Bed rest during pregnancy might seem pretty straightforward, but it’s surprisingly controversial in the birth world. Approximately twenty percent of pregnant women are prescribed bed rest each year, but the research isn’t clear on its benefits.

 

 

A Controversial Prescription

I was surprised at the number of articles I read online that criticized the prescription for bed rest. Take this snippet from a study published in The Cochrane Library in 2015:

 

Breaking Muscle Shop

There is no evidence, either supporting or refuting the use of bed rest at home or in hospital, to prevent preterm birth. Although bed rest in hospital or at home is widely used as the first step of treatment, there is no evidence that this practice could be beneficial. Due to the potential adverse effects that bed rest could have on women and their families, and the increased costs for the healthcare system, clinicians should discuss the pros and cons of bed rest to prevent preterm birth.

 

Potential benefits and harms should be discussed with women facing an increased risk of preterm birth. Appropriate research is mandatory. Future trials should evaluate both the effectiveness of bed rest, and the effectiveness of the prescription of bed rest, to prevent preterm birth.

 

Or this one, from the Society of Maternal-Fetal Medicine, which details some of the effects extended bed rest has on pregnant women:

 

Lack of weightbearing activity results in loss of muscle mass, bone mass, plasma volume, and cardiovascular capacity. Pregnant women are known to be at increased risk of deep vein thrombosis and other thrombotic morbidities such as pulmonary embolism. The data demonstrate an increased risk of thromboembolic events in patients placed on activity restrictions.

 

I’m not sure where I stand on the issue of putting women on bed rest. I've seen restricted activity have great effects for some women, such as prevention of pre-term labor and complete resoultion of a severe case of first-trimester oligohydramnios (low amniotic fluid). So I definitely think it has benefit in some cases. 

 

But regardless of whether bed rest is effective or not, could exercise make it more tolerable and reduce some of the negative side effects? So far the research seems to say yes.

 

What Research Says About Exercise

To clarify, exercise is going to look much different if you are on bed rest. You won’t be tracking PRs or measuring body composition. There won't be as much exertion as we typically think of when we hear the word "exercise."

 

What I mean by "exercise" is regular movement to help keep your joints mobile and your blood flowing. Exercising in this way will help you maintain some of your muscular strength, as well as prevent aches and pains that accompany immobility.

 

I’ve never been on bed rest myself, so I spoke with other women who have to hear about their experiences. Their stories were all different, but there was one common thread: none of their doctors recommended any kinds of exercises to do while on bed rest. So while bed rest may be a common prescription, it doesn't seem many women are aware that physical activity can make it more bearable.

 

In a 2007 article in the New York Times, author Gretchen Reynolds interviewed several doctors who suggested light exercise may be beneficial for women on bed rest. The doctors gave the following recommendations:

 

Dr. Artal, along with Dr. Grobman and two other high-risk pregnancy specialists interviewed for this article, recommend that women on bed rest see a physical therapist and, if appropriate, begin a light exercise program. (They also should seek additional opinions as to whether they need to be on bed rest at all). Presently, few bedridden pregnant women get exercise consultations, Dr. Irion said.

 

Although I haven’t been on strict bed rest before, I did have four weeks of restricted activity after my second child was born. That's not much compared to what many women experience during pregnancy, but it definitely made an impact, physically and psychologically. I remember feeling like it was going to take months to get back to the fitness level I had been at before, and this is one of the most common concerns I hear about from other active women who go on bed rest.

 

 

I spoke with Mamas on Bedrest founder Darline Turner to get her take on exercise for moms on bed rest. Not only has Darline worked with hundreds of moms on bed rest, but she’s also been there herself during her own pregnancies. Here's what she had to say about how bed rest can affect active women:

 

Research shows that significant muscle mass and strength are lost in as little as sixty days and evidence of loss can be seen in as soon as two weeks! However, for more active mamas, there is good news. Once they are off bed rest, they will regain their fitness faster than more sedentary mamas.

 

Unfortunately there will be some loss of fitness and the degree of that loss depends on mama’s initial level of fitness (the more fit she was, the more slowly she’ll lose muscle tone and strength and stamina) and how long she is on bedrest (the longer she is on bedrest, the more her level of fitness will decrease).

 

Darline recommends the following exercise guidelines for women on bed rest:

 

I recommend mamas do a full body workout. That would include leg flexion and extensions, ab/adductions, and toes pointing and flexing. For arms, using a very low resistance band or towel, shoulder flexion/extension, upright rows and “squeeze out the towel” to stretch and strengthen the wrists. Finally, if they have some movement privileges, do cat/cow on the bed or simple back extensions when they get up to go to the bathroom. They can also stretch side to side while in bed.

 

For example, here’s a video from Darline with some stretches to do to relieve back pain, which she says is one of the most common complaints she hears from women on bed rest:

 

 

Just as with during pregnancy, women on bed rest should be aware of contraindicated exercises. These include the following:

 

  • Any exercises that increase intra-abdominal pressure (crunches!)
  • Any exercises which cause you to bear down as if you are straining to have a bowel movement
  • Anything that causes discomfort
  • Twisting movements

 

Other Considerations

Emotional and mental support are just as important as physical activity, as Darline noted:

 

Quite frankly, the emotional toll is by far the most difficult aspect of bedrest. What works for a mama will vary, but in my experience, getting support is the best thing. That is why I have the Facebook group for moms on bedrest. Mamas need to be able to vent, share, and hear from other mamas who are in the same boat they are.

 

Being on bed rest is one of the most stressful events that can happen to a woman and her family. There is concern for her health and wellbeing, concern for the health and wellbeing of the unborn baby, as well as concern for the family. Physically, emotionally, psychologically, financially - it’s really difficult. The sooner a woman can interact with and vent with other mamas going through the same thing, normalize her experience, and get practical advice, the better she does.

 

If you've been put on bed rest, try to find some support in your local community. Darline's Facebook page, Mamas on Bedrest and Beyond, is a great resource. I also suggest seeking the help of your doctor or an experienced physical therapist to provide exercise recommendations.

 

Stay tuned for an eight-week series with daily movement sequences to keep your body strong and mobile while on bed rest!

 

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Photos courtesy of Shutterstock.

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