preterm labor and prematurity
The bedrest debate continues as more and more studies are advocating treatment of the causes of bedrest in lieu of activity restriction. However, there are those that are convinced that bedrest is an effective treatment for preterm labor and prolongs pregnancy. Let’s take a look at the evidence.
For over 25 years, Judith Maloni, RN, PhD researched bedrest and found that the practice has no apparent benefit and has been shown to be harmful to pregnant women. Her publication, “AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth”(1), Maloni denounced the bedrest prescription because there was no evidence to support the practice.
In 2007. NASA released an article which showed that female astronauts in space lost bone mass and muscle mass and strength in as little as 2 weeks of inactivity, and the effects were even more pronounced at 60 days.(2) They recommended that if women do have to be on limited activity for an extended period of time, they should engage in a modified exercise program to maintain bone and muscle integrity.
The World Health Organization and Amnesty International have both denounced the bed rest prescription and have had sharp criticism of the United States-which boasts the highest costs of maternity care than any other country in the world, yet has some of the highest rates of complications, bed rest, interventions, cesarean sections and maternal and infant morbidity and mortality-to rethink their maternity care practices and to bring their maternity statistics in line with the rest of the world.
In 2013, physicians in the American Congress of Obstetricians and Gynecologists began questioning the practice of prescribed bedrest and Christina McCall, MD (3) and Joseph Biggio, Jr., MD (4) both called on their ACOG colleagues to stop the practice of bedrest citing the harm that is poses to pregnant women.
However, bedrest remains a mainstay in obstetrical practice. Here in Austin, the 2 major hospital systems each have large antepartum units which cater to women experiencing pregnancy complications. My colleague Angela Davids, founder of Keepemcookin.com, recently blogged about an article by Drs. Christine Piette Durrance and Melanie Guldi (5) in which the authors concluded after an extensive review of PRAMS (Pregnancy Risk Assessment Monitoring System) data of some 200,000 women, that limited inactivity does reduce preterm birth before 33 weeks by 7.7% and low birth weight infants (weighing less that 1500 grams) by 15.4%.
So what are mamas to think? Should they abandon bedrest? Remain on bedrest? Is there a way to not have to go on bedrest, to not encounter the complications that lead to the bedrest prescription?
At this juncture if you are a mama on bedrest, I WOULD NOT recommend abandoning the care plan that your provider has put into place for you. If you have questions about whether or not bedrest is necessary in your case, speak with your provider and voice your concerns. I am a firm believer that if you have hired (chosen) a provider for services, then you should follow their directions. Now if you are having reservations about being on bed rest, its efficacy and whether or not it is doing harm to you, you must have a candid conversation with your OB and get your questions answered so that you can make an informed decision.
I myself am a proponent of mamas getting off bedrest. I believe the way to do it is to help women to be in the best shape BEFORE they ever think about getting pregnant so that when they are pregnant they are strong and healthy. Many of you reading this may be saying, “Well fat lot of good that does me now!” I sense your frustration. There is nothing we mamas on bedrest do better than second guess ourselves! But what you did in the past (no matter how recent) is of no consequence. As Dr. Maya Angelou eloquently said, “When you know better, you do better.” You know better right now, so begin taking exquisite care of yourself right now! As much as possible,
- Eat healthy, nutrient dense foods.
- Drink lots of water (1/2 your current body weight but in ounces).
- Rest (I know that sounds ridiculous, but many mamas on bedrest are so stressed out they don’t sleep well and don’t rest. Your body is not only maintaining you, it is also growing another fully complete human being. That most certainly deserves a nap!
- Do stretches t keep your muscles supple and limber. (BedrestFitness!)
- Keep your spirits up
I don’t know what is to become of bedrest and the bedrest prescription. I do know for the nearly 1 million women who will experience bedrest, you have to take care of yourself. If you are in the Austin, TX area, look me up! I always enjoy mixing with mamas and would be happy to serve you.
How are you surviving bedrest? Share your tips and comments section below.
Judith Maloni, Ph.D. AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth (Biological Research for Nursing 12(2) 106-124)
Mark Ransford. NASA-Funded Study finds Exercise Could Help Women on Bedrest November 15, 2007
Christina McCall, MD, “Therapeutic” Bed Rest in Pregnancy, Unethical and Unsupported by Data”, vol 121, No.6 June 2013, 1305-1308
Joseph Biggio, Jr., MD.“Bed Rest in Pregnancy, Time to Put the Issue to Rest!” vol 121 No. 6, June 2013, 1158-1160
Christine Piette Durrance and Melanie Guldi. Maternal Bedrest and Infant Health.
Good Morning Mamas!!
The Austin/Round Rock March of Dimes March for Babies was this past Saturday, March 9th. It was a wonderful event with over 6000 participants here in the Central Texas area. There were several corporate groups, hospital groups, families and yes, little ole me, representing Mamas on Bedrest & Beyond. It was fun to be out mingling with all the families and learning about what is being done by the March of Dimes to support families of Preterm infants. It was also really interesting to hear the stories and as you’ll see, meet beautiful little ones who fought tenaciously and made it! It is also very sobering to meet families who are walking in memory of their precious babies.
When I was leaving the event, they announced that this particular walk had raised about $280,000, but there were still monies coming in so that number is sure to climb. How fantastic for Central Texas families! I also know that a few other Mamas on Bedrest were walking in their areas. Former Mama on Bedrest Parijat Deshpande was walking out in Silicon Valley California with her family as the Ambassador family for that particular walk. Charisse Mora Medina was (or will be) walking in Southern California. I also know that KeepEmCookin and Better Bedrest both support the March of Dimes March for Babies in Maryland.
I also want to take a moment to thank those of you who graciously donated to our March for Babies campaign. We raised $205 dollars for the Central Texas March for Babies and I am very grateful for your support on behalf of Mamas on Bedrest & Beyond.
And just to give you a little taste of what the walk was like, I collected the photos that I took into a short video montage. Enjoy!!
Great News! “Former” Mama on Bedrest Parijat Deshpande and I are teaming up to bring you this month’s tele seminar, Bust Out of Your Bedrest Blues. As some of you may recall, Parijat is a clinical psychologist who specializes in dealing with the stress of infertility, high risk pregnancy, prematurity and family stress. A few weeks ago, she graciously joined me for an interview to describe her method for helping mamas deal with stress around high risk pregnancy and bed rest. Well, we both had tele seminars scheduled to address tips and techniques for dealing with Bedrest Blues. When we realized that we were both going to be talking about the same thing, we decided to come together and have one big open conversation.
So Mamas, join us for a frank and informative discussion and Bust out of Your Bedrest Blues!!
NOTE: This seminar will serve as the Third Thursday Teleseminar. The live tele seminar will be on Wednesday, March 18th, 2pm ET, 1pm CT and 11am PT. Click here to register and to receive call in information.
For those of you unable to attend the live tele seminar on Wednesday, March 18, 2015, the recorded tele seminar will be available on Thursday, March 19th. If you have a question and cannot attend the live tele seminar, or don’t want to submit your question live, feel free to submit your question to firstname.lastname@example.org and Parijat and I will answer your question during the call.
This is a unique opportunity to have two experts at your service to answer your questions about bed rest and the stress associated with bed rest. Don’t miss out! Submit your questions and join us on Wednesday, March 18, 2015, 2pm ET, 1pm CT and 11 PT.