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Coping With Bed Rest

What do you do when your doctor orders total bed rest, and it's still weeks or months from labor day? It can be a lonely and scary time, but there are ways to help cope with the situation.

And So to Bed ... continued...

"Only mild forms of high-blood pressure would be treated with bed rest at home; with anything more serious people would be in the hospital," says Jodi Abbott, MD, assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, and an ob-gyn at Beth Israel-Deaconess Medical Center in Boston.

But there also are times when bed rest may beneficial, even when the medical indications are less clear, says another expert in high-risk pregnancies:

"Even if it does not help medically, you have to deal with the psychological health of the woman," says John Elliott, MD, director of maternal and fetal medicine at Good Samaritan Medical Center in Phoenix.

"Sometimes a lot of bed rest is prescribed so that the patient can psychologically deal with the outcome better," he says. "For example, there is absolutely no data, and I firmly believe that bed rest does not help in threatened miscarriage, and yet we will tell a patient to go to bed rest with bathroom privileges when she does have bleeding and cramping in the first trimester. I do it not thinking it's going to help, but if you don't do that -- and she goes on and miscarries -- her psychological adjustment to that loss is terribly hindered, because she feels that she didn't do all she could to prevent [it]."

What's a Mother-to-Be to Do?

The range of activities allowed to a woman on bed rest depends on the reasons for the medical order, Abbott says. Some women are on very strict bed rest and are told to only get up to use the bathroom, and not shower more than once a week.

"Most people who are on bed rest, however, get up and go to the bathroom, might be able to fix themselves something to eat, but if they aren't near the kitchen we tell them to keep a cooler near the bed, or have someone make them a sandwich," she says. "And pretty much, you can only do what you'd be able to do lying down."

Fortunately, many women with the financial resources or support from their employers can work from bed using a portable computer and telephone, for example.

"When people ask a woman with a high-risk pregnancy "what can I do for you," the best thing they can do is get that computer that may be in the basement or in another room set up next to your bed," Hurley says. Women with Internet connections can download information, participate in chat groups, and just keep in touch with the world outside.

But many women don't have access to technology, and for them Sidelines and other groups offer telephone support around the clock. "It's very hard for women on bed rest to stay compliant, but since we link up women [who are currently on bed rest] with women who have already been months in bed, there's nothing that patient can tell us that we haven't already been through," Hurley says.

Sidelines network chapters are staffed by volunteer "buddies" who offer counseling, support, encouragement and sometimes just a friendly ear to other women consigned to mandatory bed rest. In some cases volunteers travel at their own time and expense to be with single mothers during labor and delivery, and one Sideline buddy managed to find Catholic nuns who were willing to donate blood to a pregnant woman who was fearful about the safety of the blood supply.

Reviewed on February 28, 2005

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