Pelvic Pain at Night? A Safer Way to Turn in Bed During Pregnancy

Short answer: Keep your knees together and use a log-roll. Squeeze a pillow between your knees, bend both knees with feet flat on the mattress, and roll knees, hips, and shoulders together as one unit. Never let your legs split apart during the turn. This protects your pelvis from the twisting force that causes the sharp jolt.

Why does turning in bed hurt your pelvis during pregnancy?

During pregnancy your body produces relaxin, a hormone that loosens the ligaments around your pelvis to prepare for birth. The trade-off: your sacroiliac joints and pubic symphysis become less stable. When you turn in bed and your legs move at different speeds or in different directions, the pelvis absorbs a twisting force it can no longer handle well. That is the sharp, catching pain that wakes you at 2am.

The pain is worse at night for two reasons. First, you have been lying still, so the joints have stiffened into their current position. Second, most people turn by swinging one leg across — which is exactly the asymmetric load that irritates an unstable pelvis.

What is the log-roll and why does it work?

A log-roll means moving your entire body as one unit — like a log rolling downhill. Nothing twists. Your knees, hips, and shoulders rotate together at the same speed. For pelvic girdle pain (PGP), this removes the torsional force that causes the catching, grinding sensation in the pubic bone or sacroiliac joints.

Icelandic midwives recommend this technique specifically for PGP. It is not complicated, but it requires you to resist the habit of leading with one leg.

Do this tonight

1. Lie on your back (or current side) and place a firm pillow between your knees.
2. Squeeze the pillow — this locks your knees together so they cannot split.
3. Bend both knees up so your feet are flat on the mattress (if on your back) or stacked (if on your side).
4. Cross your arms loosely over your chest or hold them close to your body.
5. Breathe out slowly as you begin the roll — let your knees drop toward the side you are turning to.
6. Your hips follow your knees. Your shoulders follow your hips. Everything moves together.
7. Once on your side, check the pillow is still between your knees. Adjust it if it slipped.
8. If your pelvis catches mid-roll, stop. Roll back slightly, squeeze the pillow tighter, and restart with your knees closer together.

Why does the pillow between your knees matter so much?

Without the pillow, your top knee tends to slide forward and downward during the turn. This pulls the pelvis into an asymmetric position — one side rotates while the other stays behind. That is the exact movement that triggers PGP pain. The pillow acts as a physical lock: it keeps both knees at the same width and prevents one leg from racing ahead of the other.

Use a firm pillow, not a soft one. A flat cushion compresses under the weight of your leg and loses its spacing effect. A rolled towel works in a pinch.

What about getting out of bed with pelvic girdle pain?

Getting out of bed uses the same principle: keep the pelvis neutral, never let one leg trail behind.

1. Log-roll onto your side facing the edge of the bed.
2. Keep the pillow between your knees.
3. Slide both legs off the edge together — do not let one leg drop first.
4. Use your top arm to push your upper body up as your legs drop. The counterweight of your legs does most of the work.
5. Sit on the edge for 5-10 seconds before standing. Let your pelvis settle.
6. Stand by pushing evenly through both feet. Do not lurch to one side.

Common traps that make it worse

• Leading with one leg: The single biggest mistake. One leg swinging across forces the pelvis into torsion. Always move both legs together.
• Tucked-in sheets: A tightly tucked top sheet resists the roll and forces you to push harder, which usually means one side moves before the other. Loosen the sheet at the foot of the bed before sleep.
• Too-soft pillow between knees: It compresses flat and your knees end up touching. Use something firm enough to maintain a fist-width gap.
• Rushing the turn: Speed creates uncontrolled momentum. One part of your body arrives before the rest. Slow and deliberate wins.
• Sleeping on your back too long: If you wake on your back and need to turn, do it immediately with the log-roll. Do not lie there debating which side — the longer you wait, the stiffer the joints become.

Pillow setup for pregnancy PGP

Before you go to sleep, set up your pillows so you do not have to fumble at 3am:

• Between knees: One firm pillow, long enough to extend from mid-thigh to ankles. This keeps your pelvis neutral in any side-lying position.
• Under the bump: A small cushion or folded towel under your belly prevents it pulling your spine into a twist. This is especially helpful after 28 weeks.
• Behind your back: A rolled towel or long pillow behind you stops you rolling onto your back accidentally, which means fewer turns needed overall.

A pregnancy pillow that does all three jobs works well, but any combination of regular pillows is fine. The key is that the between-knees support is firm.

When to talk to your midwife

• If the pain is so sharp that you cannot complete the log-roll even with a pillow between your knees.
• If pelvic pain wakes you more than 3-4 times per night and you are not getting enough rest.
• If you feel a grinding, clicking, or locking sensation in the pubic bone that does not ease with position changes.
• If the pain has started radiating down one leg or into your lower back.
• If walking has become painful in addition to night-time turning.

Your midwife can refer you to a physiotherapist who specialises in pelvic girdle pain. In Iceland, ljósmóðir (midwife) referrals for PGP physiotherapy are common and straightforward.

Where Snoozle fits

The log-roll works best when the mattress surface does not resist your movement. On a grippy mattress protector or high-friction fitted sheet, the turn stalls halfway because your hips stick to the surface while your shoulders try to keep rolling — and that reintroduces the torsion you are trying to avoid. Snoozle is an Icelandic-designed home-use slide sheet that reduces this mattress friction during the sideways roll. It has no handles and is not made of nylon — it is comfortable fabric designed to sleep on. In Iceland, Vörður insurance includes a Snoozle for pregnant policyholders in their maternity package, and midwives recommend slide sheets as part of PGP management at home.

Related comfort guides

• How to turn and get out of bed when sitting up makes your heart race
• Stop waking up when you turn — reduce friction and slide sideways
• Back in bed: turning feels harder — two-step reset when bedding grabs
• What is a slide sheet?
• All questions answered
• Slide sheet vs satin vs transfer sheets