Bed Rest In and During Pregnancy

Pregnant women are often advised to be on bed rest during pregnancy to treat certain pregnancy complications even there is not much solid scientific evidence that it works in most cases.

Indications for bed rest

• High blood pressure, such as preeclampsia, and eclampsia
• Risk for premature delivery
• Cervical changes, such as incompetent cervix, and cervical effacement
• Vaginal bleeding
• Multiples
• History of pregnancy loss, stillbirth, or premature birth
• Poor fetal development
• Placenta complications, such as placenta previa, and placenta accreta

Types of bed rest
Bed rest will differ from woman to woman and from one indication to the other and also how many weeks along the pregnancy is. Bed rest recommendations may range from just simply "taking it easy", to periodic resting at home to full bed rest and monitoring in a hospital.
Some women will discover that their doctor places them on bed rest for a brief period to help a complication stabilize, whereas other women may be placed on bed rest through most of their pregnancy. Bed rest can be anything from confinement to bed to just taking it easy around the house.

It is important to find out what your doctor means by "bed rest."

Level 1: Taking it easy, taking a break, decreasing your activities.
This might mean taking a break from exercising or sex from a few weeks to the rest of the pregnancy. With this type of bed rest, women need to be able to sit down and rest. This might involve taking a leave from work or getting backup help with the care of children at home.

Level 2: A few hours of bed rest each day.
This level may mean part-time work or taking off work completely. This kind of rest may be recommended for women with mild hypertension or other complications and it  may be beneficial if a baby isn't growing well.

Level 3: "House Arrest"
This requires taking off work completely, no shopping or carrying groceries. No standing for more than 5 minutes. It's a stricter type of bed rest, where women are essentially confined to the home, and activities are limited to moving around, taking showers, puttering around and mostly resting.

Level 4: Complete Bed Rest
Strict bed rest is prescribed in some cases, which essentially means lying down all day. Sometimes this can be done at home, other times in the hospital Getting up might be limited to going to the bathroom, taking a shower, and preparing a simple meal. The strictest forms of bed rest are usually done in the hospital, with a bedpan instead of bathroom privileges and all personal care provided by the hospital staff.

How does bed rest help?
In most cases, bed rest is used to help the body have the best chance to quiet down. Bed rest will be used with women who have conditions related to high blood pressure in order to decrease stress and lower blood pressure. Work, activity, lifting, or exercise may worsen or provoke certain situations, so bed rest may be prescribed to reduce vaginal bleeding or decrease the chance of premature labor. Bed rest may also be necessary (often on your side) to help increase blood flow to the placenta.

What is the best position for bed rest?
The best position for bed rest will depend on your situation and what complication your health care provider is trying to address or prevent. In most cases, your healthcare provider will request that you sleep or rest on your side, usually with your knees or hips bent, and maybe a pillow between your knees. You may be asked to lie on your back while being propped up with pillows or to lie on your back with your hips or legs elevated higher than your shoulders.

How can I deal with bed rest discomforts?
Bed rest will tend to cause your muscles to lose tone and make some of your joints ache. Lying down for long periods of time can also reduce your blood circulation. Changing from side to side will help stimulate your muscles and relieve pressure. Exercise is important for your blood circulation, but make sure that you visit with your health care provider before you begin any exercises. Below are common exercises that may be used:

• Squeezing stress balls
• Pressing your hands and feet against the bed
• Turning your arms and feet in circles
• Tensing or tightening your arm and leg muscles
• Avoid using your abdominal muscles when you are stretching or exercising

Consult with your doctor about the best ways for you to get exercise in your situation.

"Do's" and "Don'ts" during bed rest:
The "do's" and "don'ts" during bed rest will vary from woman to woman, depending on your situation and the reasons that bed rest is prescribed by your health care provider. It is important to get a clear understanding of what is allowed during your bed rest period. In most cases, bed rest will require that you avoid lifting, exercise, or any strenuous activity. Here is a list of activities to discuss with your doctorr:

• Cooking
• Light chores
• Walking
• Bath or shower
• Driving
• Exercise
• Sexual intercourse

If your bed rest occurs for a long period of time, it is important to discuss exercises or activities that you are allowed to do to keep your blood circulating.

How can I make the best of bed rest?
Bed rest may sound fun, but it is usually challenging for most women, particularly if it is for longer periods. There are a number of things you can do to make your bed rest a more positive experience:

• Establish a routine: Bed rest may lead you to feel that things are out of your control. Establish a routine to help you feel better about your situation and that you are still in control. Change into comfortable clothes and have a schedule for the day.
• Spring cleaning: Ok, yes you are stuck in bed, but this is an excellent opportunity to organize photo albums, make changes to address books, update recipes, or work on whatever other projects that need attention.
• Connect with friends: After the baby arrives you will be busy taking care of things, and visiting with friends may be difficult. Use this time to make phone calls that allow you to visit with friends and let them know more about your expected bundle.
• Baby preparations: Bed rest provides you with an opportunity to get organized and plan for things related to the baby. You can begin planning for baby names, baby registry, a new will, guardianship, insurance, baby announcements, thank you notes and financial matters. You may also use this time to order things through the internet or on the phone for the nursery or other items you will need to care for the baby.
• Medical preparations: Bed rest will also give you time to research, learn, and plan to deal with a complication, such as the delivery of a premature baby. You can get online or read books to discover how you can be prepared for handling an early delivery or other complications.
• Allow friends and family to help: Your family and friends care about you and are interested in helping you out. They know you would do the same for them, so don't be afraid to ask for help with meals, household chores or errands. You may even find that people call to ask what they can do to help. Make it easier on yourself by having a "to do" list with you.
• 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 to help you become a parenting expert. You can learn more about breastfeeding, child development, immunizations, and other things related to you, your baby, and parenting.
• Love those around you: Bed rest will require those around you to invest more in the chores, tasks and activities that you may normally have handled. Recognizing your situation, they hopefully will be doing things with a positive attitude already. But you can always take this time to do something for them to show your appreciation such as make a card, write a letter, or order a special gift.
• Get organized: Being confined to the bed does not mean that you cannot be productive, whether it is accomplishing things for your family, your home, or just doing something for yourself. Having things at your fingertips will make things easier.

Here is a checklist of items you may want near the bed or couch:

• Telephone, directory and address book
• Pens, pencils and paper
• Brush, comb, and mirror
• Books, magazines, or other reading materials
• Remote controls to TV and VCR
• Laptop computer
• Cosmetics, nail files, etc.