Bedrest

[Guest guest]

Hi All,

This is a follow-up to 'venting' - but more from a medical angle. I'm always

amazed that doctors prescribe 'prolonged bed-rest' as widely as they do. It's

clearly an intervention that has huge costs - disruption of family life,

possible

loss of income, misery and frustration for the 'restee' and her carers,

discomfort from limited positions, loss of muscle tone, possible loss of bone

density, higher risk of thrombosis and even pressure sores. What is the

evidence of the beneifts - do we know that it actually reduces the risk of

preterm labour or preterm birth? We don't completely understand the

mechanism of preterm labour with mullerian anomaly but is it likely that

normal activities (including taking a step or two up or down) are likely to

trigger it? If doctors knew how huge the emotional/social costs were (instead

of thinking 'it can't hurt') would they be so quick to prescribe it?

Judith

UD, 37 wks pregnant with no. 2

[Guest guest]

Judith

congrats on making it to week 37!!!

bedrest- i think your questions are well placed, but i

think it is very unlikely that there have been

controlled studies of bedrest for these specific MA

conditions, --and b/c it has been observed to help

anecdotally in many cases, doctors prescribe it to be

" better safe than sorry. " Recall the docs are just

trying to help us stay pregnant, and I think it is

unlikely that the National Institute of Health will be

motivated during this difficult time in our history

finnancially to fund such controlled studies of

bedrest (because the cost to society of women put on

bedrest during pregnancy is not likely to be very

large compared to other more chronic and prevalent

conditions/diseases).

Best wishes,

Heidi

--- a5her6en jtg22@...> wrote:

> Hi All,

>

> This is a follow-up to 'venting' - but more from a

> medical angle. I'm always

> amazed that doctors prescribe 'prolonged bed-rest'

> as widely as they do. It's

> clearly an intervention that has huge costs -

> disruption of family life, possible

> loss of income, misery and frustration for the

> 'restee' and her carers,

> discomfort from limited positions, loss of muscle

> tone, possible loss of bone

> density, higher risk of thrombosis and even pressure

> sores. What is the

> evidence of the beneifts - do we know that it

> actually reduces the risk of

> preterm labour or preterm birth? We don't

> completely understand the

> mechanism of preterm labour with mullerian anomaly

> but is it likely that

> normal activities (including taking a step or two

> up or down) are likely to

> trigger it? If doctors knew how huge the

> emotional/social costs were (instead

> of thinking 'it can't hurt') would they be so quick

> to prescribe it?

>

> Judith

> UD, 37 wks pregnant with no. 2

>

>

>

>

[Guest guest]

Hi, all

I guess what it all boils down to is that each of us are different and it is up

to us and our doctors to determine the best treatment. It was interesting to me

what Judith was saying about wanting a cerclage and not getting one. I sought

opinions from 4 doctors (5 if you include the one from my first pg) and all of

them agreed that a cerclage was not usually done as a preventive measure. It

seems that the general opinion is that neither a cerclage nor bedrest should be

prescribed unless absolutely necessary due to the risk of complications that

each presents. Several doctors said that without a previous second trimester

loss that they would not place a cerclage. After TTC for almost 2.5 years, I

was terrified that we would lose this baby because some doctor was going to make

me have a second trimester loss before being convinced that I might need a

cerclage.

So, I picked the doctors that were going to monitor me the most closely to see

if the need presented itself before it was too late. Sure enough, my cervix

shortened from 4.5 to 2.8 cm by the 13th week and a cerclage was placed. Up

until the 24th week, we were sailing along smoothly with a nice, long closed

cervix at 3.5 cm. I think we were all starting to think that this pregnancy

might be uneventful! Then, at almost 25 weeks I started having terrible cramps.

There was no bleeding and after lying down for a few hours they went away. I

slept the weekend and then went in on Monday. Lo and behold my cervix had

started shortening again and opening from the inside. The peri seemed to think

it wasn't significant enough to warrant bedrest and saw me again in a week.

More shortening and opening of the cervical canal. He still didn't want to

prescribe bedrest, just reduced activity. I was pretty happy about this, but my

DH wasn't. He was thrilled when my Ob called the next day to tell me to stop

going to work and rest as much as possible. At my appointment three days later

she then changed that to bedrest.

Went in again to the peri yesterday and the cervix is 3.1 cm (yeah!). Everyone

says, " Good, it's working! " so here I am at home still. I feel lucky for now,

though, because my confinement is not that strict yet. I can go to the

bathroom, eat, walk short distances, and go upstairs once a day. My work can be

done from home and my Ob agreed that I can go in to the office once a week. I'm

not having to rest on my side or with my legs up in the air, but my Ob reminds

me at every visit that if my cervix shortens less than 2.5 cm that is exactly

where I will be. When I told her how difficult that would be (I'm a go-person

like Kathleen) she told my DH to put signs that say " NICU " in the kitchen, on

the washing machine, vacuum cleaner, etc. She made it very clear that the

success of this pregnancy is dependant on me taking care of my body and putting

this little baby first.

When I read all of your stories, I truly feel for those of you on strict

bedrest. Just the few days that I have been doing this, my back & hips are

hurting from lying down so much. I can see that I will be running out of things

to do in bed soon. Lonely, bored and helpless pretty much sums up how it feels.

I honestly don't know how you do it and keep your morale up! It doesn't help

when our spouses don't support us. (, I hope yours comes around soon!

Shame on him for talking to his friend the way he did!). I am just thankful

that there are you ladies out there who have been there, done that, and lived to

tell us all how worth it it can be.

If anyone has any suggestions on good bedrest exercises, I would surely

appreciate the tips! I found a website that has a few, but if anyone has any

personal experience as to how to retain some muscle tone and minimize pains I

would appreciate it. The website is:

http://www.americanpregnancy.org/pregnancycomplications/bedrest.html

Thank you all that replied with your well-wishes and support! It seems that

there are several of us that will be having babies soon and I'm looking forward

to sharing our success stories and photos with each other!

Best wishes to you all!

Mikell, 34

26 wks 5 days

t-shape