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What is bedrest?
Nearly 1 in 5 women in the United States is put on bedrest at some point during her pregnancy. That is, she's told to spend much or all of her time lying down at home. This can last anywhere from a few days to a couple months. Healthcare providers don't usually recommend bedrest anymore because there isn't a lot of evidence to show it leads to a healthier pregnancy or birth.
Although taking to bed may sound good to an exhausted mom-to-be at first, most women find that being confined to bed, even for just a few days, is uncomfortable, boring, and inconvenient. If days become weeks, it may feel more like torture than relaxation.
Why is bedrest sometimes prescribed?
Bedrest has been prescribed for various pregnancy complications for decades. For example, it's often been prescribed if you're carrying twins (or more), have a weak cervix, or otherwise have a higher risk of preterm labor.
Your provider may also recommend bedrest if she suspects that your baby isn't growing properly in the womb (intrauterine growth restriction) or if you have placenta previa (a placenta that lies unusually low in your uterus, covering your cervix).
Finally, you may be put on bedrest at home if you have mild gestational hypertension or preeclampsia, in the hope that it keeps your blood pressure in check.
Is there research showing that bedrest helps?
There have been few studies on whether bedrest helps reduce the risk of preterm birth, and a review of the data available found no convincing evidence to justify its use. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have concluded that bedrest isn't effective for preventing preterm birth and shouldn't be routinely recommended.
There's also no good evidence showing that bedrest is helpful for women carrying multiples or for those who have placenta previa, cervical insufficiency, or intrauterine growth restriction. Some research on uncomplicated twin pregnancies found that being on hospital bedrest was linked to a higher risk for early delivery.
There's some debate among experts about whether the less severe form of bedrest, sometimes known as activity restriction, helps women with hypertension. Some studies indicate it does, but others don't.
Some say that until there's good evidence to the contrary, bedrest is worth a try. Others argue that bedrest itself can have a variety of negative effects and that women should not be subjected to it until we know that it does more good than harm.
Some providers tend to believe that the use of complete bedrest should be curtailed, and that some women would be better off just restricting their activity level, cutting back on work, avoiding heavy lifting and prolonged standing, and resting for a few hours each day.
The bottom line is that more good scientific research is desperately needed. In the meantime, providers disagree on when and how to prescribe bedrest.
How can resting in bed be harmful?
Bedrest can actually be hard on your health. Being on complete bedrest for an extended period increases your risk of blood clots. (In some circumstances, a provider may prescribe the blood thinner heparin to help prevent clots.) You may also suffer from insomnia, changes in your metabolism, bone loss, and aches and pains.
What's more, when you don't use your muscles, heart, and lungs the way you would when you move around as usual, they lose strength, leaving you weak and extremely tired. When your bedrest order is eventually lifted, it can take weeks to get your strength back, which makes it harder to care for a newborn.
In addition, bedrest can be a logistical nightmare and a financial hardship for you and your family. You may have to stop working sooner than you planned or find someone to care for your children. If you're on complete bedrest, you'll need to rely on others for everything, including bringing you food and anything else you need.
Finally, being confined to your bed can be very stressful. The boredom and isolation you're likely to feel can take a toll on your mental health.
What should I do if my provider wants me to go on bedrest?
Ask her to discuss the pros and cons with you. If you both decide that bedrest is a good idea for you, find out exactly what level of activity is allowed – whether you're supposed to stay in bed for most of the day, just rest regularly throughout the day, or something in between.
Then talk to your family, friends, and employer and make a plan. You'll need to line up a support system to help you get through the days. You can also contact Sidelines, an organization that provides support and advice for women on bedrest.
You may also benefit from counseling because you're likely to feel torn between your obligation to your unborn child and to your family or job. Counseling can be helpful for your partner as well if your bedrest is putting a strain on your relationship.
Will I have to stay in bed all the time?
Probably not. Although there's no standard definition of bedrest, your provider is more likely to prescribe activity restriction instead. If activity restriction is recommended, you might be advised to stay home and rest in bed but be able to get up to make yourself lunch, join your family at the dinner table, and take a shower, for example. Or you may just be advised to curtail your normal activities and take it easy, resting in bed for only a few hours each day.
Occasionally, being put on bedrest could mean spending most of the day in bed, getting up only to go to medical appointments, use the bathroom, and take a shower. If you're on bedrest most of the day, you may be told to lie on your side, which takes the pressure of your heavy uterus off the important blood vessels that return blood to the heart.
Use the Society for Maternal-Fetal Medicine’s Find an MFM Specialist tool to locate a high-risk pregnancy doctor near you.
Visit the Society for Maternal-Fetal Medicine's website for more information.