Is it safe to lay on the stomach at 19 weeks gestation?

From the Guidelines

Lying on your stomach at 19 weeks pregnant is generally safe for short periods if it feels comfortable to you. At this stage, your uterus has expanded but still has some flexibility, and the amniotic fluid provides protection for your baby 1. However, as your pregnancy progresses, stomach-lying will naturally become more difficult and uncomfortable. Your body will likely signal you to change positions before any harm occurs. If you experience any discomfort, pressure, or pain while lying on your stomach, listen to your body and adjust your position. Many pregnant women find side-sleeping (particularly on the left side) more comfortable as pregnancy advances because it optimizes blood flow to the baby and reduces pressure on major blood vessels.

Key Considerations

• After 20 weeks of gestation, patients should not lie supine during an endoscopic procedure to prevent aortocaval compression and supine hypotension syndrome 1.
• Patients should be kept in the left pelvic tilt or left lateral position to facilitate uterine displacement to the left side and minimize aortocaval compression, decrease the risk of hypotension, and maintain cardiac return 1.
• If you're concerned about sleep positions, you might consider using pregnancy pillows designed to support your growing belly and provide comfort in various positions.

Recommendations for Physical Activity

• Pregnant women should accumulate at least 150 min of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications 1.
• Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged 1.
• Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position 1. Always discuss any specific concerns about sleeping positions or physical activity with your healthcare provider, as they can offer personalized advice based on your individual pregnancy.

From the Research

Safety of Laying on the Stomach at 19 Weeks Gestation

• There is no direct evidence in the provided studies to suggest that laying on the stomach at 19 weeks gestation is safe or unsafe 2, 3, 4, 5, 6.
• However, studies suggest that the supine position can cause compression of the inferior vena cava (IVC) in late pregnancy, which can lead to decreased cardiac output and blood flow through the IVC 5.
• At 19 weeks gestation, the uterus is still relatively small, and the risk of IVC compression may be lower compared to later stages of pregnancy 4.
• Nevertheless, it is essential to consider the individual's overall health and any potential complications that may arise from laying on the stomach during pregnancy.
• The studies provided do not specifically address the safety of laying on the stomach at 19 weeks gestation, but they do highlight the importance of considering maternal hemodynamics and fetal well-being during pregnancy 2, 3, 4, 5, 6.

Maternal Hemodynamics and Fetal Well-being

• The size of the inferior vena cava (IVC) changes during pregnancy, with an initial increase in size during early pregnancy, followed by a decrease as gestation progresses 4.
• The supine position can cause compression of the IVC, leading to decreased cardiac output and blood flow through the IVC 5.
• Collateral venous circulation, such as the azygos system, can provide adequate venous return in the event of IVC compression 5, 6.
• Fetal well-being and maternal hemodynamics should be carefully monitored during pregnancy, especially in cases where the mother is at risk of complications or has a history of trauma 2, 3.