Women in labor often go for walks down hospital corridors because the movement is supposed to help their uterus contract and their cervix dilate. The purpose of bedrest is to do the opposite: to reduce your normal daily activity so that your uterus will be less likely to contract and there will be less pressure on your cervix.
Bedrest is something many women are prescribed when their doctors feel it will promote the health of their pregnancies. It is often recommended for preterm labor contractions; multiple gestation (carrying twins, triplets, etc.); placenta previa; cervical incompetence; interuterine growth retardation (IUGR); and a variety of conditions that can make a pregnancy more challenging.
To what extent you need to curtail your activities depends on what your doctor thinks is called for by your condition and your baby’s. Bedrest may mean an extra hour a day in bed or full time bedrest with no bathroom privileges. You may be on it for a brief period of time, or an extended one.
You might be allowed to go to work or you may be advised to work in your home. You may or may not be able to do household chores and errands. You may be able to stand and walk around quite a bit, or not at all. Your doctor will recommend positions and locations to rest in, and any pillows or other aids to your rest that might be helpful. Your doctor will also let you know just how restrictive your bedrest routine will be.
If you are put on extended bedrest, you should get a referral from your doctor for a good physical therapist. Extended bedrest can cause muscle pain and weakness, fatigue, backaches, joint pain, dizziness, or insomnia. Physical therapy or a customized exercise plan designed by a physical therapist can soothe and strengthen those muscles, improve your circulation, and increase your joint flexibility. Your doctor might also recommend a massage therapist to reduce muscle pain, spasms, and inflammation if you suffer from any of these as your pregnancy progresses.
Once your baby is born, your bedrest is not quite over. You will need a longer time to recuperate in order to regain muscle strength and recover from both having a baby and being bed bound. But you’ll also have in your arms the best pay off in the world for all that resting: your baby.
Making the Best of Bedrest
More than 700,000 pregnant women, or nearly one in six, are put on bedrest for some part of their pregnancy. This can be an extremely stressful situation for obvious reasons. When your baby is in danger and you are restricted from normal activity, all you have is time to dwell on his or her well-being. In addition, you may be required to take a leave of absence from your job, which can create financial stress for you and your family; and you will probably be restricted from household chores and prohibited from engaging in sexual intercourse, which can put a strain on your relationship with your partner.
Communication is the key to surviving bedrest. Talk with your partner to come up with a revised family budget and a list of what needs to be done around the house, as well as some alternative ways you can maintain intimacy that are safe for you and your baby.
There are several different levels of bedrest, assigned depending on your circumstances. Talk to your doctor about your particular type of bedrest and find out specifically what you can and cannot do.
House Arrest is usually not really bedrest, but simply being confined to your home. You will probably be allowed to stay on the couch, in bed, or in a sitting position, but you will be restricted from sexual intercourse, exercise, and lifting.
Partial or Modified Bedrest requires you to spend part of each day lying down and resting. You may be allowed to work at a desk for a few hours a day, but must be on the couch or in bed the rest of the time. You are restricted from sexual intercourse, exercise, and lifting.
Strict Bedrest requires you to stay in bed, sitting up only for meals and standing only for quick showers or trips to the bathroom. You may be limited in the number of times a day you can change locations.
Complete or Hospital Bedrest is the strictest form of rest and may require hospitalization. You are not allowed to get up for anything – even trips to the bathroom or for bathing. You may also be required to lie with your head lower than your feet to alleviate pressure on your cervix.
One of the most important things to do if you are on bedrest is to ask for help. You will probably not be able to do housework, laundry, cook, or care for any older children, so make a list of what needs to be done and take friends and family up on their offers to help. Make copies of your house key for close friends and family who will be visiting frequently, so you don’t have to get up to answer the door.
Since you may not be able to get up every time you want a snack or to answer the phone, keep several plastic bins around you filled with supplies, including the phone and your address book or phone directory; magazines, books, catalogs; supplies for your hobbies; and quiet toys or books to read to an older child. Have a TV and VCR or DVD player moved into the room and keep the remote(s) handy. Movie subscription services such as Netflix (or visit tv shows on some pregnancy channel) are convenient because you can keep the movies as long as you want and just drop them in the mail when you’re done and ready for more. If possible, have a computer (preferably a laptop) with Internet access close by – this is a great tool for doing research, joining chat rooms, emailing, and instant messaging with friends. Keep a fully-stocked cooler by your bed so you don’t have to get up to eat. Have someone fill it with a selection of healthy foods each day, and put warm soup or other liquids in a thermos. Disposable moist towelettes for wiping your hands and mouth after eating are handy. And don’t forget a wastebasket near your bed, unless shooting baskets from across the room will entertain you!
Sticking to a schedule will help you structure your days, make you feel as if you’re accomplishing something, and give you something to look forward to. If you are able, take a shower each morning, change out of your pajamas and into comfortable clothes, and do your makeup and hair (if those are part of your normal morning routine). This will help boost your self esteem and make you feel somewhat normal. Keep a hairbrush, clips, mascara, lipstick, and other beauty items in a little bag near your bed so you can freshen up before guests arrive. Open the drapes and windows to your room for fresh air. Keep the room as cheery and comfortable as possible. In the winter, have a portable heater and extra blankets nearby in case you get cold. In the summer, keep a portable fan or air conditioning unit handy.
You may find yourself feeling jealous of your friends or partner for being able to lead normal, active lives while you are shut in. You may also feel intense loneliness, isolation, helplessness, boredom, guilt, and fear. These feelings are all normal and be prepared to have some bad days. Don’t hesitate to reach out to your close friends, family, partner, and religious or professional counselors if you are feeling desperate. Try to stay positive and focused on the goal: delivering a healthy baby. Keep in mind that every day she is still inside you is a victory, and the better her chances for survival. Hang an ultrasound picture of your baby where you can see it and use it as a focal point for meditation and a constant reminder of why you are doing all this. Take advantage of this time to bond with your unborn baby. You will probably be able to feel every poke, turn, and hiccup more acutely than other mothers-to-be who may be on the run and too busy to notice. Try to think of this time as a special opportunity to sing, talk, and read to your baby.
There are several simple ways you can stay healthy and relatively comfortable while on bedrest. Dehydration increases the risk of preterm labor and contributes to constipation, so make sure you drink at least 8 to 10 glasses of fluids every day. Eating smaller meals more frequently may help you feel better and maintain a more balanced blood sugar level, so eat 6 to 8 small meals each day. Gently stretch your legs and arms several times a day to improve circulation and prevent clotting.
Once you have delivered your baby and try to return to your normal routine, you may be surprised how hard it is. Depending on how long you were on bedrest, your muscle tissue may have deteriorated, your energy levels dropped, and your cardiovascular system may have weakened. Bedrest is also a type of sensory deprivation so you may feel overwhelmed when you first go outside – everything may seem too bright, too fast, and too chaotic. You may feel exhausted quickly and it may take several months for you to feel like yourself again. Be patient and ease back into your normal routine slowly.
Sidelines National Support Network provides support, education, and advocacy for women with high-risk pregnancies and their families. You can contact them at www.sidelines.org or 888.447.4754 (888 HI RISK).