Knowing the rules – types of bed rest

The term bed rest is extremely vague. For many they envision being confined to their bed until their baby is born, which, in reality, is the case for only a small percentage of women. The restrictions placed on bed rest are wide ranging and can vary throughout the pregnancy.

It is important to be clear on what type of bed rest you have been placed on and your restrictions. When I was first placed on home bed rest after being diagnosed with complete placenta previa with my daughter, my only limitations were minimal trips up and down the stairs, no working as well as resting when I could. I was still allowed to go on light shopping trips or out to coffee with a friend. This changed after a bleed that put me in the hospital for 48 hours. My restrictions were then more defined and my movements limited. On my weekly visits, my obstetrician (OB) would review my symptoms, ask me about movements and, if there were no complications, allow me certain outings – car rides with my husband or ice cream at the beach. But each outing had to be within a short drive of the hospital and was for a set amount of time. Then it was back on the couch or to bed.

Be careful about Googling the term bed rest. It is too easy to pick the definition you like the best, telling yourself “well this is bed rest, so it must apply to me.” Your medical provider knows you and your pregnancy best.

Here are some common clarification questions to ask your doctor.

Time off your feet

Am I to be in bed and/or on the couch all day? Can I walk about for short periods of time? What length of time?
Can I get up to go to the bathroom? Take showers? Baths? If so, for how long?
Can I go to the kitchen to make my meals?

Sitting versus lying down

Am I allowed to sit up or do I need to lay down all the time?
Do I need to lie on my side or can I lay on my back, slightly elevated? If I can sit up, for how long?
Can I eat meals at the table or do I need to be in bed?

Activity

Can I drive myself to appointments?
Can I pick up my kids?
Can I do prenatal yoga or other light stretching exercises?
Can I get a massage or see a chiropractor?
Can I climb the stairs? If so, how often?
Can I lift things (like my kids)? Weight limits?

Make your own list of questions and discuss them with your healthcare provider. Then make a list of your restrictions, and review them each visit to see if any of the restrictions have changed. This is important, as your provider may not think to change restrictions based on changes in your pregnancy.

What to expect

Okay, so now you’re clear on what bed rest means to you. You have your list of restrictions, now what? If you only have a few days left in your pregnancy, well then kick your feet up and enjoy the last quiet moments before baby arrives. That is if this is your first child. If you have other children, enjoy some cuddle time in bed with them. However, if you have a week or more before your baby’s birth, and for some a few months, it’s time to start thinking about what to do with yourself. The first few days you will likely try to sleep in, catch up on some television and get to that book you’ve been meaning to read. But once that is done, you’ll soon find the days can be long to fill.

The first thing is to get organized. Make a list of what you want to accomplish before your baby arrives. Is there a photo book you want to complete? A book series you’ve always wanted to read? A hobby you want to take up or master – such as knitting or jewellery making? It’s a good idea to list what interests you and how you can advance those interests from your bed. Even if you are a marathon runner, you can research running tips, set up a post pregnancy eating program or research marathons you’d like to eventually run. The idea is to fulfill your passions and spend this time filling your bucket versus emptying it in boredom.

You should also enter all your medical appointments into the calendar. If your restrictions don’t allow you to drive, you will need to schedule transportation for your appointments. It is also handy to create an in-case of emergency list that is near you at all times. Who can drive you to the hospital if needed? Who can come and quickly take care of your kids? Your pet? Planning in advance can relieve some stress as you know you’re prepared if an emergency arises – even if you never have to use your list.

Emotional rollercoaster

Being pregnant is a very emotional time for women. Then add bed rest to the mix, and it can be a tearful experience.

Be prepared for all the emotions that come with being confined to the couch or bed. Having your independence taken away is challenging, but remember it is only for a short time.

It’s important to know you are not alone – even though there are many times you feel you are the only person going through this experience and none of your friends and family understand. And realize those breakdown moments where the smallest thing puts you over the edge are okay. We all have our breaking points, and having a good cry is actually therapeutic.

What set me over the edge in my confinement were airplanes going over the house – the Canadian Snowbirds. For non-Canadians, the Snowbirds are an acrobatic elite team that performs at airshows across the country.

I had read in the paper they were coming to town. Even though I’d seen them perform in the past, I was disappointed I wouldn’t be able to go to the beach to watch them – as this point in my pregnancy confined me to the couch all day.

I was watching TV and heard the planes fly over. Since I hadn’t been off the couch for a couple of hours I went outside to sit on my deck to see if I could watch them. Unfortunately the best I could get was a one second glimpse as they passed over the trees.

I went back onto the couch and broke down. I cried for at least half an hour. It wasn’t about not seeing the airshow, but about the fact the choice to see the Snowbirds had been taken away from me. I cried for the loss of my independence. I cried for being alone as my husband was at work. I cried for all the stress and worry about my baby. This was the moment my bed rest caught up with me and I fell apart. For so long I had been trying to hold it all together. To put on a strong face for my friends and family and not admit I was scared and depressed.

By the time my husband came home, I felt better. But I decided to tell him about what had happened, as I was tired of putting on a brave face. It helped me realize that I wasn’t okay and I needed to be honest about my feelings. We had a great talk. After that he was more aware of my emotions, and talked with some of my friends to check in on me.

It’s important our support team is aware of the emotional support we need. It can be hard to let them see beyond the mask, but now, more than ever, you need people to keep an eye on your emotional and mental health.

This is an area I found lacking in obstetric care. Your medical team monitors your blood sugar, blood pressure, baby’s heartbeat, baby’s position, positioning and more, but often the emotional state and mental health of mothers is overlooked.

If you are struggling, make sure you talk to your medical support team. It’s especially important if you’ve suffered from depression before you were pregnant. But even if you haven’t, the raging hormones and isolation can impact your mental health.

It’s important our support team is aware of the emotional support we need. It can be hard to let them see beyond the mask, but now, more than ever, you need people to keep an eye on your emotional and mental health.

This is an area I found lacking in obstetric care. Your medical team monitors your blood sugar, blood pressure, baby’s heartbeat, baby’s position, positioning and more, but often the emotional state and mental health of mothers is overlooked.

If you are struggling, make sure you talk to your medical support team. It’s especially important if you’ve suffered from depression before you were pregnant. But even if you haven’t, the raging hormones and isolation can impact your mental health.

I never shared my story with my OB, nor did she ever ask how I was doing emotionally. Looking back I wish I had told her, as I suffered from baby blues for the first few weeks after my daughter was born – also in silence. I was however blessed to be surrounded by a supportive group of women that I met in my prenatal classes. Two of these women were on medical leave and, while not on bed rest, shared some of my feelings of isolation. We got together once a week and these friendships helped me get through the remaining days until my c-section.