StorkNet interview with
Amy E. Tracy
Author of
The Pregnancy Bedrest Book
A Survival Guide for Expectant Mothers and Their Families


Amy Tracy: "I discovered I was pregnant the same week I started a new job. When I began showing, I told my boss the news and assured her that I'd keep working until my due date. But a few weeks later, while sitting at my desk, I began bleeding.

Panicked (I'd suffered a miscarriage before), I asked a coworker to drive me to the hospital. Doctors ran tests to see why I was bleeding (no explanation) and whether my baby was okay (he was).

When the bleeding continued after a week of at-home rest, my doctor prescribed limited bedrest - no going to the office and very little household activity. That's when the seriousness of my situation hit me.

Telling my boss that I needed to be out for a few months - in addition to my maternity leave - was one of the most difficult things I've ever had to do. My husband, George, and I also wondered how we would pay the bills, including a brand-new mortgage, if I lost my salary. And with George traveling several days a week on business and no family nearby, how was I really supposed to stay in bed? I had to at least eat!

The Bed Rest RX: Taking the Cautious Road
With few studies proving that bed rest is beneficial, some medical experts to question its effectiveness. Yet more than 700,000 women with pregnancy complications - nearly one in six pregnant woman - spend some time on bed rest. Reasons include spotting like I had or high blood pressure.

"We want to do everything possible to ensure a healthy baby, and we want the family to feel that they're doing everything possible, too," says Robert Wolfson, MD, Ph.D., a perinatologist in Colorado Springs, Colorado. "There's no way of knowing which woman and baby might benefit from bedrest."

So, it's likely that more women are asked to stay in bed than really need to. I, for one, was willing to put my life on hold if it even slightly increased my chances of having a healthy delivery. Fortunately, my bedrest sentence was relatively mild: I could sit up for a few hours a day and edit (and, thankfully, keep my paycheck).

I did feel like I was under house arrest, but other women must cope with much harsher restrictions. Pregnant with twins, Mara Tesler Stein, PsyD, a Chicago clinical psychologist, spent more than six weeks confined to a hospital bed, taking medication to control her early contractions that she says made her feel like a rag doll. Cindy Belsky, of Chantilly, Virginia, who started going into labor at 18 weeks, spent three months on strict at-home bedrest (she could only get up to use the bathroom) during her third pregnancy.

"Bedrest prescriptions vary according to each woman's symptoms and depend on individual doctor's preferences," says Judith Maloni, Ph.D., an associate professor at Frances Payne Bolton School of Nursing, in Cleveland, who has researched bedrest for more than ten years. Some women can still take daily showers; others are asked not to. If you have preterm labor, you may be expected to strap on a monitor once a day to send a contraction report to your doctor. Women with high blood pressure may be asked to track it; those with gestational diabetes may need to take glucose tests. If you think your doctor's orders are too limiting, you can seek a second opinion from a perinatologist.

How To Keep from Going Crazy
Deborah Simmons, Ph.D., of Golden Valley, Minnesota, had just started working on her doctorate degree when she went into early labor and her doctor ordered bedrest. "It was disorienting," she says. "I had assignments but wasn't even allowed to sit at my computer desk."

Now a licensed marriage and family therapist who frequently counsels couples coping with bed rest. She notes that others around you might not see your situation as a crisis, which can add to your frustration. If someone comments on your life of leisure, remind them that even though you don't look sick, your baby's and your own well-being depend on you taking it easy.

Of course, those who've been on bedrest know that it's anything but restful. You have too much time to worry about your baby, job, finances, other children, house, partner, and even how you're going to get your next meal. "Inactivity causes you to feel depressed," says Jan Page, of Marshall, Missouri, who left her job as a nurse to spend three months on bedrest due to low amniotic fluid. Page found comfort online, e-mailing other bedrest moms. "It helped to share our feelings," she says.

When I was on bed rest, I made lists of things I wanted to do (write a novel, read the classics, learn to knit), but mostly I just watched those awful daytime TV and felt guilty for not doing more. "You shouldn't feel obligated to be productive," says Dr. Stein, the clinical psychologist who spent her own bed rest in a hospital. "Do things that appeal to you, but remember that you're doing an enormous job just by getting through the day." Here are some more survival tips:

Make yourself comfortable. Paige kept plastic tubs full of reading, writing, and craft supplies within reach. Other essentials: a telephone and phone book, a cooler for meals and snacks, water, toiletries, and the TV remote.

Seek and accept help. "Though asking for help can be awkward and having people in your home can feel intrusive, you can't do this alone," Dr. Simmons says. Ask friends or family to make meals and run errands. Some bedrest moms with young children hire babysitters or temporarily send their kids to day-care centers; others rely on loved ones for child care. Later you'll have time to pay back their kindness.

Communicate with your partner. Bed rest is extremely hard on men, too. "Dads cope with financial strains, household demands, and frightened partners who need (and deserve) lots of attention," Dr. Simmons says. "Communication is more important than ever. Talk about your frustrations and how you can help each other."

Getting Back on Your Feet
After my ten weeks of bed rest and my baby's birth, I felt extremely out of shape and sluggish. But what I found really difficult was resuming activities like grocery shopping: The sounds and colors were overwhelming. Surprisingly, after months of confinement, I didn't like driving my car or being around people.

"Bedrest is a type of sensory deprivation," Dr. Maloni says. "When you first start going out, you'll feel overloaded. You'll feel physically exhausted, too. "Muscle tissue has been lost, energy depleted, and the cardiovascular system weakened. Longer and stricter bed rest results in more severe effects," Dr. Maloni adds. It can take months, or even as long a year, to feel like yourself again.

After weeks of being waited on, you may feel guilty when you don't bounce back to your pre-pregnancy energy level. But taking care of your new baby may be all you can handle right now. As you gain strength, slowly add activities.

Bed rest comes with difficulties, but there are also wonderful rewards. The most cherished, of course, is a healthy baby.

Causes of Confinement

  • Preterm labor
  • Multiple babies
  • Low amniotic fluid
  • Unexplained bleeding
  • Hypertension (high blood pressure)
  • Pre-eclampsia (a condition characterized by high blood pressure, severe swelling, and protein in the urine)
  • Incompetent cervix (when the cervix dilates, or opens, prematurely)
  • Gestational diabetes (diabetes that occurs only during pregnancy)
  • Premature rupture of the membranes (when the amniotic membranes break before the onset of labor)
  • Placenta previa (when the placenta covers the cervix)

© Amy E. Tracy

Visit Amy Tracy's website here.

To Purchase:
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click here to purchase through Amazon

click here to purchase through AmazonAfter three high-risk pregnancies and the birth of a premature baby, Amy Tracy focused her writing career on prenatal and neonatal topics. She is the author of The Pregnancy Bed Rest Book and the coauthor of Your Premature Baby and Child, and she has written articles for numerous parenting and women's magazines. Her volunteer activities include running a support program for hospitalized expectant mothers, serving on the board of a nonprofit organization that's raised over $3 million for prenatal and neonatal programs, and serving on the steering committee for the National Perinatal Association's new Family Advocacy Network. She lives in Colorado with her husband, George, and their two boys, Daniel, 13 and Steven, 11.

In The Pregnancy Bed Rest Book Amy E. Tracy shares her experiences - and those of many others - to help you and your family not only survive but thrive during your days in waiting. With information on everything from informing your employer and making arrangements with your health insurance to proper nutrition and calisthenics, this comprehensive guide also covers such topics as understanding your doctor's orders, adjusting to horizontal living, coping with hospitalization, limiting the side effects of immobility, making bed rest a family affair, coming to terms with your feelings, getting back on your feet, and so much more! See our review.

Amy recently chatted with us about all of these topics and more! We hope that you enjoy the discussion. Many thanks to our guest, Amy Tracy.

Ellen: Do you have any suggestions for what to do if your doctor isn't supportive or encouraging? Mine doesn't answer my questions and disregards my fears. I really need his support.

Amy: Ellen, I am so sorry you are not receiving the support you need from your doctor. Unfortunately, I hear this complaint from many high-risk mothers. When researching my book, I learned that the reason many healthcare professionals are not supportive is because they do not understand how bedrest affects the woman and her family. Dr. Richard H. Schwarz, a family-friendly doctor who wrote the foreword for my book, says, "As with most obstetricians who recommend bedrest to a pregnant woman with a complication, I know I have not always thoroughly appreciated, or counseled a patient about, the full impact of that prescription on her and her family."

You may need to educate your doctor by providing him with articles, books and studies about bedrest and its very real physical and emotional side effects. StorkNet will be posting an information packet on bedrest that includes some handouts for professionals. You will not only be helping yourself but helping future high-risk mothers.

Is there a nurse in your doctor's office that you could talk with? Many times nurses are often more informed and empathetic. You need your questions answered!

I am concerned that your doctor dismisses your fears. If you continue to feel that he is ignoring your symptoms and you are not getting adequate medical care, please consider changing doctors (or at least getting a second opinion). You must be an advocate for your baby (and for yourself). Please let me know how your next appointment goes.

Christine: Do you have any suggestions for staying close to my husband during this time? It's hard for him to go so long without sex and it's not allowed for us.

Amy: All the experts agree on this: The best thing you can do to stay close to your partner during bedrest is to COMMUNICATE. Talk about your feelings and encourage him to share how he feels. Talk about the uncertainties, the losses that bedrest has caused in your lives, and the adjustments your family has had to make.

You may be surprised to hear that when Dr. Judith Maloni, a leading bedrest researcher, asked husbands what was most difficult about their wife's confinement, the lack of sexual intimacy was low on the list. Sure, it's difficult, but it's not forever, and your health and your baby's health are most likely more important to your husband than immediate gratification. Still, you should talk about intimacy and discuss other ways you can show your love for one another.

In my book, I suggest ways to stay close: cuddle, light some candles and play soft music, give each other a massage, and leave love notes for each other.

James: My wife is on bedrest for the next five weeks and it's hard on her and on me. I need help! Is your book for husbands too?

Amy: It's great to have a husband here, and yes, my book is for dads, too. After all, bedrest is greatly impacting your life, as well! The earlier chapters will help you help your wife to follow doctor's orders, to eat well, and to reduce the physical and emotional side effects. But to help her, you'll also need to take care of yourself. "Chapter Seven: Your Partner's Part" discusses the common feelings of men affected by bedrest and provides some solutions for keeping your relationship intact.

While there are a lot of coping suggestions in the book, the most important one is: You must seek and accept help from others. You and your wife cannot do this alone. Ask family members, friends, coworkers, and religious and civic organizations to lend a hand. Be specific when you ask for help. For example, provide a grocery list, state where and what day that the dry cleaning needs to be picked up, and ask for meals to be delivered on certain days. Most people want to help, but they might not know how.

Jill: I have a home business and have been placed on bedrest. I'm still able to do most of my work from my laptop computer. Should I tell my clients that I've been placed on bedrest in case I end up hospitalized or delivering early? I'm worried that my clients will panic and go elsewhere for the work.

Amy: You say that you are worried that your clients may leave when they learn about your high-risk pregnancy, but if you don't tell them now, and then you surprise them with not being able to meet their needs (because of hospitalization or an early delivery), they may feel that you were dishonest, and you may risk losing them as long-term clients. You'll have to consider your clients' personalities, how loyal they are to you, your unique medical situation, and then weigh the pros and cons of telling. I understand there may be a real issue of losing a paycheck, but I lean towards being truthful.

How you tell your clients can make a big difference. First, make sure you have a clear idea of what your medical condition is and what bedrest means for you. Are you on limited bedrest and your doctor is okay with you working a certain number of hours a day? Does your doctor think you'll be on bedrest for a few weeks or until delivery? If you were hospitalized, could you still continue working? If you delivered early, would you want to continue working while your baby is hospitalized (what were your maternity leave plans before bedrest)? Letting your clients know that your doctor approves your work schedule and that you are capable of continuing to do excellent work will be very reassuring.

I continued to work full-time while on bedrest. Actually I got a lot more work done because of fewer distractions (I was tied to my desk, so to speak). I did keep my employer informed about any medical changes, so that she could be prepared if I couldn't finish my work. I kept good notes so that someone else could take over. I'm not sure what type of work you do, but perhaps you could somehow reassure your clients that you won't leave them in a jam. Is there someone you could train to finish the job, if needed? Hopefully, the more helpful you are, the less resentment your clients will feel, should you stop working.

Be honest with yourself, too. Does the work you do help to pass the time while you're on bedrest, or do you find that it is sometimes stressful? Do you need the paycheck, or could you afford to take some time off? If you were to lose your clients, would you be able to rebuild your client base? Always remember your focus should be on your baby's and your health. It may be hard for you to appreciate now, but when you look at the big picture, this is a relatively short time in your lives.

Wendy: Amy, thank you for answering our questions. Here's mine . . . I was on bedrest the last six weeks of my first pregnancy. It seemed like the longest six weeks of my life and I nearly have anxiety thinking about having to go through that again. In your experience, how often does a woman end up on bedrest a second time? I'm 22 weeks along, and I'm headed out to get your book now "just in case."

Amy: I felt the same way you are feeling when I got pregnant the second time. I wanted someone to tell me if I would again have to face bedrest and a possible preemie. Only a doctor can evaluate you and give you his/her educated opinion. Your likelihood to have another high-risk pregnancy depends on many factors, such as your medical and personal history and your current condition. You have some very real concerns, though, and I encourage you to discuss these with your healthcare provider and/or with a perinatalogist. On the positive side, if bedrest is needed, you now know what to expect, and as you'll see in my book, you can take some steps now to prepare.

On a personal note, I spent so much time worrying during my second pregnancy that I really didn't enjoy those nine months. This is something I really regret as it was my last pregnancy. Reducing your anxiety can free you to enjoy this pregnancy and get to know the new life growing within you. My best to you and your baby!

StorkNet Member: How do you stay connected with your family during hospital bedrest? I'm afraid my family will forget me and my husband will go crazy working, driving to the hospital, managing the kids . . . he can only do so much.

Amy: Hospitalization can certainly cause a lot of stress for you and your family. Here are some ideas to stay connected from the chapter "When Hospitalization Is Needed":

  • When your husband and/or children visit, post do-not-disturb signs on your door so you can spend quality time together.
  • Consider arranging overnight childcare, allowing your husband to spend a night with you on a cot or lounge chair.
  • Have family movie nights and share take-out food.
  • Schedule regular telephone calls (such as before bedtime).
  • Record special messages or favorite stories on audiocassette so your children can listen to your voice during times of separation.
  • Take Polaroid snapshots of you to give to your children and vice versa.
  • Encourage your children to keep a calendar and cross off each day that passes. Children often have a hard time understanding the concept of time and that bed rest is only temporary. Celebrate each passing week with them by sharing a special treat or playing a special game together.

There are more ideas in the chapter 7 "Your Partner's Part" and chapter 8 "Siblings in Waiting."

Cassandra: How seriously should I take my doctor's orders to go to bed? I went to the hospital for bleeding and was sent home and told to stay in bed. It's hard to stay put when I have other children and I feel okay.

Amy: It can be very frustrating to be told to put your life on hold when you feel perfectly fine. However, bed rest is not being prescribed because you are sick. Bed rest is being prescribed because your doctor believes it may help you deliver a healthy baby. And wouldn't you want to do everything possible to ensure your baby's well-being?

Bed-rest prescriptions vary greatly among doctors, based on their individual beliefs and practices. For instance, limitations can range from some activity restriction and periods of lying down, to strict bedrest at home without bathroom privileges. Make sure you understand why your doctor recommends bed rest, and get clear guidelines for what you can and cannot do. In my book I include a checklist of bed-rest restrictions that you can ask your doctor to fill out.

Jennifer: Amy, my biggest problem with bedrest is that I get restless legs and I feel my metabolism slowing down. I am generally an active person who exercises. Any suggestions? I have bathroom/shower privileges, and the rest of the time I'm supposed to be in bed, on the couch, or in our easy chair.

Amy: Research shows symptoms associated with bed rest include muscle weakness, cardiovascular deconditioning, fatigue, backache, muscle ache, joint pain, difficulty concentrating, dizziness, shortness of breath, difficulty sleeping, and weight loss. Light, doctor-approved exercises (including walking, some weight-bearing exercise, and isometric exercises) can relieve discomfort, stiffness, and stress.

Important: Please talk to your doctor about exercises that you can and cannot do. Also, ask your doctor for a referral to a physical therapist (PT), which your health insurance may cover. A PT can develop an exercise program tailored to your individual limitations and needs.

If your condition warrants a no-exercise prescription, there is little you can do to ward off muscle atrophy. Please be sure to consult a PT after your baby's healthy delivery.

Christa: What do you do about well-meaning friends who offer to help but are too busy when I ask? I want to jump out of my bed and show then what REAL help is.

Amy: Great question! Here are some suggestions from bed-rest graduates who helped me with my book:

  • When asking for help, be specific about what you need: Take me to my doctor's appointment on Tuesday; take my kids to Saturday's birthday party; vacuum my house.
  • Provide grocery lists of specific items needed, including brands that you like.
  • Ask a friend to act as a central contact, helping to organize meal deliveries or transportation. This will reduce your stress.
  • Lower your standards. Helpers won't do the job the way you would.
  • Think outside the box, and ask others besides friends and family for help. Create a community pregnancy by asking for help from religious and civic groups and anyone you have an association with.

Also, take the time to explain why bedrest is needed and how being confined to a bed or couch is hard work. Many people think bedrest is a "mini-vacation." They have no idea what it takes to put your life on hold for weeks or months! I hope your friends start to support you soon!

Toni: Amy, what do you suggest bringing to the hospital? My doctor explained to us that I might need to spend the last couple weeks in the hospital if things don't improve. Any suggestions other than the obvious toiletries?

Amy: Toni, here are some suggestions from my book (provided by women who have "been there, done that"):

  • A calendar and a clock
  • Family pictures
  • Several good clothes hangers
  • Your own pillow with an identifiable pillowcase (to keep it from going into the hospital laundry) and a favorite blanket or comforter
  • A change purse and lots of quarters for snacks and sundries
  • A telephone directory and your personal address book (take along some stationery and stamps, too)
  • Ear plugs and eye shades (the hospital can be a noisy and bright place)
  • Slippers, comfortable slip-on shoes, and socks (the hospital blankets don't always keep your feet warm)

Another bedrest graduate and I deliver gift bags and entertainment items to the hospitalized high-risk moms in our community. Here are some of the entertainment items they like the best:

  • Fuzzy posters and markers (they love these!)
  • Cross-stitch baby bibs
  • Handheld computer games, such as a Gameboy
  • Playing cards
  • Laptop computers with Internet access (we got them donated for the hospital)
  • Puzzle books, such as find-the-word
  • Manicure sets
  • Books on tape and audiocassette tapes (reading too much can get stressful on the eyes)
  • Meditation tapes and comforting books, such as the Chicken Soup for the Soul books
  • Journals (for writing down your feelings or for writing letters to your unborn baby)

My best to you and your baby!

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Pauline: Is sitting in bed as good as lying in bed? And how do you keep from getting a sore back? If I end up on bedrest at all with this second pregnancy, I need to know how to better protect my back (and legs) from getting so sore.

Amy: Your pregnancy complication and your doctor's beliefs and practices will dictate your bedrest positioning and how much (if any) you can get up and walk. If your condition permits, weight-bearing exercises, or simply getting up and walking around, can help your muscles stay strong. Isometric exercises and stretches done in bed or on the couch may relieve discomfort, stiffness, and stress. Leg and feet exercises may reduce the risk of blood clots, caused by slowed circulation. Some doctors recommend water therapy in a pool to reduce swelling, increase blood flow, and lower blood pressure.

It sounds like you may have or have had back problems. A physical therapist (PT) can evaluate your unique concerns and create an exercise program for you. A PT can also teach you the least stressful ways to sit, stand, and position yourself. If you are prescribed bedrest, ask your doctor for a referral to a PT.

I provide examples of light exercises that can be done during bedrest in my book; however, these should only be done with your doctor's approval. An example of a back stretch: While lying on your back at a left tilt with your knees bent, press your arms into the bed while exhaling. Good luck to you.

Sean: Another husband here. You need to write a recipe book for husbands who don't cook. This is the worst part. Laundry - I've got it tackled. Dinner? No way! Help!

Amy: I'll have to consider adding recipes for the cooking-challenged when I do a book revision! The first thing that came to mind when I read your message is that you probably don't have the time right now to learn how to cook. You have enough to do, so make meals as easy as possible. Ask your friends, family, co-workers, religious or community service organizations to prepare nutritional meals (see the chapter called "Healthy Horizontal Eating"). Food is one of the first things most of us think to offer in times of need, so you should get lots of casseroles.

If you really want to pick up that spatula, there are some great websites with easy meal ideas: busycooks.miningco.com; www.cyber-kitchen.com; www.quickneasyrecipes.com; www.minutemeals.com. Cooking in a crock-pot can be lifesaving: you just throw in the ingredients and let them simmer all day. See www.mega-zine.com/kitchen/crock-pot/

There are even websites to help you plan meals for the week. www.my-meals.com is an example. Happy cooking! -Amy

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