Mamas on Bedrest: “Why Wasn’t I Prescribed Bedrest???”

January 26th, 2015

Hello Mamas.

I received the following inquiry from a Mama on Bedrest:

“Hi. I’m 24 weeks along and on my last prenatal visit, my OB noted that my cervix was short. After ultrasound evaluation, he determined that a cerclage was needed. I had the cerclage placed, but my OB has not put me on bed rest. I asked if I should limit my activity and he said only if I felt contractions or otherwise uncomfortable. 

Most other women that I know who have been in this situation were prescribed bed rest. I’m really nervous that something will go wrong and I will lose my baby. What should I do?”

This is an excellent question!! First and foremost, a Mama should always listen to and follow her health care provider’s recommendations. I say this because you have “contracted” with this person to care for you and your unborn child. It only makes sense that you follow their recommendations. Now, if you find that you disagree with your health care provider on many or at least one major decision, I suggest you first talk with your health care provider and ask why they have chosen the treatment plan that they are implementing. Make sure that you understand the ENTIRE rationale behind their decision, and that you understand and are comfortable with the treatment plan going forward, including potential adverse outcomes.

If you are still uncomfortable after speaking candidly with your health care provider, I suggest getting a second opinion. Sometimes having another assessment of your situation will put your concerns to rest. Also, sometimes another person can explain things differently so that they make more sense to you and ease your mind.

Finally, if you have spoken with your health care provider and not gotten the answers that satisfy you, and you have consulted with another provider and gotten a second opinion-regardless of whether they agree or disagree with your original health care provider, you may want/need to change providers. Now I don’t say this lightly. Changing providers mid-pregnancy is most certainly not optimum, however, if you are really feeling uncomfortable with your current provider, it is in your best interest (and that of your baby’s) to work with a provider in whom you implicitly trust, with whom you feel completely comfortable and who will consult with you every step of the way making sure that you are included in treatment decisions, that you understand all treatment decisions and with whom you can speak to freely and as often as you need. If you don’t feel completely comfortable with your health care provider and feel anxious and uncomfortable with his/her treatment plan, then you may need to consider a change. But again, I highly suggest you do all that you can to work with this person who already knows you and your case.

Now, if it isn’t a conflict with your provider and you are just concerned that you should be on bed rest and they haven’t prescribed it, trust your health care provider as they are doing you a HUGE service not placing you on bed rest if it isn’t medically indicated. In our e-book, “From Mamas to Mamas:The Essential Guide to Surviving Bedrest” I spent an entire chapter discussing how bed rest is not an evidence-based treatment and that many, many obstetricians, maternal-fetal medicine specialists and many of the medical societies caring for pregnant women and their babies are urging providers NOT to prescribe bed rest, but to instead treat the pregnancy complication without the activity restriction. It sounds like this obstetrician is doing just that. What our mama should now do is at her next prenatal visit, ask her health care provider to explain to her EXACTLY why s/he did not prescribe bed rest, what s/he expects to happen with cerclage alone, what other treatments they will implement if the cervix continues to shorten to prevent preterm birth and what she can do to improve her pregnancy outcomes. In this way, Mama will have all the information she needs to take exquisite care of herself and her baby-and hopefully have all her fears and anxieties addressed and “laid to rest.”

 

What was your response to being put on bed rest or not being prescribed bed rest? Share your experience below in our comments section.

If you want to learn more about Bedrest not being an evidence based treatment for the prevention of preterm labor and preterm birth, read all about it in our e-book, From Mamas to Mamas: The Essential Guide to Surviving Bedrest” available for immediate download from Amazon.com.

2 responses to “Mamas on Bedrest: “Why Wasn’t I Prescribed Bedrest???””

  1. Wendy says:

    I had a cerclage placed at 19 weeks. After the surgery, my doctor placed me on modified bed rest, but since I had a desk job, she was pretty loose about it… she said to go to work, avoid a lot of walking, and take it easy in the evenings. After 5 weeks it was discovered at an ultrasound that one of the stitches on my cerclage had eroded. 🙁 I was immediately placed on much more strict bed rest (only up for showers and bathroom).

    Being on bed rest is the most difficult thing I’ve ever done. I have always, since the beginning, somewhat doubted my doctor’s orders for bed rest (especially after reading about the absence of real research on the subject). I’ve felt nothing but physical pain from lack of movement, terrible digestive issues from not being able to be upright, and mostly… a sense of sadness and anxiety that I’ve never felt before. Because what else is there to do but worry and sit through the physical effects of this? And this is all with an EXTREMELY supportive husband and family. There are so many women who have it much worse.

    This is my last week of bed rest. I’ve made it. Our baby is likely to be just fine. It’s such a relief. But I still don’t fully believe we’ve made it because of bed rest. My story is anecdotal, just like every other bed rest story. If women have doubts about their doctor telling them that bed rest is *not* needed, I would seriously consider this: bed rest is not well-researched. I’ve even read that there is some evidence that it only makes the situation worse. I also don’t think people realize at all that bed rest is HARD. I can’t seem to get across to people the responsibility you feel with your body… much more so than just pregnancy alone.

    And for me, I very often wonder… has bed rest itself harmed my baby in some way? Has it been good for her to be housed by a mother who hasn’t moved for most of her pregnancy? Even more importantly, a mother who’s emotional state has been filled with nothing but turmoil and sadness? How has *that* affected my baby? It’s hard to reconcile that with something that hasn’t really been proven to work.

  2. Darline says:

    Hi Wendy!
    Congratulations on making it to the end of your bed rest journey!! All of your concerns and questions are very well founded. Bedrest is not an evidence-based treatment and there is more evidence against it than for it. Slowly the wheels of change are turning, but as with anything that has been a longstanding practice, it takes a long time to change minds.

    To ease your mind a bit, it is likely that many of not most of the negative effects (at least those that you stated) are in no way harming your baby girl. As long as she has been steadily growing and developing, she is just fine. You on the other hand will need time to recover, regain your strength and endurance and to mentally heal. You are so right, bedrest is hard and often takes its hardest toll emotionally. You are so lucky to have a supportive husband and family. If there is anything that Mamas on Bedrest & Beyond can do, please don’t hesitate to reach out.

    Thanks for your comment and do let us know when the little princess graces us!! All the Best to you!

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