Bed rest (expectant management)

Expectant management is the close monitoring of a pregnancy for complications, typically requiring bed rest at home or in the hospital. Until recently, expectant management was recommended for women at high risk for preterm labor, such as those with multiple pregnancy, vaginal bleeding, or an incompetent cervix. But studies now show that:

• Expectant management is not effective in preventing preterm labor. This holds true for a variety of pregnancy complications.¹
• Strict bed rest for 3 days or more increases your risk of developing a blood clot in the legs or lungs (16 in 1,000, which is higher than the normal 1 in 1,000 during pregnancy).^{2, 3}

If you are prescribed partial bed rest

If your doctor or nurse-midwife suggests expectant management for preventing preterm labor, discuss the benefits and risks in light of your particular condition.

When you are resting or sleeping during late pregnancy, try to lie on your side. This is thought to improve blood flow to the uterus and fetus(es).

Dehydration can trigger contractions, so be sure to drink plenty of fluids each day.

Citations

1. Goldenberg RL, Rouse DJ (1998). Prevention of premature birth. New England Journal of Medicine, 339(5): 313–320.

2. Cunningham FG, et al. (2005). Preterm birth. In Williams Obstetrics, 22nd ed., pp. 855–880. New York: McGraw-Hill.

3. Kovacevich GJ, et al. (2000). The prevalence of thromboembolic events among women with extended bed rest prescribed as part of the treatment for premature labor or preterm rupture of membranes. American Journal of Obstetrics and Gynecology, 182(5): 1089–92.