July 13, 2011
Dr. Linda Cares: Should Pregnant Women Sleep on Their Left Side?
A little knowledge is dangerous; especially when it relates to medicine. A recent article in the British newspaper, Daily Mirror discussed a medical study that attempted to prove there was a link between pregnant women’s sleeping positions and stillbirth. The author is of the opinion that the study was small and biased and therefore “there is a serious need for more research before we’re in a strong position to make ¬any recommendations.” Obviously this author has limited knowledge about the cardiovascular system of a pregnant woman.
Our organs and tissues require oxygen to function. Without it, they essentially die. Blood from the lower part of our body flows back to the heart where it receives oxygen, compliments of a large blood vessel called the Inferior Vena Cava (IVC). The inferior vena cava is a large, thin-walled blood vessel located near the spine. As the pregnant uterus becomes enlarged, it can press against the IVC and reduce the amount of its blood flow. Why is that not good? Because it reduces the circulating blood flow in the body that is commonly known as our cardiac output (CO). When the pregnant uterus squeezes the IVC and reduces cardiac output, a woman might feel dizzy and even faint. Her blood supply of oxygen is reduced and the unborn baby’s is as well. When a pregnant woman in her early or late third trimester feels faint after lying flat on her back, the syndrome is called Supine Hypotensive Disorder. Her blood pressure has dropped because her cardiac output has dropped. The heart can only pump out what comes into it, so less blood into the heart means less blood going out of the heart and the patient feels faint. How is this avoided? By encouraging pregnant women in their third trimester to sleep on their left side.
What happens when a pregnant woman sleeps on her left side? The uterus is no longer compressing the thin-walled IVC but lies against the thick-walled aorta instead. The aorta brings oxygenated blood away from the heart and to essential organs and tissues. Because of its thickness it’s not affected by the weight of the pregnant uterus. What if you can’t sleep on your left side? Then sleep on your right side but avoid sleeping flat on your back.
Although medical studies have allegedly not proven that sleeping on the left side reduces stillbirths, it is still sound advice to avoid maternal and fetal complications. Remember, a healthy pregnancy doesn’t just happen — it takes a smart mother who knows what to do.
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Pregnant Women: How Sleeping Position Might Affect Baby’s Health « health care commentaries from around the world said,
July 15, 2011 at 11:25 am
[...] *This blog post was originally published at Dr. Linda Burke-Galloway* [...]
Pregnant Women: How Sleeping Position Might Affect Baby’s Health - InstantKEbooks Blog - InstantKEbooks Blog said,
July 16, 2011 at 12:23 am
[...] blog post was originally published at Dr. Linda Burke-Galloway* Related [...]
Melissa Dickard said,
August 17, 2011 at 5:44 pm
This is an absolutely ridiculous idea. A woman should lie in whatever position she is most comfortable in. The concept that “all pregnant women should only lie on their left sides because some get dizzy if they don’t” implies that women are too dumb to adjust their position if they feel faint. This is terribly insulting. When I was nine months pregnant, sometimes the only comfortable position I could find was on my back. Sometimes it felt bad, so I didn’t lay that way. Give us some credit! Of all the things we have to worry about we don’t need to (literally) lose sleep over this one!
drlindagalloway said,
August 18, 2011 at 12:53 am
It is always the mother who makes the ultimate decision regarding her care. However physiology is physiology, whether you agree with the facts or not. Women are by no means “dumb.” I happen to be a woman myself and also a mother as well as an obstetrician. When an enlarged uterus is compressing the Inferior Vena Cava, the oxygenation to the fetus WILL be compromised whether the mother feels “faint” or not. This phenomena is translated into late decelerations on a fetal monitor strip and unless you have one in your home; you will never know that your baby is compromised until the moment of truth when you enter a labor room and it is discovered that the baby is experiencing fetal distress. I have to respectfully disagree with your comments but certainly thank you for taking the time to make them.
Rosanne said,
August 21, 2011 at 10:20 am
I’ve been researching the subject of sleeping on the left while pregnant, because I am subjected to this issue on a daily basis via forums I read which are literally full of pregnant women bemoaning the fact that they can’t sleep because they are trying to force themselves into sleeping on their left – in the mistaken belief that not doing so will somehow harm their unborn babies.
I can find absolutely no viable scientific study or evidence which shows a strong benefit to sleeping on the left, particularly in early pregnancy. I have only been able to find one study conducted on a small number of women (and not conducted in a credible scientific manner) which implies a POSSIBLE link between sleeping position on the night before giving birth, and still birth. However, it concludes that further research is needed before any link can be proven, and more to the point, before women are advised to sleep on their left (and this would surely only affect sleeping position in later pregnancy).
Irresponsible reporting on the part of the media, and articles like this one, are responsible for a new generation of pregnant women mistakenly believing that they must cause themselves to suffer for the full nine months of their pregnancy, by forcing themselves to lie on their left. For many women, the lack of sleep caused by this misinterpretation or the worry and guilt caused by not doing so, is surely far more damaging than sleeping in whatever position is comfortable during pregnancy!
This partial information has resulted in an unofficial internet campaign on pregnancy websites and baby related forums, which has caused this inconclusive evidence to be interpreted as a ‘guideline,’ that many women take far too seriously. It is unfair and irresponsible to allow information like this to be widely distributed and misinterpreted, and articles like this one appear to give credibility to a theory which is, as yet, unfounded.
If Dr Linda cares, then Dr Linda needs to be aware of the widespread effect that reporting something so inconclusive to a vulnerable audience can have, and this psuedo information has done far more harm than good.
(For evidence of the damage the irresponsible reporting of this study has done, check any pregnancy forum anywhere in the world. I guarantee there will be a current thread running about struggling to sleep on the left).
drlindagalloway said,
August 22, 2011 at 12:25 pm
Rosanne, I think you are missing the point. Whether it’s the left or the right side, a pregnant woman in her THIRD TRIMESTER should not lie in a recumbent position (flat on her back) because the gravid uterus could impede the blood flow from the Inferior Vena Cava back to the heart, depleting oxygen to the baby that could POTENTIALLY cause variable decelerations that ultimately compromises oxygenation to the fetus which it needs in order to breathe. Ultimately, it’s the mother’s choice.
Rosanne said,
August 22, 2011 at 1:25 pm
Linda, I think YOU are missing the point… If it is unimportant whether a pregnant woman should sleep on her left or her right as long as she refrains from lying on her back, then why are you endorsing the advice that women should sleep specifically on their left?
I am not sure medical professionals realise that pregnant women do take any advice they are given very seriously in their desire to do their best for their unborn child – in some cases, it is taken too seriously, and those in a position to hand out advice need to be responsible with information given out.
Many women are misinterpreting guidance like this to mean that they can’t turn over throughout the night, and are consequently subjecting themselves to sleepless nights of lying on their left without altering position.
To your credit, your blog article mentions that this is really only relevant in the latter stages of pregnancy, and does state that it is OK to sleep on the right, but many online sources fail to mention this. There are women who are forcing themselves into left-sided sleeping positions throughout the duration of their pregnancy, at the expense of a good night’s sleep. There are also women who are unable to do this, and consequently feel guilty, or worry that they are harming their baby in some way.
I wish I was exaggerating, but the subject of left-sided sleeping has become a widespread, unofficial internet campaign on websites and online communities based around babies and pregnancy, and I truly believe that there is insufficient evidence at this stage to advise women that they should be sleeping on the left.
You yourself state, “medical studies have allegedly not proven that sleeping on the left side reduces stillbirths.” As far as I am concerned, something is either proven, or it is not. Something that is ‘allegedly not proven’ has to be classed as unproven, and I believe that it is unwise of those in a position of authority (such as yourself in the medical profession) to advocate any theory based on insufficient evidence, particularly when doing so comes at the cost of many women’s sleep.
I would personally say that if a pregnant woman is able to sleep on her left without causing herself to suffer, then great, go ahead and do so, safe in the knowledge that you MIGHT benefit your baby.
But advocating left-sided sleeping based on a study which is not scientifically sound merely adds to the apparent credibility of an internet rumour that has already become too widespread for its own good, and is widely misinterpreted.
I have no problem with the theory behind the benefits of left-sided sleeping. Nor do I have a problem with advising women against sleeping on their back in the latter stages of pregnancy (although I do credit women with enough sense to work that out for themselves). But I do think that advice needs to be carefully worded and backed up with evidence, in order to prevent it from doing more harm than good, and from gaining a life of its own through misinterpretation. Sadly, I have seen a lot of that already.
Although you are absolutely correct, ultimately, it is the mother’s choice.
drlindagalloway said,
August 22, 2011 at 11:56 pm
I think it’s imperative for any pregnant woman to seek the advice of her OB practitioner as the final source of reference. Thanks for your comment.
Jessica said,
November 25, 2011 at 9:28 am
Wow! I think the hormones in Melissa and Rosanne are really working on them. Or, working them up. I was just looking up sleeping positions for women and came across this. Dr. Galloway is just stating the facts. That’s her job. She can’t help it if you two don’t agree or have a problem with it. I’m 23 weeks pregnant and thrilled! no matter how I have to sleep to have this baby and make sure that he is healthy. If I’m told that the best (factual) way is to sleep on my left side, then by all means, I’m going to sleep on my left side. No harm done to my emotional state. If you don’t like your left side and think that facts are pointless, then take your own advice and listen to your body and sleep the way you want. I think it’s insane to go off the way you two did just because a doctor was putting out some helpful information to women looking for it. She’s the doctor, I’m sure she knows what is going on inside a woman’s body more than the two of you do. Yes, we as women know our bodies better than anyone else does, but that is not the subject at hand here. The point is the facts and unless you’ve gone to medical school, those are the facts. Take it or don’t, but no need to get all snippy over it.
drlindagalloway said,
November 28, 2011 at 11:25 am
Jessica, thank you so much for your comments and passion! They are well appreciated. Hope things are going well with your pregnancy.
Tanja said,
December 14, 2011 at 3:25 pm
Dear Dr. Galloway,
I would like to introduce the additional element, which is that left side sleeping and resting is also associated with reduced risk of pregnancy induced hypertension or preeclampsia. (see below).
I think you are very right to state that there is enough evidence to advise pregnant women to sleep on their left side.
Although scientific evidence could always be stronger, the likely positive effects on the mother and baby’s health clearly overweight the possible negative effect on the sleep.
Greetings
Tanja
Spinapolice RX, Feld S, Harrigan JT. Effective prevention of gestational hypertension in nulliparous women at high risk as identified by the rollover test. Am J Obstet Gynecol. 1983
drlindagalloway said,
December 23, 2011 at 12:21 pm
Thank you so much for your comments, Tanja!! Appreciate your support. Hope you will continue to follow my blog and “Like” me on Facebook. Happy holidays.
Dr.Thashmeera said,
December 23, 2011 at 11:07 am
I’m a doctor, i do agree with facts that DR.Linda has stated. I’m 25 weeks pregnant now and will do all possible things to see that my baby is healthy.
drlindagalloway said,
December 23, 2011 at 12:22 pm
Thanks for your comments! I wish you a healthy pregnancy and delivery. Please keep us posted on how the pregnancy is going.
Chukwu Chinelo said,
February 2, 2012 at 6:28 pm
I have read repeatedly the benefits of sleeping on the left side, and I ‘ve tried as much as i can to do it. but, sometimes I woke up to find myself on my right. So, I want to ask, is it terribly wrong to do so?
drlindagalloway said,
February 3, 2012 at 12:32 am
I wouldn’t be too concerned about lying on your right side. Left is preferred but as long as you’re not lying flat on your back and potentially depleted oxygen from the baby, you should be okay. Thanks for your question.
Joan said,
March 13, 2012 at 9:27 pm
I have a large fibroid on my uterus, and I haven’t been able to lie flat on my back since week 8!! (My heart starts pounding and I have a hard time breathing, I also feel very strange sensations in my lower abdomen that just don’t feel good.). And yes, I used to be a stomach and back sleeper. It stinks to have to sleep on my side – I kind of dread night because I know I’ll be so uncomfortable, but in my case my body has made it very clear that it just has to be.
drlindagalloway said,
March 19, 2012 at 9:55 am
Hi Joan,
Thanks for your comments. You are very wise to listen to your body. Hope all continues to be well with your health.
JenniB said,
April 2, 2012 at 11:12 am
This is for all those who question side-lying sleeping and lying on the left. I am not a doctor, but I am a First-Responder and also a massage therapist specializing in pre-natal massage. In all the reading I have done about this issue, all the medical personnel say that sleeping on the left side is more beneficial to baby. If that was not so, don’t you think there would be more controversy and dissension among medical professionals? But they are all saying pretty much the same thing. So I tend to believe something that the majority of learned professionals tell me. I do side-lying massage for my pregnant clients, finishing up (and spending more time) with the client on her left side.
Julie said,
April 24, 2012 at 8:30 am
“Remember, a healthy pregnancy doesn’t just happen — it takes a smart mother who knows what to do.”
So what you’re saying is that women with complicated pregnancies (abnormalies, failures, disabilities, etc) are responsible for what happens/happened?
Another false claim apart from what is listed in the comments below!
Sometimes a pregnancy isn’t meant to be. And it’s no way the mother’s fault for that.
drlindagalloway said,
April 24, 2012 at 8:49 pm
No. What I’m saying is that many complications have warning signs that are either ignored or missed by healthcare professionals and by the time these complications are recognized, it becomes a disaster. Prevention is the key to a healthy birth outcome or recognition and proper treatment of the condition before it spins out of control. If a mother is aware of the signs and symptoms of possible complications, she can INSIST and I emphasize that word that something be done. So yes, it does take a smart mother who knows what to do in order to protect her pregnancy and unborn child. 50% of pregnancies are unplanned and those “unplanned” babies turn out to be brilliant human beings if given the proper environment.
RH said,
May 4, 2012 at 1:08 pm
I have been trying to sleep on my left side but have become increasingly uncomfortable in what I can only assume is my heart which Im sure I can feel beating and feels really weird. I am now sleeping on my left but am concerned at why this is happening when we are advised to do this does this mean there is something wrong?
drlindagalloway said,
May 7, 2012 at 12:10 am
I have a few questions. How many weeks are you? Have you discussed this issue with your doctor or midwife? My first suggestion (not advice because legally, I don’t provide advice) would be to honor your body. If lying on your left side makes you uncomfortable then by all means turn on the right side. The point is to avoid lying flat on your back if at all possible. Thanks for your comment. Good luck in the pregnancy and hope you will “like” me on Facebook.
JenniB said,
May 15, 2012 at 12:18 pm
I like the “honor your body”. I have found in life that there is “no true one way”. We should be aware of what our bodies are telling us, and do what keeps us feeling healthy. If it doesn’t feel right to you, don’t do it!
Joanne said,
May 25, 2012 at 7:35 am
Since I naturally like to sleep on my left side already (not pregnant yet, but trying!) I hope if/when I do get pregnant that it will still feel as natural!
Just curious about a hypothetical/unusual scenario: I’ve heard about a few rare people whose organs are a mirror image reverse (ie. their appendix is on the left side instead of the usual right, stomach is on the right instead of the left, etc.) So in that case you would be advised to sleep on your right side instead of the left, correct? How would know if you were one of these people, since I’d imagine X-rays would reveal this but pregnant women shouldn’t be X-rayed?
drlindagalloway said,
May 28, 2012 at 10:07 am
Hi, Joanne. Thanks for taking the time comment. What you’re referring to is called a Transposition of the Great Organs and someone would be diagnosed with this condition almost at birth based on their breathing tests. However, it’s a very interesting question. Thanks for sharing.