Mamas on Bedrest: The End of Bed Rest?

June 21st, 2013

Mamas on Bedrest,

There is no medical or scientific evidence that the bed rest prescription prolongs pregnancy, prevents preterm labor or ameliorates any of the conditions for which it is prescribed. The fact that bed rest is prescribed in the face of these facts goes against the medical covenant into which health care providers enter when they swear to uphold the Hippocratic Oath as they receive their credentialing. As medical treatments and technologies evolve and improve, obstetricians and gynecologists themselves are beginning to question this commonly prescribed treatment that has the potential to do more harm than good.

In the June issue of Obstetricians and Gynecologists, McCall et. al and Joseph Biggio, MD review the practice of bed rest and conclude that bed rest is not an evidence based practice, has the potential to cause harm to mamas and babies and they recommend that the practice be discontinued-immediately.

This is a HUGE shift (okay, one that is taking place) in the position of the American Congress of Obstetricians and Gynecologists. To date, ACOG has held tenaciously to bed rest, citing the thousands of “successful” pregnancies and births as a result of the practice. However, obstetricians have ignored the negative consequences of bed rest; the potential for blood clot development and embolism, bone loss, muscle loss and depression. Additionally, the health care community has long ignored the impact that the bed rest prescription has on a woman’s family, her job/career, her finances and overall emotional well being. The focus has always been, “this is what is best for the baby-to ensure a full term outcome.” McCall et al show via an extensive review of the literature that bed rest does not ensure a positive birth outcome and noted that women who were put on bed rest are more likely to suffer the aforementioned complications and not necessarily deliver a full term infant.

Dr. Biggio accurately states in his editorial that we regard mamas and babies as separate entities; “bed rest will improve the birth outcomes for the baby”, yet we completely disregard the impact that bed rest has on mamas. Additionally, (and I believe that this is the brilliance in his statement!) mamas and their babies are most intimately connected. To regard the health and well being of one without considering the health and well being of the other is short sighted. And in view of the Hippocratic Oath, bed rest is actually “doing harm”.

Both publications accurately state that the advances in prenatal screening and treatments enable health care professionals to evaluate the status of mamas and babies and intervene as necessary. Hence, placing them on bed rest-often prophylactically-can be at the least irresponsible and at best unjust and a form of malpractice.

While it is not yet clear the direction American obstetricians and gynecologists will go with high risk pregnancies, change is definitely on the horizon. Rest assured, we here at Mamas on Bedrest & Beyond will keep our eyes and ears open and report any changes in obstetrical practices as soon as they are available.

In the meantime, know that Mamas on Bedrest & Beyond will continue to support Mamas on Bedrest and will evolve our practice and services to continue to meet the needs of high risk pregnant mamas.

What are your thoughts on this bed rest debate mamas? Share your thoughts in the comments section below!!

 

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