Bed Rest: A Thing of the Past?
Bed rest used to be recommended frequently for conditions in pregnancy, and one in every five pregnant women is still placed on bed rest, according to Obstetrics & Gynecology, the official publication of the American College of Obstetricians and Gynecologists, yet this period of “rest” may do more harm than good.
Prescribed for issues such as high blood pressure, bleeding, preterm labor and low infant birth weight, bed rest has not been shown to reduce the risk of complications or early delivery – there is even some evidence to suggest that bed rest may increase rates of preterm birth and babies with low birth weight. It also comes with real risks such as blood clots, bone loss and muscle atrophy, reduced cardiovascular capacity, financial worries, depression and anxiety, weakness and slower post-delivery recovery. In the worst cases, blood clots can develop in the extremities and travel to the lungs, causing a life-threatening pulmonary embolism. Women are more likely to develop gestational diabetes when placed on bed rest, which has implications for long-term health as well as growth and health of babies. In addition to these adverse health outcomes, bed rest can significantly affect family dynamics and well-being.
The American College of Obstetricians and Gynecologists advises that bed rest “not be routinely recommended” and the Society for Maternal-Fetal Medicine concurs.
“If you ask all the women in your mother’s and grandmother’s generation at a family reunion, you’ll likely find that many of them were told to go on bed rest at some point in at least one pregnancy. Most pregnant women, however, do better when they maintain their normal routine for as long as possible,” said Dr. Erin Stevens. “Physical activity can even reduce issues such as low birth weight or high blood pressure or preeclampsia. If your doctor mentions bed rest, it is important to delve further.”
Nevertheless, pregnancy comes with a wide range of risks, and some activity restrictions may be discussed in association with specific circumstances. As with almost anything in pregnancy, it is important for patients to talk to their prenatal care providers about their own unique pregnancies in order to make optimal choices. If recommended bed rest, you can ask questions such as: How do you define bed rest? Is it really necessary? What are the specific benefits and risks?
“Sometimes women with complications during pregnancy blame themselves or their bodies. While this can be a challenging time, do your best to avoid judging or beating yourself up,” Dr. Stevens added. “We encourage walking, meditation and deep breathing, staying connected to your support network and being kind to yourself with self-care rituals.”