I don’t know about you, but I would love to be put on bed rest. Starting today. But, not everyone wants to be put on bed rest, even if it is warranted.
I found this article on bed rest during pregnancy interesting: Get Out of Bed: Activity Restriction is Ineffective for Prolonging Pregnancy. If you’re interested, you can read it as well.
In a nutshell, bed rest is most often prescribed to prevent preterm delivery, despite the fact that there is no research showing that it affects delivery date. There is evidence that bed rest increases complications.
"Although no randomized, controlled trial (RCT) has ever shown that activity restriction prevents preterm delivery, this intervention continues to be prescribed by many obstetric providers. Such restriction is associated with excess risk for venous thromboembolism, physical deconditioning, and depressive symptoms — and may also have deleterious social and economic effects resulting from missed days of work. Investigators have called attention to the risk-benefit mismatch of this common treatment."
When considering the body, we tend to mentally isolate our anatomy and place an organ (or a system of organs) in a vacuum. Like the uterus is an upside down bag, with gravity causing the baby to tumble out, for example. When we think of the uterus this way it makes sense to reduce the gravitational load on the fetus by lying down. But the uterus is not supporting the fetus alone. There are a myriad of force-generating components that support the uterus (and inner-workings) called muscles. Muscles that, when put on rest, are less able to assist.
Oftentimes it is our robust stillness (how much do you sit? take this quiz!) preceding and during early pregnancy that is the problem in the first place. The pelvic girdle depends on upright walking to maintain its function. Without movement the pelvis can separate (pubic symphysis pain), the SI joint become unstable, and I won’t even start on the affects to the pelvic floor or on the need for intervention during the birthing process itself.
The process of pregnancy does not bode well in stillness just like the reproductive organs are not served being isolated on paper in a textbook. But if you are put on bed rest I do not suggest that you blow off the recommendation and head to Zumba class. What I do suggest is you take the linked article to your doctor to discuss it.
Many times blanket prescriptions like bed rest are given because body science is so nuanced your physician doesn’t have time to sit down and tell you things that are probably okay and things you should avoid. Also, patients have a long track record of taking a mile (she said I could exercise! jog, jog, jog) when given an inch (easy going walks and stretching are fine).
Remember that although bed rest isn’t supported by evidence, it could still be a viable prescription for you. Things are not false until proven. The decision to rest or not should come by weighing long term health outcomes for all involved. See if your doctor will allow you, in light of the new information, to try gentle, corrective exercise and walking to prevent pelvic girdle atrophy. Try things for a couple of weeks, letting your doc or midwife know, stopping if you feel like the situation is worsening. Other options are asking for a physical therapy referral for supervised exercise to prevent pelvic musculoskeletal ailments.
If your doctor blows you off or won’t even discuss the issue of prescription refinement then I suggest finding a different healthcare team. Someone who won’t pay attention to you or the evidence could have a separate agenda than your health. There are plenty of compassionate and qualified people out there to serve you. Find them and support their practice.
But, I’m totally serious. I would take a day of bed rest right now. Preferably at night.