How to Choose a Maternity Pillow by Trimester: First, Second & Third

One of the most common questions we hear from expecting moms is: "When should I start using a pregnancy pillow — and which one do I actually need?"

The honest answer is that it depends on where you are in your pregnancy. Your body changes dramatically from the first trimester to the third, and the support you need changes right along with it.

Here's a trimester-by-trimester guide to help you choose the right maternity pillow at every stage.

First Trimester (Weeks 1–12): Do You Even Need One Yet?

Most women don't feel an urgent need for a maternity pillow in the first trimester. Your belly is still small, and your body hasn't shifted its center of gravity yet.

That said, there are a few reasons to start early:

You're already a side sleeper struggling to get comfortable
Even without a large bump, many women experience lower back tension, hip soreness, and general restlessness in early pregnancy due to hormonal changes. A pillow between the knees can help immediately.

You want to train yourself to sleep on your left side
Doctors recommend left-side sleeping from early in pregnancy to improve circulation to the baby. Starting with a body pillow early makes this transition easier before your bump makes it necessary.

You're dealing with nausea or heartburn at night
A wedge pillow used to slightly elevate your upper body can help reduce acid reflux symptoms that are common in the first trimester.

Best pillow options for the first trimester:

• Adjustable Belly Support Pillow — lightweight, minimal, great for early-stage support and acid reflux relief
• A simple knee pillow or small C-shaped pillow if you just need basic side-sleeping support

Second Trimester (Weeks 13–26): When Most Moms Start to Really Feel It

The second trimester is when most pregnant women start actively looking for a maternity pillow — and for good reason.

By week 16–20, your bump is noticeably growing, your hips are widening, and the strain on your lower back becomes harder to ignore. Sleep positions that used to feel natural start feeling uncomfortable, and rolling over at night becomes a production.

This is the sweet spot to invest in a full-body maternity pillow.

What your body needs in the second trimester:

• Belly support to take pressure off your lower back
• Hip and knee alignment to reduce sciatic nerve tension
• A pillow you don't have to constantly reposition when you roll over

Best pillow options for the second trimester:

• Classic 55" U-Shaped Maternity Pillow — the most popular choice for this stage; wraps around both sides so you're supported no matter which way you turn
• Classic E-Shaped Plus Maternity Pillow — a great option if you run hot or prefer a more compact pillow that still covers head, belly, and knees

Third Trimester (Weeks 27–40): Maximum Support, Minimum Disruption

By the third trimester, sleep has become a serious challenge. Your bump is large, your hips and pelvis are under significant pressure, and finding a comfortable position can take 10 minutes of careful arranging.

What you need now isn't just comfort — it's stability. A pillow that holds its position through the night without you having to constantly readjust.

What your body needs in the third trimester:

• Full-body support that doesn't shift when you move
• Relief for hip pain, pelvic girdle pressure, and lower back ache
• Belly support that accommodates a larger bump without bunching or flattening
• Something that also works for postpartum recovery and nursing

Best pillow options for the third trimester:

• Classic 60" U-Shaped Pregnancy Pillow — the larger size is ideal for taller moms or anyone who needs more length for full leg and hip support
• Classic 55" U-Shaped Maternity Pillow — remains the go-to for most moms; the full wrap-around support is especially valuable when the bump is at its largest
• Adjustable Maternity Pillow — a great option if you have specific pain points like sciatica or hip pain that need targeted, customizable support

Quick Reference: Pillow by Trimester

One More Thing: Think Beyond Pregnancy

The best maternity pillow investment isn't one you use for a few months and retire. It's one that keeps working for you after birth.

The E-Shaped Plus converts naturally into a nursing pillow. The U-Shaped continues to provide back and hip support during postpartum recovery. The Adjustable Maternity Pillow can be reshaped for whatever your body needs next.

Choosing with postpartum use in mind means you're getting more value from the same purchase.

Not sure which pillow fits your specific stage and sleep style? Take our Pillow Quiz — it takes less than a minute and gives you a personalized recommendation.

FAQ

When should I start using a pregnancy pillow?

There's no wrong time to start. Many women begin in the second trimester when their bump starts to show and sleep becomes more difficult. But if you're struggling with back pain, nausea, or side-sleeping discomfort earlier, starting in the first trimester is completely fine.

Can I use the same pillow through all three trimesters?

Yes — many women use the same U-shaped pillow from the second trimester all the way through to postpartum. The key is choosing one with enough adjustability or size to accommodate your changing body.

What's the best pregnancy pillow for back pain in the third trimester?

A full U-shaped pillow that supports both your front and back simultaneously is typically the most effective for lower back pain in the third trimester. If your pain is more targeted — such as sciatica or hip pain — the Adjustable Maternity Pillow allows more precise positioning.

Do I need a different pillow after birth?

Not necessarily. Most maternity pillows can transition into postpartum use for nursing, recovery positioning, or general comfort. See our full pillow collection to compare options.

Want to learn more? Read our guide on how to choose the right pregnancy pillow or browse all our maternity pillows.