Bed rest: what the doctor means
29 February 2016, 14:13
To anyone who’s rushed off their feet, a few weeks of bed rest sounds like bliss, but not being able to nip to the shops, meet a friend for coffee or head to work can be very challenging.
If your pregnancy is progressing normally (a healthy pregnancy with no complications) you’ll be encouraged to stay active and fit.
However, if you’re having a high risk pregnancy, there’s a possibility that you might be prescribed bed rest during your pregnancy. This is often where you’ll be asked to stay off your feet for the majority of the day, until the delivery of your baby.
Is it necessary?
There is some controversy about whether bed rest is really effective or necessary, and there are some known downsides to being confined to bed. Side effects may include muscular aches and pains, the possibility of deep vein thrombosis (DVT or blood clots), loss of muscle tone and depression.
“Bed rest is falling out of favour,” explains Dr Jana Rossouw, specialist in gynaecology and obstetrics at Tygerberg Hospital in Cape Town.
“Previously it would be recommended for patients with hypertension, placenta praevia or any kind of high risk pregnancy, but now it seems that if patients have bed rest for most of the day, they develop blood clots and this can severely complicate their pregnancy,” she explains.
But despite a lack of clinical evidence that it helps, many healthcare providers believe that bed rest can prevent preterm labour, particularly when the mother has suffered ruptured membranes, where the cervix is very short or a cervical stitch has been put in.
Many doctors still follow the practice: “We do advise bed rest for patients, particularly those at risk of premature
labour or with prematurely ruptured membranes,” says Dr Trudy Smith, specialist gynaecologist and obstetrician at the Park Lane hospital in Johannesburg.
Have a look at: Top 5 exercise dos and don'ts
“However, we would never prescribe it for anyone who wasn’t at high risk, because you increase the risk for DVT. I wouldn’t say that it’s widely prescribed, but we would prescribe it in women who have had preterm labour previously or who have shortened cervixes,” she says.
In serious cases, many doctors would rather place the patient in hospital. “Some of our patients are admitted so that we can observe them in hospital,” explains Dr Rossouw. “We would allow them to walk in the corridors. We want them to be ambulatory, not in bed.”
Just being pregnant means a person is at a higher risk of blood clots, she says, so being immobile increases the risk.
How to survive bed rest
Get organised. Make sure you have water, healthy snacks and meals, your cellphone, laptop and all the necessary chargers (already plugged in!) within arm’s reach. A bar fridge next to your bed will help keep food and drinks within reach.
Boredom is likely to be a challenge. Organise all those digital photos into albums, plan your nursery, connect with friends or start a pregnancy journal. Say yes to friends and family who offer to help.
Expect some tears, it’s normal to feel scared, upset, or frustrated during an experience like this. Talk to your partner about how you’re feeling and seek professional help if you feel the situation is getting on top of you.
Also: Getting ready for baby
Why is it prescribed?
According to the Mayo Clinic, bed rest improves the blood flow to the placenta and may also take pressure off your cervix.
However there is no hard evidence or research that shows that bed rest makes any major physical difference to the outcome of a pregnancy, although it does seem to have a psychological benefit. It also reduces the levels of the stress hormones associated with adrenaline and dopamine that can trigger contractions.
Dr Smith explains: “When we’ve done trials, bed rest has made no difference, but psychologically it has. The more you rest, the more you are focused on the pregnancy and perhaps you feel like you are doing something.”
Dos and dont's
If your doctor does prescribe bed rest it is sure to be with good reason. What you probably didn’t know is that bed rest doesn’t automatically mean that you’ll be confined to your bed the whole time.
For some women, it just means staying off your feet more and decreasing your activity levels, but still continuing to work.
However, for moms-to-be who are put on total bed rest, it could mean staying sitting or reclining for most of the day, only getting up to use the bathroom. In extreme cases of bed rest it may include lying on your side the whole time and using a bed pan but this would usually require hospitalisation.
The dos and don’ts of bed rest depend on how much activity your doctor allows. Ask your doctor questions about how still you need to be – can you cook a meal, have a shower or do a load of laundry? Are you allowed to drive? Can you sit at a desk or even go into work for a few hours a day?