Mind Body Medicine
Restless Leg Syndrome, involuntary twitching and tingling in the legs, can be a problem during pregnancy and a particular problem for Mamas on Bedrest. The increased weight as a result of pregnancy and the increased stress on the circulatory system are the major reasons that the symptoms occur. Restless Leg Syndrome is primarily relieved by changing positions and/or getting up and moving around-both options that are limited or non-existent for Mamas on Bedrest. Conditions such as pregnancy induced hypertension and pre-eclampsia often require that Mamas on Bedrest lay on their left sides to increase blood flow back to the heart from the lower extremities, relieving stress on the circulatory system. With this requirement, leg discomfort may be exacerbated with few options for relief. Restless Leg Syndrome can progress and become quite uncomfortable, limiting Mamas’ ability to rest. So how can Mamas on Bedrest manage this non-life-threatening but very annoying problem?
Massage. As previously stated in other posts, prenatal massage is an excellent way for mamas to relax tired, aching muscles during pregnancy. Because of the additional weight, mamas’ bodies shift to accommodate the weight and as a result, the musculoskeletal system shifts out of alignment creating stress on muscles, ligaments and tendons. Prenatal massage therapists are able to rub and soothe these tired, achy tissues and relieve tension, fatigue and pain.
Relaxation. Meditation, hypnosis and deep breathing can also help relieve the symptoms of restless leg syndrome. Calming the nervous system, relaxing the mind and relieving worry, stress and anxiety often relieve the tingling and twitching associated with restless leg syndrome.
Support your legs. Adequate support and positioning will go far to relieve leg pain and restless leg syndrome. A Must have for Mamas on Bedrest is a Body Pillow, and positioning that pillow to properly support and align Mama’s body is essential. View our video on pillow positioning for a better bed rest.
Stretch. As previously stated, movement is essential to helping relieve symptoms of restless leg syndrome, yet movement for Mamas on Bedrest is limited. There are several simple stretches that mamas can do while on bed rest and we provide them on our free video channel for easy access.
Water. One reason that leg cramps and other symptoms of restless leg syndrome occur is due to dehydration. Adequate water intake is a must for all pregnant women, but especially for pregnant women with restless leg syndrome. Adequate hydration ensures that circulation flows that muscles and soft tissues are well lubricated and that muscle wastes are properly flushed away. But staying hydrated can present an additional problem for Mamas on Bedrest in that the increased fluid intake will result in increased urination. Many mamas try to limit fluid intake which only increases leg cramps, symptoms of restless leg syndrome and can increase the risk of developing a urinary tract infection. Its a delicate balance, but mamas, be sure to drink plenty of water while on bed rest.
Vitamins and Minerals. Most pregnant women are prescribed prenatal vitamins, but many of these vitamins only provide the minimum amounts of vital nutrients necessary to sustain pregnancy and mama and baby may need more. There have recently been several studies and articles published documenting the functional amounts of vitamins and nutrients that are needed to ensure that mama is getting all that she needs to remain healthy, for healthy development of the fetus and to sustain the pregnancy. Mamas with restless leg syndrome may be low on potassium or calcium. While it is not advised that mamas take mega doses of vitamins, ensuring that there is adequate, functional levels of vitamins and minerals will help prevent some of the twitching and discomfort of restless leg syndrome. In addition to prenatal vitamins, mamas may want to add or increase bananas-a good source of potassium-and calcium fortified orange juice and green leafy vegetable (also good sources of calcium) to their diets.
Restless Leg Syndrome can be an annoyance, but it needn’t incapacitate Mamas on Bedrest. Implementing the few tips above can go along way to relief and a bed rest free from leg cramps, twitching and tingling.
Mamas on Bedrest & Beyond would like to thank Tammy Mahan for sharing the perils and pearls of Restless Leg Syndrome with us.
In this the second part in this brief series on cervical insufficieny/incompetent cervix, Bedrest Coach Darline Turner offers another potential cause of CI/IC- inflammation-and discusses the role of 17 Alpha-hydroxyprogesterone caproate (17P).
There are a myriad of reasons why mamas are prescribed bed rest during pregnancy. However, in the Mamas on Bedrest & Beyond community, having an incompetent cervix is by far the most common indication.
What is an incompetent cervix exactly? An incompetent cervix (or cervical insufficiency) is when the cervix does not remain closed and elongated during pregnancy, resulting in or putting a mama at risk for preterm labor.
So the first question a mama asks when she is diagnosed with an incompetent cervix is, “Why won’t my cervix stay closed? An incompetent cervix may be the result of,
- Previous surgery on the cervix
- Damage during a difficult/traumatic birth
- Malformed cervix or uterus from a birth defect
- Previous trauma to the cervix, such as a D&C (dilation and curettage) from a termination or a miscarriage
- DES (Diethylstilbestrol) exposure
But in a large number of situations, there is no readily identifiable reason for the incompetent cervix.
Kathleen Kendall Tackett, Ph.D., IBCLC, FAPAand her colleagues have indicated another reason for the incompetent cervix-inflammation. As a result of the inflammatory response, chemicals released into the bloodstream act on the cervix to soften it, cause it to shrink and essentially “ripen” in much the same way it would at term in response to the initiation of labor. But of course, cervical ripening in the second or third trimester before 37 weeks gestation has undesirable effects, mainly preterm labor, premature delivery or, sadly, miscarriage.
Why is the inflammatory response activated in pregnant women? The main reason that the inflammatory response is activated is stress. Stress or the “Fight or Flight” response prepares the body for battle, activating a series of physiologic changes that will aid the body in the event of trauma or injury. While the “Fight or Flight” Response is completely appropriate in the face of trauma or injury helping to mitigate the damage to the body’s cells, it is an excessive response to stress and/or depression, the common psychological reasons for stress.
Now many of you reading this may be saying, “I’m not stressed. I’m busy, I have a lot on my plate.” Exactly! “Having a lot on your plate”, excessive worry…They can all illicit a stress response and start what is called the inflammatory cascade- Neurochemicals released in response to stress, acting on the cervix to ripen it. When the cervix opens, shortens and thins before 37 weeks gestation, then preterm labor is the risk.
Treatments for incompetent cervix are bed rest, a cerclage (surgically stitching the cervix closed) and progesterone supplementation. The goals of the therapies are to relieve pressure on the cervix (bed rest), keep it closed (the cerclage) and to maintain cervical integrity and relieve inflammation (progesterone). Mamas may be prescribed any one, combination or all of the therapies for incompetent cervix.
I want to add one more vital therapy to the management of incompetent cervix-stress reduction! While bed rest may initially (and over the long term) actually exacerbate a mama’s stress, it is important that mamas do all that they can to keep their stress levels low. Low or no stress shuts down the inflammatory response and as a result, the neuro-chemicals released as part of the inflammatory response are no longer released and available to act to soften the cervix.
So what are the best ways to reduce stress? According to Mamas on Bedrest:
- Watching TV/movies
- Participating in community forums
- Talking with family and friends.
Mamas, do all that you can to reduce your stress. If you are put on bed rest, it may seem next to impossible not to worry. But worry, stress and anxiety work against you and your baby. Do what you can to calm your mind, open your heart and relax.
How are you staying calm while on Bed rest? Share your insights in the comments section below.