Should pregnant women sleep on their left?

The United Kingdom has one of the highest rates of stillbirth in the developed world.1 More than 4000 infants were stillborn in the UK in 2009 (out of about three million worldwide), and 1200 of these stillbirths occurred at or after 37 weeks’ gestational age.2 In high income countries, there are 10 times more stillbirths than deaths from sudden infant death syndrome—the subject of a major campaign.3 Stillbirth affects four times more babies than Down’s syndrome. A sophisticated screening programme is recommended and widely offered for Down’s syndrome, yet screening for stillbirth in the general population is confined to measurement of the external size of the uterus with a tape measure at each visit, according to the current National Institute for Health and Clinical Excellence Antenatal Care guideline.4 Any simple intervention that reduces the risk of stillbirth would be extremely welcome. Could the linked study (doi:10.1136/bmj.d3403), in which Stacey and colleagues found an association between maternal sleep position and risk of stillbirth,5 constitute the basis for a “not back to sleep” campaign for pregnant women?

Evidence based guidelines on sleep in pregnancy from professional organisations are sparse. Advice on the internet abounds, but much …