Pregnancy Bed Rest: Your Survival GuideNatasha Polak
Ask any pregnant woman what she desires most, and she’ll likely tell you she hopes for a healthy baby and a safe, easy delivery. Many expecting women take their prenatal vitamins, modify their diets, drink lots of water, exercise, try to minimize stress, and visit with their obstetricians or midwives regularly, all in attempts to avoid pregnancy crises. Yet there are still some women faced with health complications—theirs or a baby’s—who are eventually put on bed rest.
When Bed Rest Is Needed
“The most common reasons [for bed rest] include when a woman has a medical history of preterm labor, has an incompetent cervix, blood pressure problems, or is carrying multiples,” says Lainey Millikan, Obstetrical RN Educator with the Women’s Health Partnership, PC, in Indianapolis, Indiana. Preexisting conditions can also impose a greater risk for needing bed rest during pregnancy.
Bed rest, often prescribed at the onset of a health concern to keep a woman’s condition stable and avoid a lengthy hospital stay, can reduce the chances of a difficult labor and of the baby needing neonatal intensive care.
Types of Bed Rest
A woman is generally instructed to adhere to either one of two types of bed rest:
- Modified bed rest requires a pregnant woman to rest when possible, especially if she is working or cares for other children.
- Strict bed rest limits a woman to bed for most of the time, usually with the exception of bathroom needs and sometimes meals. More specifically, “Modified bed rest means pelvic rest often, and strict bed rest means mainly lying in a supine position,” notes Dr. Jacalyn McCloskey, MD, OB-GYN with the William Beaumont Hospital in Royal Oak, Michigan. Any situation where an extended period of standing is necessary should be avoided, such as cleaning, cooking, taking the stairs, or lifting moderate-to-heavy objects.
Some of the questions women should ask their healthcare practitioners when prescribed bed rest include:
- What are my limitations?
- How long am I to remain on bed rest?
- Can I travel or drive?
- Can I shower or bathe?
- Can I eat meals at the table?
- Am I allowed to continue working?
- Can I do any chores at all?
- Is sexual intercourse allowed?
Bed rest usually lasts anywhere from a few days to until a condition improves or it is safe to deliver. More frequent prenatal appointments (or in-home visits with the midwife or a nurse for those who are unable to travel) will keep track of progress and gauge when it is safe to be off bed rest.
Does Bed Rest Ultimately Work?
“It depends on the pregnancy,” Millikan explains, when answering this common question. “Changing the force of gravity usually helps minimize preterm labor. It also helps keep blood pressure stable and low.” Bed rest will not necessarily prevent low-weight or stillborn births, the need for a Cesarean section, or cure placenta previa or existing heart conditions for the mother or baby.
Coping with Bed Rest
Bed rest can be frustrating and scary—and what may begin with a sense of relief can soon turn into a reason for any pregnant woman to become stir crazy. Dr. McCloskey (who was on bed rest with three pregnancies), Millikan, and other women who have experienced bed rest offer these tips on coping with the days, weeks, or months ahead:
- Develop a good relationship with your prenatal caregiver and keep in contact. Don’t hesitate to call with questions, problems, or concerns you have, or write them down and share them at your next appointment.
- Build a good support system. Don’t be afraid to ask for help from family and friends—whether it’s with housework, cooking, childcare, or if you just need someone with whom to talk. If you don’t know anyone who can help, talk with your caregiver about local services that provide assistance to women with high-risk pregnancies. Knowing that things are taken care of will help ease stress, warding off further complications.
- Additionally, you’ll want to keep in touch with others in similar situations. A community of moms-to-be who are also on bed rest will allow you to vent your frustrations to other women who can relate and provide everyone the opportunity to share tips. Look online, check the phone book, or talk with your caregiver for support groups in your area to join.
- Keep what you need nearby. If you live in a home with multiple floors, stay in a room closest to where you can still take care of reheating your meals. Use paper plates and plastic eating utensils, and if possible have a mini fridge or cooler for beverages and perishable foods, and a wastebasket in the room. If you have other family members who start the day with you before heading to work, try to get as much done with their help as possible (such as showering, grooming, or eating).
A quick way to have the necessities at your fingertips without cluttering your existing space is to set up a convenient staging area, such as an ironing board, for your things. You may want to keep the following items handy:
- Telephone and phone directory/emergency contact list
- Bottles of water, to avoid accidental spills
- Television remote
- Tissues, hand wipes, or paper towels
- Hairbrush or comb
- Toothbrush and toothpaste, mouthwash, and dental floss
- Soap and a washcloth
- Any medicines you need, including Tylenol, antacid, and your prenatal vitamins
- Reading materials or other entertainment
- Bag of forks/knives/spoons and paper plates
- Notepads or notebooks, pens or pencils
- Headband, ponytail holders, or hair clips
- Exercise elastic band
- Heavier items, such as hand weights or a laptop computer, which can be stashed under the bed or couch, a mini fridge, or even on a cooler.
- Stick to a daily routine to help ward off depression. Creating a schedule for yourself will give you a reason to get through one day at a time. Camp out on the couch for the day, if possible, and leave the bed for evenings. The change in scenery will help you feel less cooped up.
- Remind yourself of the life growing within you—and enjoy the time you have with your baby while he or she is still inside your womb. Before you know it, you won’t be feeling those kicks inside you, and you’ll be holding a squirming infant, instead. Spend time bonding with him or her by reading aloud or playing music for baby. You may even want to keep a journal specifically for your unborn baby, letting him or her know your thoughts as you journey through this difficult stage of pregnancy.
- Bond with your older children. Bed rest doesn’t mean that a bedridden mom can’t interact with her older children. In fact, periods where the children can sit with her for quiet activities, such as watching television, homeschooling, playing games, or reading, will provide the children with the attention they need and help the mother feel less isolated from her family.
- Take care of yourself. Spend time meditating; read uplifting materials; continue to maintain good eating, drinking, and hygiene; give yourself pedicures or manicures; listen to music and sing if you want. These will all help boost your mood.
- You’ll also want to busy yourself with activities. Why not redo your address book, draw plans of the baby’s nursery, plan menus, write lists, or pay the bills? Oddly enough, most women on bed rest are compelled to take on detail-oriented tasks and organization endeavors, and what were once mundane tasks will now help you have a sense of purpose. Enjoy the fun things you’ve not had the time to do, like shopping online, completing crosswords and puzzles, needle crafts, scrapbooking, reading, and writing.
- Catch up on your rest. While that may not be a problem for some, other women may find that they ordinarily maintain a very fast-paced schedule and even in pregnancy have not allowed themselves some time to slow down. Now is the time to adjust and listen to your body when it needs rest.
Avoiding and Treating Additional Complications
Women on bed rest commonly suffer from a variety of problems that can lead to further complications if left untreated. Be aware of these and ask your physician about taking precautions to prevent problems:
- Constipation can sometimes be avoided or treated with stool softeners.
- Weight gain and muscular weakness can be treated with simple weight lifting for your arms, stretching exercises, or exercises using an elastic band. Take care not to strain the abdominal muscles. Speak with your doctor before beginning any exercises while on bed rest.
- Muscular, or joint or hip pains caused by side-sleeping can be relieved with Tylenol or massages. Although sleeping on the left side is ideal in keeping blood pressure low and baby comfortable, avoid sleeping on only that side to stop hips or legs from hurting. Use body or U-shaped pillows for easier positioning. Lying on your back or stomach is discouraged.
- Acid reflux can be treated with medication, antacids, or by propping your head with pillows to keep from lying flat, if possible. Learn more here.
- Blood clots can be avoided by frequent leg movement and massage.
All in all, remind yourself (and anxious family members) of the objective—to deliver a healthy baby! Although it may not seem like the end is in sight, know that bed rest is just a temporary situation. Before you know it, you’ll be holding your baby and wondering where the time went!