Article Re: Bed Rest not recommended or effective?? Wanted to share.

kristin172429

Did you see this in Parenting.com?  I thought it was fascinating.  You hear so much about people being put on bedrest, but rarely do you hear that it is not a recommended treatment and has no studies proving it effective!!!  Really surprised to read this.  

**Disclaimer: I am not questioning any treatment provided by any doctor - I know a lot of people on this board are on bed rest.  I just wanted to share the information! 

Here is a quick excerpt from the article:

" Though 90 percent of obstetricians prescribe bed rest to women with complications that increase the risk for preterm labor, such as high blood pressure, carrying multiples, and vaginal bleeding, no solid studies have ever shown that it's an effective treatment. In fact, according to the American College of Obstetricians and Gynecologists (ACOG), "bed rest does not appear to improve the rate of preterm birth and should not be routinely recommended." And yet, doctors continue to do so to nearly 700,000 expectant patients -- about one in five -- each year."

https://www.parenting.com/article/is-bed-rest-bunk-21333669?page=0,0&cid=preg-newsletter-week27d3-bullet1 

easjer05

I've been told that by numerous doctors, but it is disingenuous.  There are no studies, because they find it difficult to get volunteers for such studies.  Would sign up for a study that put you in a normal activity group if you'd just been told that you were high risk for pre-term birth?  Or had high blood pressure?  Or a shortening cervix?  It's unethical to perform such a study to correct scientific standards, so most studies in this field are retroactive case studies, and those are limiting. 

How one defines pre-term birth is also limiting.  I assume ACOG is defining as any birth between 24 and 36w6d.  Obviously, that will include a huge number of births, but there is a difference between a birth at 28 weeks and 35.  And there is no good way to prove from a case study that bedrest got someone from 24 weeks to 30 weeks.  Still a pre-term birth - but probably a huge difference to the future health of the child.

The condition for which one is bed-resting also plays a role.  It is unlikely it would be helpful in a shortening cervix, but it possibly might in an opening cervix (there is a difference).  Less activity is proven beneficial in high-blood pressure patients and can make a difference in bleeding for women with partial or full placenta previa in late term.  The article doesn't differentiate between the causes for bedrest, and makes the excellent point that 'bedrest' is a loosely defined term meaning a variety of things between patient and doctor.  For some, it's limited activity and resting with feet up at home, for others, it's bedpans and bed-showers.

True, there are drawbacks to bedrest, unquestionably.  But to dismiss it fully on the basis of there being no scientific proof is foolhardy, imo.  A previous OB told me when I had extreme bleeding that there was no point in bedrest then, and I think he was right.  I was passing clots whether I rested or no.  But my peri was clear that the less activity I undertake now, the longer he expects me to be able to avoid full bedrest.  I'm very restricted through the remainder of my pregnancy at this point.  But it's a lot better than having to stop work early and not being able to get out of bed, so I put up with it.

KShiz

Yeah, I'm hanging onto the idea (like easjer05 said in her reply to my post below), if something "bad" does happen, I'd rather know that I did everything possible to keep the baby inside than ever wonder IF I could have done things differently.

When my water broke @ 35.5 weeks w/ my DD, it was as I was climbing back into bed after getting up to go to the bathroom. I had gotten into bed on my hands and knees and then twisted onto my side, it was the pressure of the "twist" that broke my water. Now, who knows whether if I hadn't twisted, maybe my water wouldn't have broken? Maybe I would have made it one more day? One more week? Needless to say, I'm walking on eggshells now that I've had that experience regardless of what an article says.

kthappy76

I have read about this too and have been told the same by both OBs and MFMs. 

My OB is conservative and knowing what we've been through to get and stay pg and that a small stitch is the only thing keeping me that way, even given the inconvenieces and real physical and mental toll of long term bed rest, we are not in a position to question that it may not actually be helping.  We do know it isn't hurting us more than losing our babies would.

MotherMonster

I'm with the previous poster over the studies and those being unethical...however my stand point is also gravity is a law...No one can change gravity unless we go into space or live in a simulator. I'm at high risk for pre-term labor and that's what I say and I'm sticking to it!

OfficiallyHollyC

I'd rather not take the chance. I credit my stint on bedrest with producing a happy healthy baby boy. I was actually bothered by a Dr at my practice who did not want to follow my primary Dr's orders for bedrest. I requested not to be seen by her again. I prefer being overly cautious.

firstmom2b

Seems like it's just a newer recommendation, and so there just isn't the scientific evidence to back it up yet.

All I know is I'm pretty darned sure my contractions were triggered by physical activity and now one week into bed rest, I'm feeling progressively better. If a muscle relaxant can stop contractions, I don't see why bed rest wouldn't be beneficial in the same way! : ) 

Now, my doctor tells me that if I'm meant to go into preterm labor, I'm going to - no matter what. It's a little confusing. It's almost like there are two separate issues - pre-term labor that just happens, and then pre-term labor that can be triggered from environmental factors? Regardless, if contractions can affect your cervix - don't see how minimizing them could be a bad thing. Relaxing does seem to help with that.