How do I get Comfortable in Bed While Pregnant?

Guide to Pillows, Mattresses, and Alignment

Sleep often stops feeling simple once you are pregnant. As your body changes, so does bedtime. A growing bump, sore back, burning heartburn, aching hips, and restless legs can all add up to nights where you just cannot find a good position. 

This guide will walk you through safe and comfortable sleep positions by trimester, how to use pillows, mattress tips, and simple adjustments, body alignment basics to protect your back and hips, extra tricks if you still cannot get comfy, and when to talk to your GP or midwife about sleep problems. The aim is to give you practical, realistic ideas you can use straight away. It does not replace medical advice. If you have pain, shortness of breath, or any symptoms that worry you, contact your clinician.

1. Sleep Positions in Pregnancy: What Is Recommended and Why

First trimester

In the first trimester, most people can safely sleep in whatever position feels comfortable, including on your back or stomach.

Focus on:

• Resting when you can

• Establishing a calming bedtime routine

• Use a small pillow under your knees if your lower back hurts

Second and third trimester

As your uterus grows larger, lying flat on your back for long periods can press on major blood vessels. This may reduce blood flow and make you feel dizzy or unwell.

Most guidelines suggest:

• From about 20 weeks, try to sleep on your side, ideally your left, but any side is better than flat on your back

• If you wake up and find yourself on your back, do not panic. Just roll back onto your side, with the help of pillows if needed

2. Pillows: Your Best Friend for Comfort

You do not always need a special pregnancy pillow, although some people love them. You can use the regular pillows you already have and place them in smart ways.

Key goals with pillows

• Support your bump

• Keep your spine in a neutral line

• Stop your top leg from dragging your hips and back out of line

• Reduce pressure on sore hips and shoulders

Basic side sleeping setup

Try this simple side lying setup:

1. Head pillow:

• Use a medium height pillow so your neck is in line with your spine, not bent up or down

2. Pillow between your knees:

• Place a firm pillow between your knees and maybe your ankles

• This keeps hips, knees, and ankles lined up and reduces hip and lower back pain

3. Pillow under your bump:

• Use a small, soft pillow or rolled towel under your belly to stop it pulling downward

4. Back support pillow:

• Tuck a pillow or rolled blanket along your back

• This stops you from rolling flat onto your back and gives a “hugged” feeling that many people find comforting

You can build this with 3 or 4 normal pillows.

Pregnancy pillows: what types help

If you want a dedicated pregnancy pillow, common shapes include:

• Long body pillow (straight):
  
  

• You hug part of it, and place another part between your knees

• Good for full body support on one side

• C shaped pillow:
  
  

• Curves along your back and between your knees

• You can flip it to support your front or back

• U shaped pillow:
  
  

• Supports both sides at once

• You lie in the middle, with your legs hugging the bottom section, and your head on the top

• Bulky, but can be very supportive

You do not need the most expensive pillow. Look for:

• Washable cover

• Enough firmness to support legs and bump

• Size that actually fits your bed and matches your height

Cheap pillow hacks

If you are on a budget:

• Roll up a blanket or towel and secure it with a band to make a firm “sausage” to go behind your back or between your knees

• Use cushions from your sofa to build support around you

• Use a small travel pillow under your belly or behind your lower back

3. Mattress Comfort: Soft, Firm, and Simple Fixes

Your mattress does not need to be perfect, but it should support your spine.

What to look for in a mattress during pregnancy

• Not too soft:
  
  

• You should not sink in so deeply that you struggle to turn

• Too soft can worsen back and hip pain

• Not rock hard:
  
  

• An extremely firm mattress can cause pressure on the hips and shoulders

• This can wake you up often as you roll to relieve pain

• “Medium firm” with some cushioning usually suits most bodies
  
  

You do not have to buy a new mattress for pregnancy. Try easy changes first.

Simple fixes if your mattress is too hard

• Add a foam or memory foam topper for extra cushioning

• Use a thick doona or blanket folded under your hips and shoulders, then a fitted sheet on top

• Combine with a pillow between your knees to reduce hip pressure

If your mattress sags or is too soft

• Try rotating or flipping the mattress if the design allows

• Place a firm board or piece of plywood underneath (if safe for your bed frame) to reduce sagging

• Use extra pillows under your waist or behind your back to keep your spine in line

If back or hip pain is severe and ongoing, ask your GP, midwife, or a physiotherapist who works with pregnant people for personalised advice.

4. Alignment Basics: Protecting Your Back and Hips

Good alignment means your ears, shoulders, hips, knees, and ankles are roughly in a straight line when you lie on your side.

Side lying alignment checklist

When you lie on your side:

• Head and neck:
  
  

• A pillow fills the space between your head and the mattress

• Your nose and sternum should face straight ahead, not down or up

• Shoulders:
  
  

• Do not twist your upper body forward or backward

• The shoulder should be “stacked” over the other

• Hips:
  
  

• Hips should be one above the other, not rolled forward or back

• A pillow between your knees prevents your top leg from pulling the top hip down

• Knees and ankles:
  
  

• Both supported by the pillow if possible, not with the top leg hanging in mid air

• Bump and lower back:
  
  

• A small pillow or rolled towel under your belly stops it from pulling downward

• A pillow behind your back can stop you rolling flat

This alignment reduces strain on your lower back, pelvis, and hips and often helps with pelvic girdle pain.

5. Position Adjustments for Common Problems

If you have hip pain

• Place a thick, firm pillow between your knees and down to your ankles

• Add extra cushioning under your hip (folded blanket or soft layer)

• Try slightly rolling your upper body forward or back a small amount, supported by pillows, so you are not directly on the sore side

If your shoulders hurt

• Use a slightly softer pillow under your shoulder area or extra padding under your torso

• Hug a pillow at chest height so your top arm remains supported and your upper body does not twist down towards the mattress

If you get heartburn or reflux

• Raise the head of your bed slightly, for example, with blocks under the bed legs, or

• Use extra pillows or a wedge pillow to keep your upper body at a gentle angle

• Sleep on your left side, where possible

• Avoid large meals and eating right before bed (your GP or midwife can give tailored advice if heartburn is severe)

If you feel short of breath when lying flat

• Avoid lying flat on your back

• Use pillows to prop yourself into a gentle incline, half sitting position on your side or slightly reclined

• Mention any ongoing breathlessness to your clinician, especially if sudden or severe

6. Turning Over and Getting Out of Bed Safely

As pregnancy progresses, turning over and sitting up can be uncomfortable.

Tips for turning in bed

• Keep your knees together when rolling to avoid twisting the pelvis

• Roll with your whole body as one unit, shoulders and hips moving together

• Use your arms to help push and guide your movement

• If your bump feels heavy, support it with your hands or a pillow while you roll

Getting out of bed

Instead of sitting straight up:

1. Roll onto your side, facing the edge of the bed

2. Drop your legs gently over the side

3. Push yourself up to sitting using your arms

This “log roll” technique puts less strain on your tummy muscles and back.

7. Night Time Toilet Trips, Heat, and Restless Legs

Frequent trips to the toilet

• Keep a small light or night light so you can see safely without fully waking yourself

• Keep slippers or shoes by the bed to prevent slips

• Try reducing fluids slightly in the last 1 to 2 hours before bed, but do not cut fluids too much throughout the day

Feeling hot and sweaty

• Use light, breathable sleepwear (cotton or bamboo)

• Use layers of blankets instead of one heavy doona, so you can adjust easily

• Keep the room cool and well ventilated where possible

Restless legs or muscle cramps

• Gently stretch your calves and legs before bed

• Try a warm bath or shower to relax muscles

• Make sure your pillow placement does not force your ankles or knees into an awkward position

• Tell your clinician if restless legs or cramps are frequent or severe, as they may want to check things like iron levels

8. Naps and Rest Positions During the Day

You do not always have to lie in bed to rest.

• Use a recliner chair or couch with pillows to support your lower back and under your knees

• Side lying on a couch with pillows between your knees and under your bump can give quick relief

• Short naps can help if night sleep is broken

Try to keep long daytime naps earlier rather than late afternoon, so you still feel sleepy at night.

9. When Sleep Problems Need Medical Advice

Contact your GP, midwife, or antenatal clinic if:

• You have severe back, hip, or pelvic pain that is not eased by position changes or simple pain relief

• You wake at night with chest pain, severe shortness of breath, or heart racing

• You have numbness, pins and needles, or weakness in your legs or arms

• You feel very low, anxious, or distressed about sleep, and it is affecting your daily life

10. Quick “Bed Comfort” Checklist

Use this as a simple reminder:

1. Choose side sleeping, especially after 20 weeks.

2. Support your head and neck so they are in line with your spine.

3. Place a firm pillow between your knees and ankles.

4. Add a small pillow under your bump.

5. Tuck a pillow behind your back for support and to stop rolling.

6. Adjust your mattress comfort with a topper or extra padding if needed.

7. Keep a gentle incline if you have heartburn or feel breathless lying flat.

8. Roll to your side and push up with your arms when getting out of bed.

9. Keep the room cool and comfortable, with a night light for toilet trips.

10. Talk to your GP or midwife if pain or sleep problems are severe or worrying you.

Conclusion

Finding comfort in bed during pregnancy can be a journey of trial and error, but it is a journey worth taking for better rest and well-being. By understanding recommended sleep positions, strategically using pillows for support, making simple adjustments to your mattress, and focusing on good body alignment, you can significantly improve your sleep quality. Remember to listen to your body, adapt these tips to your unique needs, and do not hesitate to seek advice from your GP or midwife if pain or sleep disturbances become severe or concerning. Prioritising your comfort and rest now will benefit both you and your growing baby.