Not long ago, those with high-risk pregnancies were routinely sent to bed—or at least to the couch—to wait out the remaining weeks or months until they could safely deliver. But more recent research has shown that bed rest during pregnancy may not only be unnecessary…it may actually do more harm than good. Here’s what to know about pregnancy bed rest.

The Difference Between Bed Rest and Activity Restriction

True bed rest means laying down for most of the day and night and limiting activities to only those that are biologically necessary, like going to the bathroom and eating. If you have stairs, your doctor may ask you to avoid them. You might have to keep your showers quick and infrequent. Someone on bed rest typically needs a lot of help and support, especially if they already have children.

Activity restriction is less severe and varies depending on the situation. It might include not lifting anything over 20 pounds (such as a toddler!), limiting exercise and not spending all day on your feet.

Pelvic restriction or pelvic rest usually refers to sexual activity. The concern is that orgasmic contractions (with your partner or alone) could stimulate preterm labor contractions. If you are put on pelvic restriction, make sure to clarify what is forbidden and what is allowed. For instance, penetrative sex may be off the table while other forms of intimacy are fair game. 

Why Experts Are Rethinking Bed Rest

Despite the fact that nearly 1 in 5 pregnant folks have their activity restricted at some point during pregnancy, there is no medical evidence that bed rest improves pregnancy outcomes. For example, in a 2013 study of women with shortened cervixes, bed rest did not make their pregnancies last any longer than those with unrestricted activity.

What we do know is that bed rest can have a negative impact on one’s physical health, mood, career, and family life. Since bed rest hasn’t been proven to help but has been shown to hurt, the American College of Obstetricians and Gynecologists has gone as far as to call bed rest “unethical.” The organization recommends that “activity restriction should not be prescribed routinely as a treatment to reduce preterm birth.” 

The Problem With Bed Rest

Although bed rest is sometimes prescribed, it can come with serious physical, emotional and financial repercussions. Prolonged bed rest poses the serious risk of blood clots. It may also cause bone loss, decreased cardiovascular capacity, and decreased strength and muscle tone, which is hardly ideal for enduring the marathon of labor and birth!

Being unable to participate in normal daily activities while enduring the hormonal rollercoaster of pregnancy can lead to anxiety and depression. Another issue is the guilt and uncertainty bed rest can stir up. You might think, “I’m really hungry, but if I go get a snack, will I go into premature labor?” You may be tempted to blame yourself if something does go wrong, thinking it was all your fault for not adhering perfectly to the bed rest rules.

What’s more, managing work and family while on bed rest is a huge challenge. If you can’t perform your job from home, you might have to take a leave of absence and lose wages. Your partner might need to miss work to care for you—especially if there are other children in the family. This can cause huge financial hardship at the absolute worst time…when a new baby is coming.

If your doctor does prescribe bed rest, make sure you ask questions and determine if there are good reasons, and not just outdated medical tradition, behind the decision.

Why Bed Rest Is Sometimes Prescribed

Historically, bed rest has been prescribed when a pregnant person has complications that might lead to premature labor. The theory as that laying low—literally—limits the gravitational pressure on the pelvis and helps the baby (or babies) stay put until fully viable. However, as previously mentioned, there’s not strong evidence that this is the case.

Still, conditions that are sometimes treated with bed rest may include:

  • Cervical insufficiency, meaning the cervix is shortened or funneling
  • Hypertension or preeclampsia
  • Vaginal bleeding
  • History of late-term miscarriage or premature delivery
  • Preterm labor that was successfully stopped
  • Preterm premature rupture of membranes (PPROM)
  • Growth issues with baby
  • Carrying multiples

How to Make the Most of Bed Rest If It Is Prescribed

Even though the tide is turning away from bed rest, there are still occasions when it may be warranted. If your provider does recommend staying off your feet, here are ways to make bed rest a more pleasant experience:

  • Treat yourself to cozy loungewear or PJs…that’s your wardrobe for now.
  • Binge-watch without guilt.
  • Stay connected by video chatting with friends and family.
  • Even if you’re not supposed to exercise, ask your doctor if it’s all right to perform gentle stretches (such as turning wrists and ankles) to keep your muscles limber and your blood flowing. Having a daily stretch routine gives structure to your day, too.
  • Find a prenatal masseuse who makes house calls. Pregnancy massage can help with your circulation, aches and pains and stress.
  • Start a meditation practice with an app like Headspace to keep yourself calm and centered.
  • Keep a journal or even a blog that you share with friends and families…you might just find the humor in bed rest.
  • Shop online for nursery items, baby bodysuits, and baby books. You’ll have loads of time to do your research and comparison shop!
  • Try a craft you can do laying back like knitting or needlepoint.

Remember that even if you do nothing at all during bed rest, you’re actually doing everything—you’re growing a human baby!

More Answers to Your Pregnancy Questions:

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REFERENCES

  • Society for Maternal-Fetal Medicine: Activity Restriction in Pregnancy
  • Activity Restriction Among Women With a Short Cervix, Obstetrics and Gynecology, June 2013
  • “Therapeutic” Bed Rest in Pregnancy Unethical and Unsupported by Data, Obstetrics and Gynecology, June 2013
  • Center for Disease Control and Prevention National Blood Clot Alliance: Stop the Clot, Spread the Word
  • Bed Rest and Immobilization: Risk Factors for Bone Loss, NIH Osteoporosis and Related Bone Diseases National Resource Center, November 2018
  • Effects of Bedrest 1: Introduction and the Cardiovascular System, Nursing Times, November 2018
  • Your Pregnancy and Childbirth Month to Month, The American College of Obstetricians and Gynecologists 
  • The American College of Obstetricians and Gynecologists: Will I Need Bed Rest Near the End of My Pregnancy? 

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.