Bed rest in Pregnancy!

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Pregnancy is a natural phenomenon to reproduce and continue the progeny. The pregnancy is often a blend of eternal happiness to give birth to a life,  mixed with the fear of fatal complications to mother and fetus.

Bed rest during pregnancy is sometimes prescribed to help prevent complications.

What bed rest means?

In some cases, bed rest during pregnancy simply means decreasing your activity level for a period of time. You might be free to move about the house, as long as you avoid lifting children and doing heavy housework. Depending on the demands of your job, you might even be able to continue working.

In other cases, bed rest guidelines are stricter. You might need to remain in a sitting or reclining position most of the time, only getting up to use the toilet or shower. You might not be allowed to work or do even light household chores until the baby is born.

If your health care provider prescribes total bed rest during pregnancy, you might need to lie on your side at all times — including when you eat. Personal hygiene might be limited to sponge baths and a bedpan. This type of bed rest might require hospitalization.

In which conditions is bed rest recommended?

The bed rest in pregnancy is advisable under certain special circumstances to give the body its best chance to normalize and recover and prevent any fatal complications to mother and baby.

  • High blood pressure in pregnancy such as preeclampsia and eclampsia.
  • Risk of miscarriage due to threatened abortion, bleeding pervaginum, cervical incompetence, cervical mouth opening.
  • Antepartum active vaginal bleeding.
  • Premature labour.
  • Multiple gestation especially conceived with infertility treatment.
  • Bad obstetric history or history of recurrent miscarriages or premature deliveries.
  • Intrauterine fetal growth.
  • Placental complications such as placenta or vasa previa, placental abruption, abnormal placental implantation like accreta etc.

How does bed rest in pregnancy helps?

It is proposed that the bed rest in pregnancy helps through-

  • Decreases physical, mental and emotional stress.
  • Restriction of physical exertion reduces maternal requirements and ensures availability of adequate nutrition for fetal growth.
  • Increases utero-placental blood flow and improves fetal nutrition.
  • Normalizes maternal pulse rate, blood pressure and anxiety.
  • Controls vaginal bleeding by promoting clot formation and stabilizing it in case of bleeding from placental bed.
  • Decreases the chance of premature labor.

What is the ideal position for bed rest?

bedrest4

The best position for bed rest will depend on the particular situations and will be informed by your health care provider.

However, in most circumstances, the side lateral position (left or right lateral) with knees and hips bent in comfortable position and may be with a pillow between your knees is advisable.

Sleeping straight on dorsal position may lead to compression of inferior vena cava by the gravid uterus and decrease in return of blood to heart, further compromising maternal-fetal blood circulation.

gravid uterus pressing IVC

In case of premature rupture of membranes leading to active leakage of amniotic fluids or premature opening of cervical os, however the patient may be advised to rest on her back with her lower limbs propped up higher than the levels of shoulder to negate the effect of gravity.

trendelenburg-position-bed

Know the rules?

If your health care provider recommends bed rest during pregnancy, ask plenty of questions to make sure you understand the rules.

  • Time – Why do I need bed rest? When will it begin? Will the restrictions be lifted if my symptoms improve?
  • Position – Is it OK to sit up? For how long? Can I climb the stairs? When I lie down, do I need to use a certain position? What can I do to help prevent blood clots?
  • Personal care – .Is it OK to get up to use the toilet, take a shower or wash my hair? Is it OK to eat dinner at the table? Can I fold laundry or do other light chores? Can I drive a car? Is it OK to do gentle stretching or other types of exercise?
  • Sex – Is it OK to have sex? What about oral sex? Masturbation? Orgasms?

What are the side effects of strict bed rest in pregnancy?

A stay in bed for few days or weeks might seem like a welcome break, however after some time same appears as punishment.

  •  Leads to depression and low self confidence.
  • Decreased blood circulation with stasis of blood leads to risk of hypercoagulability that may result in clot formation in calf vessels leading to deep vein thrombosis. It is fatal condition that may lead to sudden Maternal death.
  • Decreased blood circulation also negatively affects the maternal-fetal blood supply further compromising the baby.
  • Prolonged bed rest may result in decreased bone mass, loss of muscle tone and joint pains.
  • May lead to financial crisis due to lack of work.

How can I deal with the discomfort of Bed rest?

There are a number of activities you can engage in to make your bed rest a more positive experience:

  1. Establish a routine & Get Organized: Bed rest may make you feels emotionally confined or isolated. Mood changes, guilt, anxiety and depression leads to sense of helplessness and worthlessness.Establishing a routine and getting organized may help to take the control over situation
  2. Gentle movements and exercises: Changing from side to side, light exercises like steps, deep breathing, turning arms and feet in circles, tensing or tightening your arm and leg muscles etc will help stimulate your muscles and relieve pressure long with ensuring blood circulation. However, discuss your limit of activities with your doctor.
  3. Interesting activities: Activities like organizing photo album, updating address book or recipes, painting, and listening music can make this period memorable and fruitful.bed rest1
  4. Connect with friends: After the baby arrives you will be busy, so connecting with friends may be difficult. Use this time to make phone calls to your friends.
  5. Baby preparations: Bed rest provides an opportunity to plan baby’s welcome. Work on baby names, thank you notes, financial matters or purchasing required things with the help of online shopping.
  6. Medical preparations: Bed rest will also give you time to research and plan to deal with a complication. You can get online or read books to discover how you can be prepared for handling an early delivery or other complications.
  7. Seek help: One can seek help from family and friends to make this period memorable.
  8. Become a parenting expert: Bed rest provides you with an excellent opportunity to search the internet, read books, and go through baby and parenting magazines to gain information on parenting.
  9. Family time: In modern day busy life style, we hardly spend any time with our family and friends. Bed rest provides best time to express our love and gratitude to them by means of card, letters or ordering a special gift.

Don’ts of Pregnancy:

  • Avoid strenuous exercises or those in which bending forward, balancing or increasing intra-abdominal pressure is required.
  • Avoid strenuous activity.
  • Avoid lifting heavy weight.
  • Avoid sexual intercourse. However gentle foreplay is recommended as a stress buster.

Does prolonged strict bed rest really help to prevent preterm labour.

According to most meta analysis and cochrane review, there is not enough studies from good quality to say that whether bed rest helps to prevent miscarriage or not.

bed rest cochrane

Disclaimer:

The information is shared to create awareness towards Pregnancy and Childcare to reduce maternal and child deaths. Atmost care has been taken by the author to include the verified information from authentic sources. However, kindly discuss the same with your health care provider before implementation.