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I started using this very early on (from about 7 weeks) since I had one lying around that my sister-in-law had given me.
Even before I had a sizable belly, I was so uncomfortable in bed. This pillow helps alleviate the back pain, hip pain, aching knees and aching belly that are so common during pregnancy.
I also put a regular pillow in the center of it to support my belly, which I find incredibly important.