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The supine position, sleep & exercise during pregnancy

The supine position (laying on your back) should generally be avoided when exercising during pregnancy. Even sleeping positions can be difficult as you progress into the later weeks of pregnancy....

pregnancy supine positionBeing in a supine (laying on the back) position can restrict or affect blood flow to your baby, in mainly the second and third trimesters of pregnancy. This is because your growing baby is making the uterus heavy, and in the supine position it can place pressure on a major blood vessel called the 'vena cava'.

The vena cava lies on the right side of your body. During pregnancy your enlarged uterus also naturally leans towards your right side (as it moves up and out of the pelvis after 12 weeks). This can make the vena cava blood vessel prone to becoming compressed while lying on your back. A reduction on blood flow back to the heart can indirectly the blood flow to your baby.

The current ACOG guidelines for exercising in the supine position is:

"no exercise be done in the supine position after week 16"

However, it has been found that low intensity supine exercise does not affect significantly cardiac output until after week 35. As such, you can see that the ACOG guideline of 16 weeks for all exercise is on the conservative side, but, as always, we recommend to err on the side of caution and allow only 2-3 minutes of supine exercise at a low intensity after 16 weeks. If you experience dizziness or light-headed feelings it is advisable to roll onto your left side, then slowly sit up.

So what about laying on your back when not exercising?

If you lie flat on your back for a few minutes or more during the later months of the pregnancy (after about 24 weeks of pregnancy), you may start to feel light-headed, dizzy and possibly breathless, even when not exercising. This is normal, but you try to avoid these feelings.

Generally you need to lay quite flat on your back before the vena cava becomes compressed, so by laying on your right or left side, sitting in an upright position, or even in a semi-upright position, you can avoid vena-caval compression. Again, if you experience dizziness or light headed feelings it is advisible to roll onto your left side and then slowly sit up.

Sleeping during pregnancy

supine pregnancyMost women have trouble sleeping at some stage of their pregnancy. Sleeping on your left is best during pregnancy because the vena cava runs up the right side of the body. However either side is acceptable, and you may like to experiment with pillows and cushions to make yourself more comfortable when sleeping, particularly in the later stages of pregnancy....if you can sleep at all! Some women find their sleep patterns all over the place throughout pregnancy, and here's what you can expect:

First Trimester - at this point your mind and your body can play a tug of war with your sleep. Your body may be forcing you into naps that you aren't used to or don't want. On the other hand your mind may be whirring at top speed and keeping you awake, or even more likely refusing to let you fall asleep after one of your nightly trips to the bathroom.

Morning sickness can greatly affect your energy levels, and feeling unwell might make sleep (and everything else!) more difficult. You may also be continuing to work a regular job and the changes in your sleep patterns and energy levels will cause more stress than normal. Try to get as much rest as possible and listen to your body when it's asking for more sleep!

Second Trimester
- this trimester might be your best chance for sleep! Your body isn't aching too badly and your mind has settled down as the pregnancy is accepted. You'll have found a pattern or routine and will be physically and mentally more stable.

Third Trimester - Many people will tell you that the lack of sleep in the third trimester is merely a way to prepare for some of the endless nights that lie ahead! Dealing with the aches and pains, your bladder constantly calling and the thoughts that begin to invade your mind about parenting and labor and birth can wreck your sleeping patterns.

Sometimes women will also begin snoring during the last trimester. This is normal and will usually go away after the birth.

Finding a comfortable sleeping position is likely a big challenge now. Back and belly sleepers are having a particularly hard time dealing with life at night, so there are wedges that are sold as special pillows, but usually a full length or long pillow does the trick.

Sleeping in a chair during the very late stages of pregnancy might result in your best sleep! In the final four to six weeks, you may find that you get your best rests by sleeping sitting up.

Tips for good sleep during pregnancy:

* Regular exercise, but not close to bed time, will help you sleep and help with energy levels.
* Avoid meals close to bed, particularly if heartburn is a problem for you.
* Pillows! Use them where ever you need them: between your knees for aching hips, under your belly for support, behind your back, and under your head.
* Nap when you can, though this can be difficult with other children around. Enlist the help of family or childcare if you need some time to sleep.
* Sleep in or head to bed early for good pregnancy sleeping.
* Try relaxation techniques before bed, such as playing quiet music, meditation, burning incense, taking a warm bath, getting a gentle massage, or drinking a warm glass of milk.
* If you wake up in the middle of the night or have trouble falling asleep, you might like to get up for a bit and read or do something not too stimulating.
* If leg cramps wake you up at night try stretching prior to going to bed to avoid them.

To find out more about the supine position, sleeping during pregnancy, pre natal fitness or pregnancy fitness please contact us!


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