Cincinnati Family Magazine

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May 22, 2024

Expecting: Everything to Know About ‘Bed Rest’

A growing number of physicians are moving away from the concept of strict bed rest.

If you are having complications during your pregnancy, your OB/Gyn may not prescribe to you what was once referred to as “bed rest” but rather “activity restriction.” Over the years, bed rest has actually been known to cause more problems than solutions to your pregnancy which is why the term “bed rest” is increasingly becoming known as “modified activity” or “activity restriction” amongst physicians.

From Bed Rest to Modified Activity

Whether you’ll be asked to actually “put your feet up” really boils down to your practitioner’s preference. According to Andrew Chang, MD with Kettering Health Medical Group OB-GYN, bed rest has been commonly thought to help with preterm labor/preterm birth and possibly preeclampsia. However, over time, evidence has shown that that not only does it not help prevent those things, it may increase risk of blood clots, deconditioning and bone demineralization.

“Modified activity, weight lifting restrictions, and pelvic rest are more commonly recommended to obstetric patients who are at increased risk for preterm labor, vaginal bleeding and preterm premature rupture of membranes,” Chang explains.

About an estimated 20 percent of pregnancies in the U.S. each year are being prescribed activity restriction by their OB/Gyns. According the American College of Obstetricians and Gynecologists, “there are no studies documenting an improvement in outcomes in women at risk for preterm birth who are placed on activity restriction, including bed rest and there are multiple studies documenting untoward effects of routine activity restriction on the mother and family, including negative psychosocial effects.”

Therefore, the ACOG does not recommend traditional bed rest stating that there is no evidence that it actually helps prevent or treat pregnancy complications. Modified activity may mean avoiding lifting objects less than 20 pounds, avoiding anything in the vagina and not overdoing things, says Chang.

“I recommend mothers to continue their daily activity, but avoid excessive activity like exercise, but to continue daily living activities,” he continues.

When Modified Activity May be Ordered

Your doctor might prescribe either modified activity at home or admission for observation at the hospital if you are experiencing major complications in your pregnancy. Although there is no “one size fits all” in this situation, in general, if you are at risk for preterm labor, vaginal bleeding, preeclampsia, preterm premature rupture of membranes, multiple babies, impaired fetal growth or have discomfort in your third trimester, you would qualify for modified activity at home, says Chang.

Since bed rest is not recommended by many physicians due to its risk of causing blood clots and other complications during pregnancy, your doctor might instead put you under the hospital’s care due to complications or give you restricted activity to do at home.

“We don’t recommend strict bed rest so depending on the diagnosis that warranted modified activity they can even continue to do low intensity exercise (ie. brisk walking),” says Chang.

Reduced activity at home/work might mean to shorten your workday in your third trimester, schedule regular times to rest and restrict activities such as exercise, stair-climbing and walking or standing for extended lengths of time. In general, reduced activity outside the hospital means you’re still up and walking around, doing some work, easy errands and light chores. So don’t expect to have to sit and kick your feet up for long periods of time. Reduced activity at the hospital would mean constant monitoring at the hospital, which means hospital admission. By nature, you can expect to spend some more time in bed than if you were at home. However, since there are concerns about prolonged inactivity, doctors will often take steps to make sure you remain healthy by prescribing light physical therapy during your stay, blood thinners and/or leg compression devices to prevent leg clots and physical therapy with prolonged hospitalizations.

Finding Support

Pregnancy alone can bring many challenges, and if you add modified activity or hospital observation to the mix, this can take a toll on a woman’s mental health. Undergoing complications in pregnancy while being limited to everyday life activities is hard for anyone, which is why having supportive family and friends by your side can make this whole process easier.

“I think having a good support network is critical,” says Chang. “Asking friends, family, or significant others for help is a good starting point. Seeking help from a licensed Behavioral Health Specialist would be another good source.”

For the most part, many women who are recommended for modified activity in the outpatient setting normally adjust, he continues. The time where mental health becomes a concern is when moms are admitted for preterm, premature rupture of membranes, putting them in the hospital for weeks during their pregnancy.

“I think having good social support is key,” Chang says. “Keeping busy with activities, games, walking around the unit, going outside for short periods of time (if allowed by the staff) can all be accommodations to help mothers cope with this.”

Connecting with Your Mental Health

No one said this time would be easy. It will bring many challenges, so finding ways to support your mental health is key during this time.

Stay connected. This is when you need your friends, family the most, and don’t forget your OB/Gyn. Reach out to support groups on social media to connect with other moms maybe going through the same thing.

Structure your day. Establishing a routine, whether it be penciling in a quick walk around the neighborhood, or organizing your paperwork,
routine is routine.

Work from home. Ask your boss if you can work remotely as long as your practitioner and supervisor are all on the same page.

Pick up a new hobby. Get crafty or teach yourself some new tricks and trades.

Organize and get ready for Baby. This is a great time to get your photos organized and gather everything you need for your new bundle’s arrival.

Start a journal. Recording your thoughts can help you express how you feel and help you cope with your mental health.

Seek support. Modifying your activity in pregnancy can be very emotionally challenging. Never hesitate to reach out to a family member, friend or mental health specialist for support.

About the Author

Amanda Hayward

Amanda Hayward is editor of this publication. She is from Cincinnati, Ohio, and a mom of three with one on the way. If she's not writing for Cincinnati Family, you'll find her running, juggling kids, teaching group fitness classes and cooking up healthy recipes.