What to expect when you're expecting (218 page)

Certain moms-to-be are more likely to wind up on bed rest, including those who are over 35, who are carrying multiples, who have a history of miscarriage due to incompetent cervix, who have particular pregnancy complications, or who have certain chronic conditions.

Whether bed rest truly helps prevent preterm labor or minimizes the risks of other complications, it is clear that being off your feet for a long period of time comes with its share of drawbacks. Women on prolonged bed rest can suffer hip and muscle pain, headaches, muscle loss (which can make it much harder to bounce back after delivery), skin irritations, and depression, and may be more prone to blood clots. Not being able to get moving may also aggravate many of the normal symptoms of pregnancy, such as heartburn, constipation, leg swelling, and backaches. Finally, bed rest may decrease your appetite, which might be good for your waistline (what waistline?) but not so good for your growing baby (or babies), who counts on those extra calories and nutrients.

The good—and reassuring—news is that many of the side effects of bed rest can be minimized with these tips:

Keep things circulating. Maximize blood flow to your uterus by lying on your side, not your back. To feel cradled and comfortable, put a pillow under your head, a body pillow under your belly and between your knees (or two pillows), and perhaps a pillow behind you as well, if that helps you balance. Change sides every hour or so to lessen body aches and prevent skin irritations.

Types of Bed Rest

“Bed rest” is the general term used when your practitioner wants you to limit your activities. But it’s likely your marching (or in this case, nonmarching) orders came with a list of very specific can-dos and definitely don’t-dos. That’s because bed rest comes in a variety of packages, from just getting off your feet every couple hours, to resting in bed but being allowed to get up periodically, to staying in bed with bathroom privileges, to staying in bed 24/7 (sometimes in the hospital). What kind of bed rest you’re prescribed depends a lot on why you’ve been put on bed rest to begin with. Here’s the lowdown on each type of bed rest:

Scheduled resting.
In the hopes of preventing full bed rest later, some practitioners ask moms-to-be with certain risk factors (such as multiples or advanced maternal age) to rest for a prescribed amount of time every day. The recommendation may be to sit with your feet up or lie down (better yet, nap) for two hours at the end of every workday or rest for an hour, lying down on your side, for every four hours that you’re awake. Some practitioners may ask you to simply shorten your workday in your third trimester and restrict activities such as exercise, stair-climbing, and walking or standing for extended lengths of time.

Modified bed rest.
With modified bed rest, you’re generally prohibited from working, driving, and doing household chores (now that’s something to celebrate!). Sitting up at your desk to surf the web is okay, as is standing just long enough to make yourself a sandwich or take a shower. You may even be granted one night a week to go out, as long as your outing doesn’t involve a long walk or any stairs. Women on modified bed rest may split their day between the couch and the bed, but going up or down stairs should be kept to a minimum.

Strict bed rest.
This usually means you need to be horizontal all day except for bathroom trips and a brief shower (a tepid bath is preferred). If there are stairs in your house, you’re going to have to pick a floor and stay there. (Some women will be allowed to make a roundtrip once a day; for others it might be once a week.) And your spouse (or your mom or a friend or the person you hire to help you) is going to have to make sure that the chores are getting done and that you have all you need to get by for the day. This may mean keeping a cooler or a mini fridge with breakfast, lunch, dinner, and lots of healthy snacks by the side of your bed.

Hospital bed rest.
If you need constant monitoring as well as IV drugs because preterm labor has already begun, you will be admitted to the hospital. And if your labor is successfully stalled, you may need to extend your hospital stay to ensure total bed rest. Your bed may even be positioned at a slight angle (feet higher than head) so that gravity can help keep your babies growing in your womb for as long as possible.

Move what you can. Talk to your practitioner about doing arm exercises each day (using light weights) to keep your upper-body muscles from weakening—usually allowed if you’re on modified bed rest. If you get the go-ahead, you can perform bicep curls, tricep curls, and overhead presses, all in a sitting position. Follow with stretching and shoulder rolls.

Stretch what you can, as much as you can. Also check with your practitioner about whether gentle leg stretches—flexing your feet and circling your ankles (without lifting them above hip level)—can be on the bed rest agenda. This can prevent blood clotting in the legs and may keep your muscles a little stronger.

Watch what you eat, and how much you eat. A significant dip in a mom’s appetite can lead to weight loss for her and a lower birthweight for her baby—so if you find yours slacking, fight back by grazing on nutritious, easy-to-digest snacks (high-fiber ones, like dried fruit, will also combat constipation). Of course, if you find yourself eating too much (out of boredom or depression), excessive weight gain might also become an issue—so keep an eye on nonstop nibbling, too, especially high-calorie nibbling.

Keep the fluids flowing. Staying hydrated is always important when you’re expecting, but especially on bed rest (getting enough fluids will minimize swelling and constipation, and possibly prevent contractions). So make sure your bedstand is stocked with water and other beverages.

Beat heartburn with gravity. More lying can spell more heartburn. Sitting up slightly in bed (if you’re allowed), especially after eating, will keep the burn at bay.

Keep your expectations realistic after delivery. Cut yourself some postpartum slack, factoring in all that your body has been through. You just won’t have the same aerobic capacity or muscular strength that you had before you took to bed, even if you were off your feet for just weeks. So give yourself a chance to recover, and plan on building back up to your former fitness level slowly. Walking, postpartum yoga, and swimming are good beginning activities when your practitioner green-lights exercise again.

Bed rest doesn’t just impact your physical well-being. It could also affect your sanity. To stay sane while you’re staying horizontal:

Reach out.
Keep the phone by your side, and let family and friends know they need to be on call for venting (or whining, or worrying, or giggling). Stay connected through e-mail as well (this is one of the many reasons why you’ll also want a computer by your side—or a laptop on your lap, or where your lap used to be). And don’t forget to visit websites and message boards, where you’ll meet other moms-to-be in the exact same shoes (or slippers).

Be prepared.
Anticipate what you’re going to need each day, and ask your spouse to gather it together for you before he leaves in the morning. Stock a bedside mini fridge or cooler with lots of water, fruit, yogurt, cheese, and sandwiches. Be sure the phone, magazines, books, and TV remote are all within arm’s reach.