Nearly one in five pregnant women is put on bed rest to alleviate certain pregnancy complications. Bed rest ranges from simple periodic resting at home to full bed rest with monitoring in a hospital. Since bed rest not always includes a bed, “activity restriction” is more accurate. In some cases, women are placed on bed rest for a brief period of time until a complication stabilizes while, in others, women may are placed on bed rest throughout most of their pregnancy. Bed rest can be at home or at the hospital.
However, for the last few years, experts are shying away from bed rest. For example, the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) do not recommend traditional bed rest, stating that there is no evidence that it actually helps prevent or treat pregnancy complications. This practice has even been called “unethical” in one influential publication (see here), since “is inconsistent with the ethical principles of autonomy, beneficence, and justice.”
Common reasons for bed rest
There are a variety of reasons, chronic and acute, why your healthcare may order bed rest. These are the most frequent:
- Pregnancy-induced high blood pressure, such as preeclampsia or eclampsia
- Cervical changes, such as incompetent cervix or cervical effacement. If your cervix shortens early, you may need a cervical cerclage, which essentially stitches your cervix closed, and activity restriction is typically prescribed
- Early labor
- Multiple babies
- History of pregnancy loss, stillbirth, or premature birth
- Placenta complications, such as placental abruption, placenta previa, and placenta accreta
How bed rest helps
In most cases, bed rest is used to reduce pressure on your cervix and strain on your heart while increasing circulation to your uterus. In case of doubt, ask your healthcare provider.
Best positions for bed rest
It depends on the reason why you were told to bed rest. You may be asked to lie on your back while being propped up with pillows or to lie on your back with your hips or legs elevated higher than your shoulders. For some women, the best position is on the side, with the left side being preferred and the right side as an alternative when the left gets sore. This is to relieve pressure on the large vein that carries blood back to the heart from your feet (called the inferior vena cava) and to prevent putting pressure on your liver.
Risks of bed rest
Bed rest may cause your muscles to lose tone, some joints to ache, skin irritation, bone loss, and even blood clots in the legs. The stricter a woman’s bed rest, the worse these side effects seem to be, studies show. Some women on bed rest have also complained of heartburn, constipation, and leg swelling. Changing from side to side will help stimulate your muscles and relieve pressure. Eating a well-balanced diet with extra fiber and drinking enough water may help prevent constipation.
Discuss with your healthcare provider exercises that may help you alleviate the bed rest discomfort:
- Squeezing stress balls
- Pressing your hands and feet against the bed
- Turning your arms and feet in circles
- Tensing or tightening your arm and leg muscles
- Avoid using your abdominal muscles when you are stretching or exercising. Again, consult with your healthcare provider about the best ways for you to get exercise in your situation.
Questions to ask your healthcare provider regarding bed rest
- How long will I need bed rest?
- Do I have to stay in bed all the time? Can I go to work?
- Can I get up to shower or use the bathroom?
- Can I do normal household chores and take care of my other kids?
- Should I avoid lifting anything heavy?
- Should I lie on one side or stay in a certain position?
- Is sexual activity OK? If so, what kinds and how much?
Activities you can do while on bed rest
A variety of factors influence what you can and can’t do while on bed rest. Some of these time passers may work for you:
- choose a pediatrician (see here)
- write up a birth plan (see here and here)
- start a pregnancy blog (see here)
- start a family tree that you can share with your child someday
- choose baby names
- organize photo albums
- participate in Pregistry’s social media (Facebook, Twitter, Pinterest, Flipboard)
- seek out a support system (see here)
- watch Netflix, Amazon or Hulu shows
- answer text messages and emails
- write thank-you cards if you’ve already had a baby shower; if not, start addressing the envelopes to people (friends and family) whom you know will probably give gifts
- build an email and phone list of people to call when the baby comes
- contact your job about your maternity-leave benefits (see here)
- fill out health insurance paperwork for your baby in advance