When to start using a pregnancy pillow

There is no set week to start using a pregnancy pillow. Many people start in the second trimester, when ACOG suggests side sleeping may be best¹, and well before 28 weeks, when the NHS advises falling asleep on your side². Starting a few weeks before you need it gives you time to get used to it.

The two dates to know

Two pieces of guidance shape the timing:

Neither says you need a pillow. Both say that later in pregnancy, side sleeping is the goal. A pillow is a way to make that comfortable.

Signs it is time

• You wake with a sore hip from side sleeping.
• Your lower back aches in the morning.
• You keep waking on your back.
• You cannot get comfortable and lie awake shifting.
• Your bump feels heavy and pulls when you lie on your side.

Any one of these is a reason to try a pillow, whatever the week.

Starting early

Some people start in the first trimester, especially if they already sleep on their side or have hip or back ache. There is no harm in using a pillow early if it is comfortable. It also means you are used to it when the bump grows.

Starting in the second trimester

This is the most common time. The bump begins to show, stomach sleeping becomes awkward, and ACOG's advice on side sleeping applies¹. ACOG suggests a pillow between your knees and another under your belly, or a full-length body pillow¹.

Starting later

It is never too late. If you are past 28 weeks and struggling, a pillow can still help you stay on your side for the remaining weeks. The NHS also says not to worry if you wake up on your back; just turn onto your side².

What to use

Our comparison of a pregnancy pillow vs a regular body pillow explains the shapes.

Getting used to it

1. Start with the pillow between your knees only. 2. After a few nights, let the curve or a second pillow sit under your bump. 3. Add support behind your back if you roll. 4. Adjust the fill, if you can, so the knee section is thick enough to keep your top knee level with your hip.

Positions in detail are in how to use a pregnancy pillow: 5 positions.

Back ache and timing

Back ache often prompts people to start. The NHS suggests looking for maternity support pillows, getting enough rest, and using a mattress that supports you properly³. A pillow at night can be part of that.

How long you will use it

Many people use a pregnancy pillow until the birth and keep using it afterwards, for back support when sitting up or for side sleeping. That makes earlier buying better value. See using your pregnancy pillow after the baby arrives.

Buying in time

Order a few weeks before you think you will want it, so it arrives and you have time to adjust it. Our pregnancy pillow page compares the shapes.

The Cove Pregnancy Pillow is a 52 inch crescent with an adjustable shredded memory foam fill and a 100 night trial, which covers most of a second and third trimester.

Left or right

The NHS says the safest position to fall asleep in is on your side, either left or right². The Sleep Foundation describes the left side as often considered best⁴. See why sleeping on your left side is recommended in pregnancy.

By trimester

If you are expecting twins or more

The bump grows faster with twins or more, so many people need support earlier [source needed]. Ask your midwife about positions, and consider starting with pillows in the early second trimester.

Signs the pillow is not right

• Your top knee is pushed higher than your hip: the knee end is too thick.
• The bump section pushes you onto your back: it is too thick or too high.
• You wake hot: use a breathable cover, and see our guide on keeping cool.
• It ends up on the floor: choose a longer pillow you can hug.

When to ask for advice

Ask your midwife or doctor if you have pain that keeps you awake, feel breathless or dizzy lying down, or have any concern about your baby's movements. For movements, contact your maternity unit straight away.

This guide is waiting for review by a qualified reviewer. The full picture is in sleeping during pregnancy, trimester by trimester.