Healthy Pregnancy Series: Bed Rest

Last week, we talked about pregnancy complications.  And we noted that for many women, complications are just concerns that could go wrong, but usually don’t.  But for some women, those concerns are severe enough that they need to be on bedrest for part or all of the pregnancy.  What might cause a doctor to recommend bed rest?  What does “bed rest” really mean?  And what do you do if you have a job or other children?

Generally, a doctor will put you on bedrest if you have the following problems:

• Threatened miscarriage
• Pre-term labor
• High blood pressure that only resolves with rest
• Constant exhaustion/difficult pregnancy

The first two are the most common.  But, if you’re not feeling well and constantly need to call or see the doctor because something’s just not right, the doctor may recommend bed rest.  The first two are also the most serious.  Both usually end after the threat has passed (so, the end of the first trimester or a couple weeks after a threatened miscarriage; and once you reach 36 or 37 weeks or “full term” for preterm labor).

What Does “Bed Rest” Mean?

Well, this varies widely!  If you are, for example, having Braxton-Hicks (practice contractions) often when you are too active, your doctor may simply ask you to be less busy and spend more time with your feet up, and definitely stop if you start to feel an increase in contractions.  This could be very minor “bed rest” — “just don’t do too much activity.”

Other women may need to spend so many hours per day resting, or even actually in bed, but may be permitted to get up briefly to go to the bathroom, get food, or help with children.  Some women who are mostly in this boat (without any severe symptoms) and have other children may choose to spend most of their days on the couch, but otherwise get up as do the household chores and childcare as needed.

A few women are in such serious conditions that they require hospitalization and total bedrest — no getting up for anything (except maybe to use the bathroom).  They cannot care for children, they cannot prepare meals, they cannot do chores.  They are required to stay in bed all the time, whether they are at home or the hospital.  This is usually used in cases of stopped pre-term labor, early water breaking (like at 32 weeks, way before baby should come), or pre-eclampsia that has gotten bad.  Sometimes, in these cases, bedrest only lasts a few days before the baby has to be born, ready or not.  Other times it can last for weeks, while the baby grows and develops as much as possible.

So, bedrest can vary depending on what your needs are.  Make sure you discuss your situation with your doctor to find out how serious it is and how much you really need to rest.  A lot of women who work or have other children are very concerned about bedrest because it is not easy to just “drop everything” when you have other responsibilities!

What Do I Do if I Work or Have Kids?

Honestly, it’s actually an easier situation if you work but do not have kids.  You may have been at your job long enough to have built up some sick or vacation time, and you may just be able to start your maternity leave early.  You may be able to take an unpaid leave of absence if you haven’t built up the time.  While this isn’t ideal, since you don’t get paid, it’s an option if you truly need it.

Some women may be able to work from home, if they are able to sit up in bed and use a laptop.  This can be a great option for some women.

Other women, who have been at their jobs for at least a year and work in companies with at least 50 employees, can use FMLA (Family Medical Leave Act) in order to take a leave of absence from their jobs.  This may be paid or unpaid, depending on your company’s policies, but FMLA does not specify or guarantee pay.

If you have children…things may get tricky.  You’re on 24/7 and your child can’t just “go away” for awhile.  Luckily, there are several options:

1. Ask if you can care for your child from bed.  If you can get up for a few hours a day, this might be enough to do what needs to be done.  You can simply have your husband bring you easy snacks, toys, and diapers so that you don’t need to get up to entertain or change your child.  Older children (3 or so) are also great at fetching diapers, toys, and small snacks for you.  Then, spend the time while you can get up to cook a couple easy meals, put the child down for a nap, etc.  You can also try to spend a lot of time resting on a couch in your children’s playroom.  Use the TV, too — when you are sick, it is your friend!
2. Ask if friends or family can come to help you.  If you have friends or family nearby, perhaps they can stop in a few times a week to bring you meals, do a load of laundry, or take your children while you nap.  If you cannot get up at all, perhaps a family member would even be willing to stay with you for awhile to take care of things while your husband is at work.  In some cases, older children could even go stay with Grandma for awhile.
3. See if your husband can work from home and/or take some sick/vacation time.  Perhaps your husband has a job that can mostly be done over a computer.  Maybe he can do that from home for now so that he can help take care of you and your children.  Or, maybe he could take a day or two off every week, or only work mornings for awhile so he can be home as much as possible to help.
4. Hire a mother’s helper.  If you can find a teen nearby who is homeschooled (ideally), maybe he or she can come over for a few hours a day to help take care of your children.  Some might even be willing to do chores, but in most cases this would be left to your husband.  (The reason it’s better if the mother’s helper is homeschooled is so they can come in the middle of the day, when you’ll need help with getting lunch, putting kids down for naps, etc.  Others could come in the late afternoon afterschool but by then your husband is probably coming home soon anyway.)
5. Hire a doula.  Yes, you may only be familiar with birth doulas.  But there are postpartum doulas, too, whose job it is to take care of other children, help out around the house, etc.  Hire one to come in a few hours a day to take care of the things you can’t do.  They do work with mothers before the baby comes in situations just like this!  Your insurance may even cover it, if it’s a medical necessity.

Of course, if you’re in the hospital, many of these options are negated.  In that case, you will need to either temporarily place your older children in daycare so your husband can continue working, or he will need to take time off to care for them, or you’ll need a family member to stay with them.

Bedrest is not easy.  But when you’re talking about your health and that of your baby’s, you have to do what you have to do.  With support from family and friends, you will get through this difficult time and it will be well worth it on the other side!

(And a small note: even if you do have to be on bedrest in one pregnancy, it does not mean you will always have to.  I know one woman whose water broke at 32 weeks and was hospitalized until her baby was born at 35 weeks.  Her second baby, she carried to 40 weeks with no problems.)

Have you ever been on bedrest?  How did you handle it?

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