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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:
Amazon
U.S.
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Canada
|
 After
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.
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