Bed rest and pregnancy

Article in Harper's Magazine questions whether bed rest is helpful in pregnancy.

Is bed rest helpful or harmful for pregnant women?

For years, obstetricians and midwives (as well as grandmothers-to-be) have recommended bed rest to treat a variety of pregnancy related problems including premature birth, preventing miscarriage, poor fetal growth (IUGR) high blood pressure and pre-eclampsia (toxemia).  Even fertility doctors have gotten in on the game, recommending bed rest to improve IVF pregnancy rates. The question that pregnancy researchers have been trying to answer and the impetus for article above, recently published in Harper's magazine: is does bed rest help?

The science behind bed rest and pregnancy

The idea that bed rest is beneficial for pregnant women certainly makes sense to most people including most womens' health care professionals recommend bed rest. Most obstetricians and midwives have been trained to use bed rest as a treatment but now in the age of evidence based medicine that therapy is being called into question.The problem is that there are few if any studies that show any benefit to bed rest during pregnancy. To be fair, there is also little evidence to suggest that it is not helpful either.

In contrast, there are are a number of studies showing the benefits of exercise for pregnant women, and moderate exercise is now encouraged in healthy pregnant women by organizations such as the American Congress of Obstetricians and Gynecologists

So, why care about bed rest in pregnant women since it is harmless?

Bed rest is not harmless. Bed rest increases the risks of a number of complications including:

  • Blood clots
  • Depression
  • Low birth weight
  • Slower recovery from childbirth
  • Loss of bone and muscle mass
  • Loss of income
  • Stress at home

In fact the more strict the bed rest, the higher the risk and severity of these side effects are.

Discussing bed rest with your OB

Making decisions about your medical care is an individualized decision a woman should have with her Obstetrician or Midwife, and bed rest is no exception. Bed rest is neither a cure all for pregnancy complications nor something to be avoided at all costs.