(published in American Baby, May 1994)
RX: Bed Rest
By Theresa Jarosz Alberti
When I became pregnant, the idea of bed rest was the furthest thing from my mind. I was healthy and felt fine. I’d never even known anyone who had been put on bed rest. But in my 24th week of pregnancy I went into pre-term labor, and was confined to my bed on doctor’s orders. During my weeks of bed rest– one week at home and six weeks in the hospital– I found I was not alone; the antepartum unit (for hospital bed rest) was surprisingly busy during my stay.
Lying down and getting all the rest you want may sound like a dream come true. I had several visitors tell me they’d gladly switch places with me. But I knew that after a day or two of being uncomfortably pregnant, with tubes and monitors attached to their body, legs aching from inactivity, hospital food to eat and nothing on TV, they’d be dreaming of switching back!
One out of every four or five pregnancies is labeled “high risk,” which means the possibility of complications is higher than normal. This translates into roughly one million women in the United States who are likely candidates to spend some time on bed rest.
Since I was pregnant with twins, I was considered high risk for a number of complications. One occurred in my twenty-fourth week: preterm labor. Bed rest, combined with medications, enabled me to carry my babies to 31 weeks. Even though they arrived two months prematurely, my son a daughter had few difficulties and came home one month after they were born.
Bed rest makes sense: while lying down, your body focuses on your baby, since you no longer need much energy for your activities. The flow of blood and oxygen to the baby is best while you’re lying down on your side, and babies often gain weight faster when their mother is on bed rest. Also, your body doesn’t have to deal with the sometimes harsh effects of gravity. For a pregnancy with complications, these changes can make a world of difference.
What does bed rest mean?
It’s important to get detailed answers from your doctor concerning your situation. After all, there’s more to bed rest than just lying down. Ask:
Where am I able to spend my time? If your complications are minor, you may be able to stay at home. When IV medication is needed or the complications become threatening, hospitalized bed rest will be necessary. In my case, I was originally put on bed rest at home and given oral medication, because I was only one centimeter dilated. One week later I dilated further and intravenous medication was needed to stop further dilation, so I had to be admitted to the hospital.
How should I lie? You may be allowed to sit up partially or may have to lie on your side with your head elevated.
How long will bed rest be necessary? Some women are on bed rest for only a few days; others, for weeks or months.
Will I be given medications? Your doctor will certainly discuss your need for them; find out how they may affect you physically or emotionally.
How often or at what times can I get up? Trips to the bathroom, daily showers, and eating meals at the table may be permitted—or not. If you have young children at home, you may not be able to comply with bed-rest orders. This, too, you should discuss with your doctor.
My husband reacted to my being put on bed rest by channeling his concern into creating the perfect bed-rest environment for me. His creative worry paid off in a more pleasant experience for me.
Give some thought to where you can most comfortably spend your time on bed rest. If you’ll be at home, the living room sofa, a day bed and the bedroom may all be options (depending on your doctor’s orders). Consider how you could rearrange each area, or what could be brought in, to creative the most pleasant and convenient space possible.
Carts, low tables, tray, or shelves will keep things handy and provide space for working and eating. You’ll want a phone with a long cord, and a chair or two for visitors. Don’t forget entertainment equipment: a TV and VCR with a remote control, a tape or CD player, and a radio. Such items are necessities for you on bed rest, for entertainment and also to help you feel connected to the outside world.
If you’ll be alone during the day, have someone prepare a cooler of food for you daily. Keep this, along with pitchers of water and juice, near your bed or sofa. Keep hot water in an insulated container for instant coffee, tea or cocoa.
If you’ll be on bed rest in the hospital, think creatively about that space, too. Request extra bed trays to keep things handy. Take comfort items from home: bathrobe, pillows (with extra pillowcases), slippers, a fancy water pitcher and drinking glasses, nail polish and files, perfume and scented soaps, and framed pictures of your family. You may also want your own nightgown, although bed rest can be messy. My abdomen was slathered with conducting gel several times a day before monitors were attached, and I found it hard to eat neatly when lying down. So you may prefer hospital gowns.
For entertainment I had a VCR hooked up to the room, TV, a tape player, radio and portable CD player. You may be able to borrow a VCR from the hospital.
Here are some additional ideas for the hospital or at home:
–Lying down will be more comfortable with lots of pillows.
–For additional comfort and to avoid bed sores, us a foam “egg crate” mattress on top of your mattress (available at medical-supply stores, or your hospital may supply one). A bolster is helpful to support your back, you must lie on your side. You can make one by using masking tape to hold four rolled blankets.
–A laptop desk, a clipboard, or a cookie sheet taped to a pillow will make writing easier.
–If you worry that your husband or birth coach might be hard to reach when needed, rent a pager (available from many hospitals). Because my husband isn’t always near a phone, I often used the pager, even in non-emergency situations, to reach him.
Bed Rest and Them
As difficult as bed rest is for you, don’t forget that it also affects the others in your life. Your husband has now taken on the triple burden of caring for you, the entire house, and still working full-time. He is undoubtedly under stress, not to mention extremely concerned for you and the baby. Be kind and don’t take him for granted. Show your appreciation by doing something special for him. Send a card or love letter to his office, buy tickets for him and a friend for a night out or ask a friend to take him out for an evening.
If you have children at home, this time will be difficult for them. Depending on their ages, they may not even understand why “mommy can’t get out of bed.” If you’re bed resting at home, make space for children in your room by placing tables and chairs near your couch or bed. Have games and toys there, or make up a second bed rest spot for you in their play room. Some mothers have the impossible situation of caring for very young children while bed resting. If this is you, realize that you may be forced to get up for them now and then (but avoid it as much as possible). Plan activities to keep them busy by your side and get any outside help you can.
If you’re in the hospital, call your children often, write them letters and let them visit. Sending home tapes of you reading their favorite stories is often a comfort for younger children. If older, allow your children to feel “part of the team” by discussing how much their help is doing for the family, or talking about the new baby with them.
In times of trouble, people often want to reach out a helping hand. If anyone asks how they can help, never say, “no, thank you.” You and your family are in a difficult situation, and soon you will have the challenge of a new baby to care for. There is plenty to help with… a hot meal for your husband, taking the kids for an afternoon, housecleaning, yard work, laundry, etc. Accept help guiltlessly. Wouldn’t you do the same for them? Let them do it for you.
For hospitalized bed resters, one final group of “others” to consider is your medical staff. On hard days, it’s easy to take out your frustrations on those nearby. While no one expects you to be Ms. Sunshine, be as polite as you can. These people will be by your side for the next days, weeks or months. They can make your life more comfortable, and they will be more apt to give you the respect and care you deserve if you return that respect. Also, if for any reason you are uncomfortable with the care you’re receiving, talk to your doctor or one of the lead nurses. You are a paying customer.
Taking Fun Lying Down
Bed rest can be boring. Especially when time looms out before you, weeks and months to stay in your bed. You can spend the entire time feeling sorry for yourself– that’s an option. But you can also use your creativity to make this as pleasant as possible. Think of how many times you’ve said to yourself, “If only I had the time…” Now you do.
Getting outside is a real morale booster. Discuss this option with your doctor. If you’re in the hospital, ask if you can have a half-hour wheel chair ride. Getting outside in the warm summer air always made my day. If you’re at home and it’s nice outside, have someone set up a lawn chair in the yard and spend the afternoon there. When your entire world is reduced to one room, being outdoors can make you feel whole again. Take any chance you get.
A TV and VCR are good, convenient sources of entertainment that can also help you feel connected to the outside world. If you don’t have cable, consider subscribing for the period you’re in bed to have a little more variety. Have someone rent video tapes for you or borrow from a friend’s collection.
Learn a new craft, or practice one you already know. While I’m not big on crafts, I learned cross-stitch and enjoyed the productive feeling of finishing baby bibs while watching TV. If you’re in the hospital, ask for the occupational therapy staff. Their job is to keep you “occupied,” so they can teach you a craft and supply you with projects. One roommate of mine industriously finished a baby step stool– sanding precut wooden pieces, painting and varnishing it, all while laying in bed! If you’re at home, find someone who can teach you, or learn the craft from a book or kit. Try rug hooking, make Christmas gifts, learn to draw, paint by numbers…
If you enjoy reading, catch up on all you’ve been meaning to read. Read books, magazines or the entire newspaper. Try books by one author, books in a series, books that will help your career. Borrow books from friends, have someone buy them, or phone the local library and see if they deliver to the homebound. Don’t forget books on tape (great while working on a craft project). Having someone read to you can be nice as well.
How about all those letters you’ve been meaning to write? Write letters to old friends, far away relatives or letters to the editor. Writing in a journal can help get your feelings out. Write a letter to your unborn baby. Write a love letter to your husband. Write thank you’s now for any gifts you’ve received.
Have your partner set up a special “date” once a week. Whether you’re in the hospital or at home, have him pick up some special food, bring candles and sparkling grape juice. Or try a picnic lunch. You can watch a movie together, snuggle together as best you can, play soft music, or just talk.
Another possible activity is working from home. Many jobs can be accomplished with the aid of a lap-top computer and a phone. Since stress can often be work-related, such an option should be discussed with your doctor.
If you’ve tried all the previous and are still bored: get someone to play games with you, learn a foreign language, have your hair cut, put on makeup, blow bubbles, color with crayons or markers, organize a photo album, or enter every contest that is advertised in magazines or on cereal boxes. You might win!
Handling the Hard Days
A friend of mine sent a small pile of gifts with instructions to open one gift every other day for a week. At that time I’d been in the hospital nearly a month and was having many hard, tear-filled days. I looked forward to opening those small trinkets just like it was Christmas. This friend knew how to blast the bed rest blues away.
One way to handle hard days is to add morale boosters to your daily routine. Give yourself something to look forward to (little things can mean a lot). Paste a wall full of yellow post-it notes, one for each day on bed rest. Rip one off each day and smile as the mass grows smaller. Or get a large calendar so you can cross the days off.
Plan weekly rewards. Passing into another week is a real accomplishment, so treat yourself. Slice a favorite cake into sections, one for each upcoming week of bed rest. Wrap and freeze the slices, then every week defrost a slice and eat it as a special dessert.
Flowers or balloons bouquets are a cheap way to brighten your room and can really lift your spirits. Order some for yourself.
Moral support from current or former bed resters is important– such women truly understand. If there are other bed resters in your hospital, see about getting together, or at least get their phone numbers so you can talk. When I was in the hospital, we had a meeting of five bed resters, all wheeled down to the family lounge for our “antepartum club.” There are also bed rest support organizations in some cities. Find out from the hospital staff or your doctor if there’s one in your area.
If you’re short on visitors, notify your church that you are on bed rest and going through a difficult time. Most will send out visitors and offer whatever support they can.
If you’ve tried all the previous and are still depressed: call someone, read cartoon books, rent a funny movie, or just cry. Sometimes you just need to get it all out.
Keep in mind that even the hardest of days can be turned around with a little forethought. My hardest day of bed rest was when my sister got married and I couldn’t attend. While heartbroken, I didn’t want to spend the day crying. Instead, I asked a friend to pass the day with me; we talked and ate special food. On my request, the wedding party came out to the hospital for a brief visit, and my husband videotaped the day’s festivities. I actually have pleasant memories of that day. If you find yourself in a similar situation, consider the alternatives. If it’s a holiday, birthday or shower, perhaps you could have the event in your hospital room or home. If that’s not possible, plan your own special day and have someone videotape the event (cameras can be rented from video equipment stores for reasonable rates).
The best news about bed rest is that it does end. The days, weeks and months will pass, you will bring your baby home and your life will be full again. In my blackest moments, when my hospital stay seemed endless, people would tell me, “When you hold those two healthy babies in your arms, it’ll all be worth it.” I’d nod my head but I really wasn’t sure.
Now I can look at my toddling one-year olds and the pain of those bed rest days has faded. I see bed rest as one of my first gifts to my children. And yes, it was worth it!
PREVENTING PREMATURE BIRTH
Every year, 9% of women giving birth in the United States experience preterm labor leading to premature birth. Unfortunately, babies born more than three weeks before their due date can have serious problems breathing, eating and keeping warm. The good news is that any woman who knows the signs and symptoms of preterm labor and monitors herself for them daily has an 80% chance of avoiding premature birth. Should you experience any of the following, notify your doctor immediately.
*A sudden increase or change in vaginal discharge.
*Any vaginal bleeding.
*Five or more contractions in an hour. (Be aware that contractions may not be painful; some involve only a tightening and relaxing of the uterus.)
*Menstrual-like cramps or pelvic pressure.
*A low, dull backache that doesn’t improve with rest.
*Persistent diarrhea or intestinal cramps.
*A general feeling that “something is wrong.”