Sleep during pregnancy and after childbirth

Although it may sometimes be objectively difficult, during pregnancy it is essential that the woman is able to get enough sleep. You can greatly reduce the risk of insomnia and other sleep disorders by following a few simple guidelines and common sense. The same is also true after giving birth. In this article we will look at what expectant mothers and new mothers should and should not do.

Sleep and pregnancy

Sleep disorders such as insomnia, sleep apnea, and restless legs syndrome are common during pregnancy.

Physical changes such as cramps and nausea that occur in a woman’s body can also significantly worsen the quantity and quality of sleep.

Pregnancy is commonly divided into 40 weeks or three trimesters.

This pregnancy sleep guide will cover the various changes in sleep and the consequences that occur in each individual trimester.

Finally, we will also mention postpartum sleep problems, as well as the   fetal sleep routine .

Sleep and drowsiness in the first trimester of pregnancy

The first trimester of pregnancy covers the first 12 weeks (calculated from the first day of the last menstrual period); so wants an international convention implemented also in our country.

As for pregnancy in this period, it is known that,

  • within days of fertilization, the fertilized egg grows into a larger cell body known as  a blastocyst , and attaches itself to the inner wall of the uterus.
  • This implant triggers a spike in progesterone levels in the woman’s body, a natural hormone that regulates the various phases of the reproductive cycle.

With regard to progesterone, it should be specified,

  • that progesterone is considered a soporific hormone, which means that it can induce early sleep onset;
  • that higher levels of progesterone can lead to excessive sleepiness (sleepness is difficulty staying awake) during the day, and trouble sleeping at night;
  • that these sensations can be so strong that they can be mistaken for cold or flu symptoms and can lead to insomnia,
  • [remember that insomnia can manifest itself as either difficulty falling asleep or difficulty staying asleep, and increased progesterone levels can lead to both types of insomnia].

As for the blastocyst and its effects on sleep, it must be said,

  • that in the woman’s body, this exerts pressure on the uterine wall which is located near the bladder;
  • that this pressure, together with the increase in progesterone, will make you feel the need to urinate much more frequently ,
  • and frequent nighttime visits to the bathroom are especially (but not necessarily) common among pregnant women during the first trimester of pregnancy.
  • What’s more, the uterine pressure on the bladder would also seem to lead to lucid dreams, or rather a nocturnal tale whose  plot can be directed .

The third and subsequent weeks through the eighth week of the first trimester , a period known as the embryonic stage, are characterized by significant bodily changes in both the woman and the embryo:

  • the growth of the embryo could cause severe cramps in the woman, especially in the pelvic region;
  • her breasts also begin to swell as her body begins to prepare for breastfeeding;
  • All of these changes can also negatively affect sleep.

In addition, pregnant women in their first trimester often experience excessive nausea, a condition commonly called morning sickness.

By the ninth week, the embryo will become a “fetus,” and the uterus will be the size of a large tomato.

For this reason, cramping and nausea will likely increase during the remaining four weeks of the trimester.
So here are some tips to reduce physical pain and get enough sleep during the first trimester of pregnancy:

  1. Experts suggest taking a short nap or two in the early afternoon to maintain your nighttime sleep cycle.
  2. Getting exercise in the morning can help maintain a healthy sleep cycle.
  3. Avoiding consuming large amounts of fluids in the evening should cut down on overnight trips to the bathroom.
  4. Eliminating or reducing caffeine consumption during pregnancy is still good for the fetus, and can help the woman sleep better as well.

Sleep and drowsiness in the second trimester

The fetus grows considerably during the second trimester: by the twenty-seventh week it will weigh on average over one kilogram.

New mothers often start to feel the baby move from the 18th to the 22nd week, while women who have already given birth in the past may notice these sensations as early as a few weeks before.

The second trimester is considered the best trimester for women in terms of sleep.

Your body has become accustomed to progesterone levels, so daytime tiredness and sleepiness are less pronounced.

Morning sickness is also rarer than in previous weeks.

This is the best time to find a good sleep rhythm, and the woman should try to “take advantage” of it to arrive as fit and “rested” as possible in the third trimester.

However, some physical ailments could be around the corner, and inevitably undermine the quality of a woman’s sleep.

Heartburn and gastric reflux , for example, are quite common ailments during this period.

Nocturnal leg cramps can also be a problem, especially pain in the calf muscles.

While these will likely become more pronounced during the third trimester, cramping often begins during the second trimester.

Another second trimester concern is preeclampsia, a complication characterized by high blood pressure.

The symptoms of preeclampsia usually begin after the 20th week of pregnancy.

These symptoms include headache , sensitivity to light, nausea, shortness of breath and decreased urination.

Preeclampsia is quite rare and, in addition to disturbing a woman’s sleep, it can have very serious consequences both for the fetus and for the woman herself: therefore it must still be treated.

Follow these guidelines, and you should be sleeping soundly and staying healthy throughout your second trimester.

Avoid eating and drinking certain things to make sure these second trimester symptoms aren’t too severe: Spicy or fried foods can cause heartburn, while carbonated drinks can worsen the effects of leg cramps (note alcoholic beverages must be strictly prohibited during pregnancy).

Try to stand or sit upright for at least four hours after eating, in order to facilitate the digestive process and mitigate heartburn.

In the case of cramps, do not try to extend the muscle in the opposite direction of contraction until the cramp has passed.

See your doctor right away if you start having symptoms of preeclampsia or if you notice a sharp increase in your blood pressure levels.

Sleep and drowsiness in the third trimester

The last, but certainly not the least important trimester of pregnancy is the third: it begins during the 28th week and lasts until delivery.
As for the length of time, an average pregnancy lasts 40 weeks, but some mothers can give birth naturally even at 41 or 42 weeks (after which we generally proceed with induction).

The third trimester is a time of extraordinary fetal growth. For this reason, when it comes to sleep routine, the third trimester is considered the worst of all.

Unfortunately, these developments can cause the woman severe pain.

Most pregnant women experience severe lower back pain during the third trimester due to excess weight around the midsection, and leg cramps can become more intense.

Frequent episodes of urination will begin again as the fetus moves to the lower pelvic region.

It’s all of these factors that can seriously disrupt your sleep cycle: The vast majority of pregnant women wake up three to six times each night during their third trimester.

In addition to insomnia due to physical discomfort, third trimester women are also prone to other serious sleep disorders:

  1. to restless legs syndrome,
  • about 20 percent of pregnant women will have restless legs syndrome, a condition characterized by painful tingling or itchy sensations under the skin.
  • Restless legs syndrome has been linked to iron and folate deficiencies, so your doctor may prescribe supplements to relieve some of your symptoms.
  1. to obstructive sleep apnea,
  • it is a transient but repeated interruption of breathing during sleep: this is another sleep disorder commonly reported by women in their third trimester.
  • Obstructive sleep apnea occurs when the airways are partially or completely blocked, causing shallow breathing or shortness of breath during sleep.
  • Many women snore during pregnancy due to swollen nasal passages, and snoring can progress rapidly to obstructive sleep apnea, particularly in women who were obese before their pregnancy weight gain.
  • Obstructive sleep apnea in pregnant women is a serious problem because the lost air supply can lead to hormonal surges powerful enough to compromise the health of the fetus.
  • Obstructive sleep apnea has also been linked to an increased risk of preeclampsia.

During the third trimester, it’s important to prepare for the worst sleep of pregnancy.

Here are some tips for getting through the third trimester at your best.

  1. Reduce your fluid intake in the late afternoon or evening.
  2. Make sure you empty your bladder completely before going to sleep.
  3. Eat a complete and balanced diet without sacrificing iron-rich foods to prevent restless legs syndrome and leg cramps.
  4. Stretching and light exercise in the morning can help keep the body active, improving sleep and reducing symptoms of the disorders described above.
  5. Sleep on your left side to relieve pressure on your lower back. This fact will also increase respiratory circulation and help prevent apnea.
  6. For the most comfort in bed, place a pillow between your knees, behind your back and under your lower stomach. The so-called “full body” pillows for pregnancy are also very comfortable.

Sleep after childbirth

Even the period immediately following birth is often characterized by sleep-related problems that have less to do with physical changes to your body, and more to do with the newborn’s sleep patterns.

  • Caring for a newborn can be an exhausting task.
  • On average, babies wake up every three to four hours, although this varies considerably from child to child.
  • Taking care of your baby’s needs can quickly take a toll on their mind, body and mood, not to mention sleep.

After giving birth (but in many cases even before giving birth) some women develop postpartum depression.
Postpartum depression (which may be due to hormonal changes, or genetic predisposition, or stress, or other environmental factors), if left untreated, can lead to severe insomnia.

So plan to stay up through the night in the weeks and months after your baby is born.

Here are some tips for women to improve the quality and quantity of sleep after childbirth.

  1. Put the newborn to sleep in a crib next to your bed. This saves you from getting up and walking around the house at night.
  2. Breastfeed if possible. Natural breastfeeding triggers a hormone called prolactin, which can make you drowsy.
  3. Both parents can arrange to get up alternately at night. In this way, both mom and dad are guaranteed at least one night out of two of sleep.
  4. Don’t ignore the early warning signs of postpartum depression: These include sadness, irritability, loss of appetite, inability to concentrate, and sleep onset problems.
  5. See a doctor as soon as these symptoms come to light.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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