Monday, July 23, 2012

What is Modified Bed Rest?



The question came up at yesterday's morning session, "What is modified bed rest?" Modified bed rest is ordered by your obstetrician or perinatalogist to extend the gestation period. It is appropriate when there is some obstacle to completing a forty week pregnancy and staying off your feet may be all that is necessary to prolong your pregnancy. It is accomplished at home and it's up to you to follow doctor's orders. The problem is often that the doctor doesn't have time to explain what these new limitations are or how serious compliance is for the goal. We tend to think, " Bed rest at home? If it was really a problem, I'd be in the hospital. " And that's where the miscommunication can be particularly troubling.


Bed rest is ordered for a variety of pregnancy complications. It could be bed rest with vaginal precautions which means, no sexual intercourse. Often ordered early in a pregnancy when there may be unexplained bleeding. Makes sense to keep things out of your vagina i.e. tampons...... and to "lay low". May not save a pregnancy however it sure cuts down on the guilt factor. You are doing everything there is to do. 


Bed rest may be ordered temporarily after some procedures. Chorionic villus sampling, amniocentesis, cerclage and it makes good sense to also use vaginal precautions. Some times a woman has high blood pressure noticed at a prenatal appointment ( those appointments that you think are stupid because they last thirty seconds and no one does anything ). Simple bed rest, preferably on the left  side as much as possible is often all it takes to keep blood pressure within normal limits

Modified bed rest means to stay off your feet. In bed, on the sofa, in a chair with elevated extremities. You may get up to use the bathroom, take a shower, make a quick sandwich, brush your teeth. Then go back to staying off your feet. Drink a lot of water, that always seems to be the universal panacea. Modified bed rest means you may go to your doctor's appointments ( of course ), your private childbirth or lactation class, even  to your mom's, if you stay off your feet once you get there.


Modified bed rest doesn't mean that you should go to the grocery store to pick up a few things. It means you shouldn't go to the mall for those last layette necessities. You shouldn't go to the movies and you should  not go out to eat. Your shower may have to be postponed and may have to became a welcome the baby party. Sometimes a small shower can be moved to your house with you on the couch. 


Modified bed rest can be very challenging. Boredom is a terrible thing. Invite friends and family to visit you, but don't entertain. Let them do the moving around. Videos, books, magazines, ipods and iphones and notebooks and laptops are all allowed unless the doctor specifically says no to additional stress that may increase blood pressure ( like working at home ). Modified bed rest means no laundry and no cooking. No setting up the crib. You may be able to find a therapist for a pregnancy massage at home, perhaps a manicurist who makes house calls.


It doesn't mean just staying at home. It means resting. And it can make the difference between a prolonged hospital stay or the birth of a premature infant. It is serious. Even though it's at home, it's doctor's orders: bed rest. If you have doubts about what you are doing, you probably shouldn't be doing it. And if you have questions, you should call your provider. It's your responsibility.