Bed rest — increasingly known as activity restriction — can mean different things to different doctors, from just getting off your feet every couple hours to a hospital stay. It’s estimated that activity restriction is still being prescribed in about 20 percent of pregnancies in the U.S. each year. But whether you’ll be asked to actually “put your feet up” really boils down to your practitioner’s preference. A growing number of physicians are moving away from the concept of strict bed rest, instead using it only as a last resort. In fact, the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) do not recommend traditional bed rest, stating that there is no evidence that it actually helps prevent or treat pregnancy complications. But that doesn’t mean that your practitioner won’t ask you to refrain from some of your usual activities to protect both you and your baby. Here’s what you can expect from activity restriction, including how to stay mentally and physically healthy when you’re spending less time on your feet.
Bed rest used to be categorized as one of the following: scheduled resting, modified bed rest, strict bed rest and hospital bed rest. But doctors today are moving away from these distinctions, instead recommending one of the following two categories depending on the severity of the pregnancy complication:Reduced activity at home/work: Some practitioners may ask you 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. But in general, reduced activity outside the hospital means you’re still up and walking around, doing some work, easy errands and light chores (hand over the yard work to your partner!).Reduced activity at the hospital: Some patients require constant monitoring, which means hospital admission. And just by nature of being in the hospital, you’ll be spending a lot more time in bed. However, given the concerns about prolonged inactivity, doctors often take steps to ensure moms-to-be remain healthy by prescribing light physical therapy during patients’ stays.
Certain moms-to-be are more likely to wind up on activity restriction, including those with certain chronic conditions. There are also certain pregnancy conditions that may prompt your doctor to reduce your activity:Doctors who prescribe activity restriction say it can reduce some pressure on your cervix and strain on your heart while increasing circulation to your uterus. If your doctor prescribes some level of activity restriction and you’re not sure why, ask. She should be able to explain to you what the benefits are along with whether or not they outweigh the risks.Being off your feet for a long period of time comes with its share of drawbacks — which is why many doctors are more likely to be cautious in doling bed rest out. Prolonged inactivity can lead to hip and back pain, muscle atrophy (which can make it harder to bounce back once you deliver), skin irritation, bone loss and even blood clots in the legs. It may also aggravate many of the normal symptoms of pregnancy, such as heartburn, constipation and leg swelling, as well as increase your risk for gestational diabetes, since your body isn’t breaking down glucose at its usual rate.
In addition, research has established a link between decreased appetite (which can happen with activity restriction), maternal weight loss and low birth-weight infants. In other words, if you don’t have an appetite and therefore aren’t getting enough to eat, there’s a good chance your baby isn’t either.Medical experts have also warned that prolonged inactivity can lead to depression — and that the depression sometimes hangs around after the baby arrives. Be aware of the signs: unshakable feelings of sadness, loss of appetite and major mood swings. Any pregnant woman may experience each of these symptoms at various times, but speak to your practitioner if these symptoms feel hard to manage.Bed rest, unfortunately, is no pajama party. Once reality sets in and you realize that you can’t do some of the things you’re used to doing, any appeal is lost pretty quickly. After you find out from your doctor exactly which activities are allowed (and which aren’t), use these tips to minimize some of the side effects.
Given the reservations many doctors have about prolonged bed rest now, it’s unlikely that you’ll find yourself completely bedridden — and you may be surprised at the things you can still do when you’re being asked to do less. A few suggestions:Living with limitations can drive you a bit nuts, especially if you’re normally a very active person. Sometimes keeping yourself busy can provide a welcome distraction. A few suggestions:Remember that you’re simply starting the parenting process a little earlier than most, doing what’s best for your child — even if it’s not terribly fun for you. Every day you take it easy is one potentially more day your baby (or babies) grows inside you, giving him or her (or them) the best chance at being born healthy and strong.Depending on how much your activity is restricted, you may need to make some changes around your home:Your partner: Depending on what your doc OKs, your partner may be responsible for most of the household chores, errands and meals (which is a tall order for some partners!).
Intercourse might be taken off the table, too (although there are other ways to share intimacy and fun), so try to be gentle and patient with each other. Encourage your partner to go out with friends occasionally. And try to make sure that (s)he has a support system in place.Your children: If you already have children — especially little ones (who just want to be picked up and carted around on mom’s hip) — activity restriction can be an added challenge. You’ll probably be looking at less tickle-fights and twirls and more tea parties, books and board games. If at all possible, have someone else take your toddler for a run around outside every day, since burning off some of that energy may facilitate quieter playtime with you.Keep your expectations realistic after delivery. Cut yourself some postpartum slack, factoring in all your body has been through. Depending on the level of activity restriction, you may not have the same aerobic capacity or muscular strength that you had before.