What to Know

• When and why bedrest is recommended
• How to cope – mentally and physically – with bedrest

The latest recommendations from the American College of Gynecologists and Obstetricians caution against the use of bedrest in preventing preterm birth due to lack of evidence that it does so. In addition, ACOG suggests that it may cause more harm than good, including increased risk for blood clots, weakening of bones and negative mental health implications. If your healthcare provider is suggesting bedrest, be sure to discuss your situation thoroughly, including other possible treatments and alternatives.

However, certain pregnancy complications such as high blood pressure (preeclampsia), a weak (incompetent) cervix, preterm labor, premature rupture of membranes, placenta issues or vaginal bleeding, can result in your doctor prescribing bedrest. The rationale being that resting in bed on your side will relieve cervical pressure, increase circulation to the placenta and increase the odds for a healthy pregnancy.

The amount of bedrest prescribed can range from intermittent to complete depending on the severity of your condition. Intermittent bedrest might involve lying down on your left side for 1 hour, 3 times per day and is commonly recommended for women experiencing mild to moderately elevated blood pressure. Complete bedrest typically involves staying in bed at a hospital at all times except to use the bathroom (or for very concerning cases, your mobility is fully restricted in which case you’ll have to use a bedpan). A pregnant woman with a premature rupture of membranes, for example, might be placed on complete bedrest.

Bedrest (and especially complete bedrest) can have negative physical effects, including muscle atrophy and weakness and potential bone loss from your drastic reduction in movement and activity. The psychological impact of complete bedrest is also not to be ignored – depression and increased anxiety from your separation from a support network, family, work life (and possibly income) and the inability to engage in normal preparations for the baby (like setting up the nursery or attending the baby shower) can take a serious toll.

What to Do

If your healthcare provider is suggesting bedrest, be sure to discuss your situation thoroughly, including other possible treatments and alternatives.

Engage in physical activity while in bed

Any physical activity (as long as your healthcare provider gives the OK) is important to avoid the muscle loss, increased swelling, weight gain, constipation and persistent feeling of sluggishness that can result from inactivity while on bedrest. Start small by periodically switching sides so you do not cause joint and muscle discomfort from applying pressure on one side only. Then try some simple exercises to maintain muscle tone, healthy circulation and a positive outlook. Here are some examples:

• Bedrest-yoga: stretch and flex your upper and lower extremities
• Knee bends: Bend and straighten each leg several times per day. Alternate between flexing and pointing your toes.
• Arm raises: Inhale and bring your arms over your head; exhale and bring your arms back to your sides. Repeat for a total of 10 times.
• Elbow bends: Extend your right arm straight up above your head and then bend the right elbow. With your left hand, press down on the right elbow to increase the stretch. Repeat on the other side.
• Neck rolls: Gently roll your neck in each direction to release tension and maintain range of motion.
• Shoulder rolls: Roll your shoulders forward for 3 rotations and then back for 3 rotations to release muscle tightness.
• Piriformis stretch: Place your right ankle over your bent left knee and pull your left knee towards your abdomen for a nice stretch. Hold for 10 seconds before switching to the other side.
• Arm and leg extensions: Extend your right arm and left leg and move them in small circles for 30 seconds. Repeat with the left arm and right leg.
• Forward bend: Take a deep breath, extend your legs and gently lean forward as you exhale.
• Wrist and ankle rotations: Extend your right arm and left leg and rotate your right wrist and left ankle for 30 seconds to increase circulation. Repeat with the left arm and right leg.
• Quad stretch: Bend your right knee and grab your right ankle to stretch your right quads. Repeat with the opposite leg.
• Isometric Exercises: Periodically squeeze a stress ball in your hands throughout the day. You can also tense your arm and leg muscles for 30 seconds and then release.
• Pelvic floor exercises or “Kegels”: Squeeze and release the pelvic floor muscles with your breath in a repetitive, rhythmic pulse. For example, squeeze for 1-2 seconds on your exhale, then release for 1-2 seconds as you inhale. Repeat with the next breath. Another variation is to squeeze and hold for 10 seconds and then release for 10 seconds. Try doing 5 of each type for a total of 30 pelvic floor muscle squeezes per day.

Maintain a healthy diet

Eat a healthy, high-fiber diet and stay hydrated while in bed to prevent excess weight gain and constipation.

You may be tempted to snack on junk food to treat yourself during bedrest boredom, but don’t give in to that impulse. Instead, reach for veggies, fruits, whole grains, and adequate protein intake to stay on the right track.

Keep your eye on the prize

It is normal to feel disappointment, stress, boredom, and resentment while on bedrest, but remember the great reward at the end of this journey – each day you are getting closer to holding your baby in your arms! Notice your baby’s movements and stay connected to his activity and growth. Let these positive feelings for your baby overshadow any negative reaction to bedrest. Know that your efforts are helping your baby get off to a healthy start. Bedrest does not last forever – you will get through it!