Sleep position that reduces stillbirth risk

It is every mother’s wish to carry her pregnancy to term and give birth to a healthy baby without complications.

However, this may not become a reality for some women.

In 2016, Mary Mutua was excited about her pregnancy and was looking forward to beginning a new life with the baby.

Unfortunately, she lost the child through stillbirth, 30 weeks into her pregnancy.

“Everything seemed normal, my pregnancy didn’t have issues. So I don’t understand how I lost the child,” she says.

“After it happened, I became sick and got into depression. I am still healing slowly, trying to come to terms with the loss before I can even begin thinking of another child.”

According to the World Health Organisation (WHO), stillbirth refers to a baby born with no signs of life at, or after 28 weeks of pregnancy.

In Kenya, statistics from The Ending Preventable Stillbirths report show that about 23 out of 1,000 children die daily at birth. This translates to 96 stillbirths per day.

The major causes of stillbirth include prolonged pregnancy, birth defects, foetal growth restrictions, childbirth complications, infections in pregnancy (malaria, syphilis and HIV) and certain conditions (especially hypertension, obesity and diabetes).

Aside from addressing the above risk factors, new research shows that a seemingly simple measure such adopting right sleeping positions can lower women’s chances of suffering stillbirths.

A new study published in the Lancet EClinicalMedicine Journal indicates that sleeping on the back during pregnancy leads to an almost threefold stillbirth risk among affected mothers.

The research, which gathered data from the United Kingdom (UK), United States (US), New Zealand and Australia, was the first to report maternal sleep-related practices as risk factors for stillbirth.

This study included 851 bereaved mothers and 2,257 women with an on going pregnancy.

Its major finding was that going to sleep while lying on the back – from 28 weeks of pregnancy onwards - increased the risk of stillbirth by 2.6 times.

This heightened risk occurred regardless of the other known risk factors for stillbirth.

According to the researchers, the results thus indicate that pregnant women can lower the risk of stillbirth by sleeping on their side and not on their back.

This recommendation has since been included in the UK’s National Health Service (NHS) guidance designed to bring about reductions in the number of babies who are stillborn in the country.

Dr Tomasina Stacey, one of the lead authors of the study from the University of Huddersfield in the UK noted that pregnant women who sleep on their backs did run a higher risk of stillbirth because the weight of the uterus can reduce blood flow to the baby.

In a bid to find a solution to the high rates of stillbirth, Dr Stacey notes that the research team decided to look at a range of modifiable risk factors and sleep position was one of them.

"The next phase is to ensure that there is consistent advice from healthcare professionals and we will be looking to see if there are ways of helping to support women to sleep in the side position.

"Only a small proportion of women will be affected. But the studies that we did suggested that women were quite happy to change their going to sleep position if it was better for their babies," said Dr Stacy.

Dr Nelly Bosire, a gynaecologist based in Nairobi, states that as a general rule, women should avoid sleeping on their backs during the second and third trimesters of pregnancy.

Instead, they should sleep on their left side.

“It is important to keep that in mind. Even though in most cases, expectant women my just find themselves sleeping on their side naturally as it becomes really uncomfortable to sleep on their back as the pregnancy progresses.”

She notes that the back sleep position rests the entire weight of the growing uterus and the child on major veins that supply blood to the heart from the lower body.

“If this is not corrected, the pressure can cause obstructions in the veins which will lead to less blood flow to the heart and as a result, the entire body.

This means that the body will also have insufficient oxygen, which can make the mother suffer from headaches, dizziness and faint frequently.”

Other adverse effects caused by the back sleep position include backaches, breathing issues, digestive problems, low blood pressure, haemorrhoids and reduced nutrient supply to the child.