By the time you hit your third trimester, baby is heavy, and your body is preparing for birth. This can lead to some aches, pains and unwanted ailments that can actually keep you up at night! Want to get some good sleep before baby gets here and you have to do post-midnight feeds and diaper changes? Here are 5 reasons why you’re likely tossing and turning during the final stretch of pregnancy and what you can do to soothe some of these pregnancy insomnia woes.

5 reasons why sleeping gets harder in the third trimester

1. Back pain

Whether it’s the added weight and general change in your center of gravity that is causing your back to ache or it’s an early sign of labor (in which case it won’t be relieved by lying down), this is a very common issue in late pregnancy.

Make yourself as comfortable as possible in bed with lots of well-positioned pillows for support and try doing some yoga poses to work those muscles and loosen up those tight spots. Laying down with pregnancy pillows, as opposed to standing and sitting, can actually help relieve some of the pressure you are experiencing.

Related: Tips to relieve back pain in pregnancy

2. Braxton Hicks

Feels like you’re having contractions? If they stop or ease up when you lay down or take a warm bath, they are most likely Braxton Hicks contractions. These are a tightening sensation across the abdomen that is common from about 20 weeks onward and can get to be quite intense later in pregnancy.

They are a sign that your uterus is preparing for labor and are nothing to be concerned about. Before bed, try to relax as much as possible. Put your feet up, take a warm bath and drink lots of water.

Related: What are Braxton Hicks?

3. Heartburn

Baby is growing and is hungry but is also so big that you have very little room for food! This can cause heartburn in the second half of pregnancy that often seems to only get worse as baby grows. It also gets worse when you lay down, which doesn’t make getting some shut-eye a whole lot easier. You can find relief in pregnancy-approved antacids, but try to avoid spicy foods as much as possible, and eat a couple of hours before going to bed.

You can also opt for small meals throughout the day to satiate that raging appetite and put less pressure on your system, and elevate your head when you are laying down. And finally, homemade remedies, like apple cider vinegar, ginger and yogurt can all balance the acidity production in the stomach.

Related: A nutritionist’s guide to the best foods for pregnancy, from the early days to the third trimester

4. Sciatica pain

The sciatic nerve starts at your lower back and runs all the way down your buttocks to the back of your legs, ankles and feet. When the nerve gets compressed, it can cause a sharp, shooting pain, a tingling or even numbness along the entire nerve.

While the cause of this is usually not from pregnancy, the added weight gain, increased fluid retention, expanding uterus, growing belly or baby settling into his final downward position could put pressure on the nerve, leading to what is commonly known as “sciatica.”

To relieve the pain, apply a warm compress and relax in a comfortable position. Try to sleep on the side where you do not feel the pain, as this will relieve some of the pressure to the nerve. Acupuncture and prenatal massage can help as well as pelvic tilts to strengthen your core muscles and reduce the inflammation.

Related: The new mama’s guide to pregnancy symptoms

5. Lack of bladder control

Feeling a bit of leakage here and there? Don’t worry, it is totally normal, albeit a bit embarrassing. The added weight and pressure on your bladder can lead to a few squirts when you sneeze or laugh to hard. If you have a vaginal birth, then unfortunately this annoying pregnancy symptom might stick around for a while until you rebuild those muscles.

What can be done? Work those pelvic floor muscles. The stronger and more flexible they will be in holding and releasing in that urine, the better they will be at preventing leakage. Make sure you are drinking plenty of water, and add some high fiber foods into your diet. These help avoid constipation, which adds extra pressure on your bladder.

Written by Sasha Romary. Sasha launched The Modern Mama in 2016 to provide maternity and postpartum support to women worldwide. As a trained postpartum doula, Sasha uses evidence-based information and a practical approach to supporting new parents in preparing for the arrival of a new baby and in the early days of parenthood. Follow her adventures at @_themodernmama.

A version of this story was originally published on June 22, 2021. It has been updated.