Surviving bed rest
Pregnancy, while one of the most joyous times in a woman’s life, is also one of the most physically and physiologically stressful times. There is no doubt in anyone’s mind that pregnancy fundamentally changes a woman’s body; some women will gain as much as half of their pre-pregnancy weight during their pregnancies. Others will develop gestational diabetes, pregnancy induced hypertension or, in more severe cases peripartum cardiomyopathy (enlargement of the heart) or kidney failure. During pregnancy, the body increases its blood volume by 50 to better be able to nourish the growing fetus and maintain mama. Most women will “sail” through their pregnancies, labors and deliveries, have healthy children and will “live happily ever after”. Others won’t be so lucky and they or their children will perish from primarily preventable forms of heart disease.
Cardiovascular (heart) disease is a leading cause of death in the United States. A recent article published in Obstetrics and Gynecology reports that researchers in Illinois found that from 2000-2011, nearly 20% of all maternal deaths were heart related, Here is what they found:
- Most of the deaths occurred in the third trimester or within 6 weeks of the post partum period.
- Most of the heart related problems happened in women ages 30-39, while the most severe cases occurred in women over 40.
- Cardiomyopathy (enlarged heart)in pregnancy is a rare cardiac occurrence, is almost exclusively caused by pregnancy and occurs more often in young women, 20-29 years.
- Death from cardiomyopathy is more likely to happen in very young women, less than 20 years old.
- Black women have significantly higher rates of pregnancy related heart disease compared to White or Hispanic women.
- 28% of all of the deaths were potentially preventable.
Yes, you read that last bullet point correctly. Twenty eight percent of the cardiovascular deaths that occurred during or just after pregnancy in the Illinois report were potentially preventable deaths! So what should you, as a Mama on Bedrest do to protect her heart?
- Schedule and maintain your regular prenatal visits. Early detection and early action are the hallmarks of treatment success for any disease, but especially cardiovascular disease during pregnancy.
- Notify your health care provider immediately if you notice any heart palpitations, difficulty breathing, unusual swelling in the hands, feet, face, changes in urine output. Now this may be difficult as you are likely experiencing all of these symptoms as a result of your pregnancy. Suffice it to say that if you have an increase in any of the symptoms or if they suddenly occur where they didn’t previously exist, then consult your health care provider.
- INSIST ON FOLLOW UP AFTER YOU HAVE YOUR BABY!! One of the key points that came out of the points that came out of the Illinois study is that most of the heart disease related deaths occurred after 6 weeks post partum. Many women have their post partum follow up visits with their obstetricians and then don’t return for a year or unless there are other issues. If you had a problem, even a minor problem during your pregnancy, FOLLOW UP FOR UP TO A YEAR POST PARTUM. Many conditions will “flare” with the fluctuation of hormones during the post partum, i.e. get worse, so you want to be closely monitoring for symptoms.
It is imperative that mamas receive comprehensive care of cardiac problems and are fully treated to avoid-or at least mitigate-heart problems in the future. Thankfully not all mamas who have heart problems will die, but many will have life long problems as a result of incomplete care. Be sure to have ongoing follow up and let all subsequent providers know that you experienced heart problems while you were pregnant.
The authors also note that providers must do a better job of
- educating their patients about the signs and symptoms of cardiovascular disease
- referring patients immediately to specialists when problems occur
- continuing to monitor their patients’ conditions well into the post partum period, as long as a year post partum.
As this article clearly states, death from cardiovascular complications is very often preventable. Patients and physicians alike must be aware of the signs and symptoms of cardiovascular disease and both must have a low threshold for seeking evaluation; patients from their obstetricians, physicians from their specialists colleagues. Finally, it is imperative that women who developed cardiovascular symptoms during or just after pregnancy be evaluated for an extended time in the post partum, often up to one year post partum.
What is it like to have a pregnancy related heart problem? Hear a mamas story.
Have you experienced a heart problem during your pregnancy? Please share your story.
If you have more questions, email firstname.lastname@example.org
Lately I have been bombarded with messages and e-mails from Mamas on Bedrest seeking for financial help. I hear you and I so wish that I could help. Unfortunately, Mamas on Bedrest & Beyond was never designed to provide financial assistance to families in need.
This is not a new issue. Mamas on Bedrest & Beyond has been a staunch advocate of paid family and maternity leave since its inception. We have traveled to the halls of congress with other family leave proponents to petition legislators to pass a paid family leave bill without success. To date, The National Partnership of Women and Families, MomsRising and others continue to press for paid leave, and while we have gotten close, there still remains no uniform, national paid family leave for new parents. Thus the United States has the dubious distinction of being the only industrialized nation on the planet not to offer paid family/maternity leave to its citizens. In terms of countries with medical leave benefits, we rank approximately 168th out of 172 nations that offer medical leave benefits. The only other countries without paid leave policies are Lesotho, Swaziland and Papua New Guinea. Thus the United States, one of the richest nations on the planet, the nation that spends more for health care than any other nation on the planet continues to have birth outcomes and overall health outcomes that rival those of developing nations without technological resources. It is a sad state indeed.
The Family Medical Leave Act is the best that we have and that has its restrictions. Passed in 1993, FMLA allows an employee to take up to 12 weeks of unpaid leave to care for a family member or for the employee to undergo treatment for illness and continue to have healthcare coverage during this time as an employee benefit. But there are some caveats. First, FMLA does not apply if you work for a small company with less that 50 employees. For companies larger than 50 employees or electing to enact FMLA, if an employee is out beyond the 12 weeks, the employers is not obligated to keep them as employees and many people have lost their jobs due to prolonged illness and absence. Additionally, while employers may be required to keep you on as an employee, they are not required to keep you in your same position or at your same salary. So after your leave, you may return to your place of employment but not to your same position.
Some individual companies have elected to offer their employees paid medical leave. This is a very individual decision and one that is not at all regulated. If your employer offers a paid leave benefit, you need to contact the human resources office to see what the rules and stipulations are regarding the paid leave. You will want to ask if there is a minimum amount of time you have had to be with the company in order to be eligible for the benefit as well as ask if you have to be a full time, salaried/exempt employee.
What else can Mamas on Bedrest do? How is a mama supposed to go on bedrest, rest, relax and calmly gestate her baby when she is filled with anxiety about her family’s finances? There are a few things that mamas can do that may help their financial situations. We offer these suggestions:
- Learn the laws and regulations governing paid leave for your state. Three states, California, New Jersey and Rhode Island, offer paid family and medical leave. All three states fund their programs through employee-paid payroll taxes and are administered through their respective disability programs. Other states and counties have various medical leave laws, so visit your state, county and local webpages to see what your area offers in the way of medical leave.
- Check with your state’s labor office. Some states have a disability program and take a portion out of your paycheck for this program. If this is the case, you may be eligible to apply for benefits. Often the benefit is a percentage of your pay, say 60%, but isn’t 60% of your salary better than nothing? These programs also have various rules and regulations so check with your state labor office for complete details and to learn how to apply if there is a program for which you are eligible.
- Speak with your employer. Some employers are willing to make allowances for your absence. In some cases, if you are able to work from home, they will set you up with equipment to continue working while on bedrest. In other situations you may be able to job-share; a co-worker covers for you now and you cover for them when you are able. Many employers are more amenable to being flexible than losing an employee and having to find and hire a replacement which actually represents a substantial cost to the employer.
- Consider Work from Home options. If you aren’t eligible for any sort of paid leave, your state/county doesn’t have a disability program and your employer/job won’t allow for you to work from home, you may want to consider work from home options. Some mamas have started businesses while on bedrest, working as virtual assistants, bookkeepers, medical transcriptionist and other jobs that have nominal equipment requirements and flexible hours. If you aren’t sure what types of work from home opportunities are available, I strongly suggest that you visit Theworkfromhomewoman.com. This website is run by my friend and colleague Holly Hannah and offers tips and advice for moms who want to find legitimate work from home opportunities.
I realize that adding to the stress of being placed on bedrest and worrying about how you are going to make ends meet you may not feel like looking for a job, but I have to say that many a mama has created a wonderful business out of her bedrest experience. (i.e. Mamas on Bedrest & Beyond, the Bedrest Concierge, The Sleep Whisperer just to name a few! Also, check out our podcasts! There are several mamas there who have taken their pregnancy/bedrest experiences and turned them into satisfying and profitable businesses!). While being placed on bedrest may not seem like an opportunity, it may in fact be the start of something wonderful for you! Check out your options. Look at the resources available to you. Ask those around you if there is something that you can do to pass the time that would help them. You may be surprised at what opportunities come your way!
If you have found a way to stay financially solvent while on bedrest, or if you have started a business while on bedrest, please share your story in our comments section below. You truly are an inspiration and other mamas will greatly benefit from your wisdom and savvy!!!
Calling your attention to an amazing organization that is doing exceptional work globally for mamas, The Maternal Health TaskForce (MHTF). A project of the Women and Health Initiative at the Harvard T.H.Chan School of Public Health, MHTF is working towards:
- Making the most up to date evidence-based information is available to practitioners, provider, researchers and anyone with a vested interest in helping and supporting women during childbearing
- Provide opportunities for the global maternal health community to come together to discuss and create unified policies on women’s health issues globally
- Provide resources and support for research in Maternal/Infant/Child Health
- Train the next generation of Global Women’s Health Practitioners and researchers.
I receive the MHTF e-newsletter and the last newsletter was all about Maternal Mental Health. Maternal Mental Health is an often overlooked (ignored!!) part of women’s health. Current research estimates are that 10-15% of women in upper income countries (like the US, Canada, Australia and the UK for example) experience perinatal mental health disorders. In lower and middle income countries (Africa and parts of Asia), the current estimate is closer to 33% and many researchers feel that this number is low because until now mental health in childbearing women in these countries hasn’t been addressed. However, the impact of adverse maternal mental health has had significant impact on maternal health, infant and child health and the maternal child bond, so researchers and clinicians both are very keen to study the various mental health disorders common in childbearing women-mainly depression and anxiety.
Over the last month, MHTF had a blog carnival addressing mental health issues in childbearing women in their Mental Health: The Missing piece in Maternal Health series. It’s a really interesting series of blog posts and reflect how pervasive mental health disorders are in childbearing women, and how overlooked the signs and symptoms have been until very recently. The blogs also address how the stigma of mental health is so strong in all countries regardless of economic status, and this stigma is keeping many women from receiving much needed care. The articles do a wonderful job of highlighting the issues surrounding the stigma of mental illness, how women are not being heard in terms of the emotional toll of adverse birth outcomes and barriers to care. I highly recommend taking a look.
For those of you not really interested in global women’s health and need assistance closer to home, (i.e. for yourself!!) I am happy to announce that our Third Thursday Teleseminars are going video! It has long been a dream of mine to be able to bring Mamas on Bedrest together to be able to talk and share ! I have been researching platforms on which to do this for years and until recently, the platforms were just too grainy (i.e the images were really not that good), Platforms were only able to accommodate up to 10 participants or platforms that could accommodate more than 10 participants had hefty user fees or required expensive software. Now there is Zoom web conferencing and it’s amazing! I attended a web conference using it last week and I could clearly hear and see all of the other participants! So we are giving Zoom a test drive for our Third Thursday Teleseminar, July 16, 2015. Login details will be shared in our upcoming newsletter and will be available on our website. So if you have concerns about anxiety, depression or other feelings you may be having during your bedrest journey, this is the perfect time and place to bring your concerns.
In the meantime, share pressing questions or concerns in the comments section below or send an e-mail to Info@mamasonbedrest.com for a 24hr response.