Value of Bed Rest Questioned

About 95 percent of obstetricians report prescribing bed rest for patients at risk of preterm labor due to high blood pressure, vaginal bleeding or a multiple pregnancy. For women who need to work to support their family, being labeled a high-risk pregnancy and prescribed bedrest can be devastating news.

The prescription of bedrest doesn’t seem to rely on much scientific evidence and many experts doubt the benefits of immobility. The American College of Obstetricians and Gynecologists states: “bed rest, hydration and pelvic rest does not appear to improve the rate of preterm birth and should not be routinely recommended.”

In many cases, doctors prescribe bed rest due to limited options, and because it doesn’t require clearing with insurance companies and reduces liability to the doctor should a patient go into preterm labor.

Women on bed rest are severely limited. They are unable to drive a car, have sex, cook meals, walk up stairs or stand in the shower. Going to work and taking care of children becomes impossible.

Proponents of bed rest insist that the practice prevents preterm birth by limiting stress, decreasing pressure on the cervix, increasing blood flow to the uterus and diminishing uterine activity. In addition, many women feel certain that lying down helped to stifle contractions.

A major snag in the debate, though, is that most women who go into preterm labor do not have any prior indicators.

In addition to the affect on a woman’s lifestyle, downsides to bed rest are numerous; most notably, the lengthened recovery time after giving birth. Women on bed rest lose muscle and bone mass and have an increased risk of injury. The psychological effects of being labeled high-risk and suddenly being unable to tend to important day-to-day tasks are considerable.

Despite the debate over the use of bed rest, it may still be helpful for complications such as an incompetent cervix, according to some medical professionals.


[LA Times]