A national online survey in Ireland (September 2024) assessed awareness of and barriers to advised maternal going-to-sleep positions from 28 weeks' gestation among 769 women who gave birth beyond 28 weeks in the prior two years, analysed through the COM-B behavioural framework.
85% reported sleeping in an advised position; however, only 60% linked the recommendation to stillbirth prevention, and healthcare professionals rarely raised stillbirth risk. Accurate knowledge was the strongest predictor of adopting the advised position (OR=4.22, p<0.001); reflux relief as a motivation sharply reduced adherence (OR=0.14, p<0.001).
- Cross-sectional, self-reported design limits causal inference and introduces recall bias. - Online convenience sample may over-represent educated or digitally engaged women, limiting generalisability. - Retrospective reporting on sleep behaviour during pregnancy may not reflect actual night-to-night practice.
Clinicians should explicitly name stillbirth prevention when counselling pregnant women about sleep position from 28 weeks — simply advising side-sleeping without explaining *why* leaves a critical knowledge gap. Women who frame the advice as 'better for the baby' are far more likely to follow it, suggesting motivational framing matters as much as the information itself.
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