a reinforced edge frame. Neither Simba nor MattressOnline lists any foam. I like this combination for someone who wants give from fillings around the shoulder and hip, with springs supporting their middle, and who dislikes the slow response of memory foam when changing sides.
Simba calls it plush, while MattressOnline calls it medium to firm. Read the return terms so you know the conditions for judging it lying on your side at home. Simba lists a cover that isn't removable and flat delivery, so look elsewhere if you need a washable cover or rolled delivery. It's single-sided, with head-to-foot rotation every couple of months during the initial six months, then twice a year. That upkeep needs planning alongside delivery. Check the route into your bedroom and arrange help with rotation if you need it.
If you prefer cushioning that moulds around your shoulder and hip, the Tadley is a straightforward foam-and-spring option. Dreams lists a memory foam comfort layer over pocket springs, plus I-Fibre polyester fillings under a knitted SmartSilver cover, and grades it medium. Your shoulder and hip can sink into the foam while the springs support your middle. To my mind, this suits someone who enjoys an enclosing feel and is comfortable with the slower response of memory foam as they change position.
The rotation routine is the commitment to check with this one: Dreams specifies head-to-toe rotation weekly during the initial three months, then monthly, with no flipping. Make sure you can manage that or have someone to help. If washing the cover is essential, ask Dreams to confirm whether it comes off before ordering. Look elsewhere if you dislike the effort of moving through slow foam. Read the comfort-return conditions and, when trying the mattress, turn from side to side several times to check you're comfortable moving.
A choice of Soft, Medium or Firm gives you more than one version of the Air 6.0 Memory to assess. Bensons lists zoned Sensaform memory foam with air channels over a system combining full-height nested pocket springs and a layer of mini pocket springs. The quilted surface contains Truecomfort fillings made from recycled PET, and there's reinforced edge support. I think this suits someone who likes moulding foam but wants a choice in how much give they get when their shoulder and hip press into the mattress.
Bensons opens the product page on Firm, so change that selection deliberately if another tension suits you better. An untouched basket setting is an easy detail to miss. Skip this build if slow memory foam already makes turning over hard. Bensons specifies regular rotation without flipping, so plan for that upkeep. Ask whether the cover is removable if you need to wash it, and read the return conditions before paying. Check that both your basket and order confirmation record the tension you intended to buy.
