I've been lucky so far and have been able to get a pretty good night's sleep (most of the time). I had to get up in the middle of the night to use the bathroom during the first trimester and again now that I'm in the third trimester. It wasn't a problem during the second trimester, though!
To get comfy, I use a series of pillows. I highly recom- mend the Boppy pregnancy wedge pillow. You can get one for about $15 on Amazon, or at Motherhood Maternity. At first I used it between my knees. Then, as the belly got bigger, I started using it to wedge underneath the belly (which is its intended purpose). It provides some support so the belly doesn't feel like it's just hanging out there, or drooping onto the mattress. I usually have to flip over a few times during the night, and I bring the wedge with me to the other side.
I also put a full size pillow between my legs and knees. I think that helps with keeping the hip joints in line (although my hips still hurt when I wake up!). Finally, I have a small pillow that I put behind my back when I feel like I need support there.
So, each night I build a little nest and have a fairly comfortable sleep!
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