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Pregnancy bed rest: When it's needed, what it means

Understand bed rest side effects

When you're on bed rest, joint pain and muscle aches are likely. You may feel weak or dizzy when you stand up. Bed rest also may increase the risk of blood clots, especially in the veins in your legs. Decreased bone mass may be a concern as well.

Emotionally, you may feel confined and isolated. Mood changes, guilt, anxiety and depression are common — and your partner may feel the same way. Child care is often a source of stress. If you're not able to work, finances may become a concern as well.

After delivery, the effects of muscular and cardiovascular deconditioning may linger — slowing your ability to get back to your usual activities.

Know the rules

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

  • Timing. Why do I need bed rest? When will it begin? Will the restrictions be lifted if my symptoms improve?
  • Position. Can I sit up? For how long? Can I move around the house for a change of scenery? Can I climb the stairs? When I lie down, do I need to use a certain position?
  • Personal hygiene. May I get up to use the toilet? Take a shower? Wash my hair?
  • Activity. May I eat dinner at the table? Work at the computer? Fold laundry or do other light chores? Drive a car? Take care of my kids? Do gentle stretching or other types of exercise?
  • Sex. Can my partner and I have intercourse? Is oral sex OK? What about orgasms?

Making the best of it

Remember that each day of bed rest brings you one day closer to delivery. In the meantime, consider these tips:

  • Get organized. Make sure everything you need is within reach — such as the telephone, your address book, a computer, a cooler stocked with bottles of water and healthy snacks, tissues, lip balm, hand wipes, the remote control, books and magazines, writing material, and extra pillows and blankets.
  • Beat boredom. E-mail your friends or write letters the old-fashioned way. Organize photos or start a scrapbook. Knit the baby a sweater. Read your way through the best-seller list. Learn relaxation techniques for labor. Plan weekly menus and grocery lists. Balance the checkbook, pay the bills and update your family's budget. Shop for baby goods online.
  • Stay limber. If your health care provider approves, set aside time for stretching or other gentle exercises.
  • Accept help. When friends and loved ones ask what they can do, be prepared with a list of specific tasks — mowing the lawn, shopping for groceries, picking up movies or library books, cleaning the bathroom, taking the kids to the park or simply keeping you company.
  • Help older kids adjust. If you have other children, provide as much stability as you can — whether it's a regular baby sitter in the morning, a favorite aunt to pick them up from school or weekend visits from grandparents. Remind them that you must stay in bed so the baby will be healthy when he or she is born. Do quiet activities together, such as reading books, coloring or watching movies.
  • Seek support. Some days will be better than others. To help maintain a positive attitude, connect with other moms-to-be on bed rest. Check for support groups, bulletin boards and chat rooms online.
  • Expect emotional challenges. Share your fears, hopes and concerns with your partner. Let each other vent if needed. If sex isn't allowed, look for other ways to maintain intimacy. Take time to kiss, hug and caress.

If the isolation or frustration of bed rest is more than you can handle, consult your health care provider or a mental health professional for additional support — and look toward the future with your baby in your arms.

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References
 
  1. High blood pressure during pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp034.cfm. Accessed Feb. 12, 2009.
  2. Morgan MA, et al. Obstetrician-gynecologists' screening and management of preterm birth. Obstetrics and Gynecology. 2008;112:35.
  3. Fox NS, et al. The recommendation for bed rest in the setting of arrested preterm labor and premature rupture of membranes. American Journal of Obstetrics and Gynecology. 2009;200:165e1.
  4. Norwitz ER. Prevention of spontaneous preterm birth. http://www.uptodate.com/home/index.html. Accessed Feb. 23, 2009.
  5. Smith V, et al. A systematic review and quality assessment of systematic reviews of randomised trials of interventions for preventing and treating preterm birth. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2009;142:3.
  6. Johnson JR, et al. Cervical insufficiency. http://www.uptodate.com/home/index.html. Accessed Feb. 23, 2009.
  7. Kaji T, et al. Effect of bed rest during pregnancy on bone turnover markers in pregnant and postpartum women. Bone. 2007;40:1088.
  8. Complications symptoms, diagnosis, and treatment. The National Women's Health Information Center. http://womenshealth.gov/pregnancy/complications/complicationssp.cfm. Accessed Feb. 23, 2009.
  9. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 5, 2009.

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May 23, 2009

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