Ask the Moms, part 17 – bed rest

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Bed rest. Those two words were my primary fear from the moment I considered getting pregnant. And when I found out I was having twins, I freaked out even more. I do not deal well with boredom or isolation, and I knew that having multiples upped my risk of being placed on restricted activity. But in truth, a twin pregnancy is not a guarantee of bedrest. Higher-order multiples, and it’s pretty close to a sure thing, but not necessarily so with “only” two babies. The HDYDI moms, naturally, run the gamut.

The Good

There are people who feel really good throughout their twin pregnancy. I swear! Snickollet even went to the gym at a whopping 38 weeks (and, may I say for the rest of us, “holy crap!”). There are indeed those among us who can keep right on going up to the day of their scheduled c-section. But even if you’re not a pregnancy superhero, you do have the potential to make it through your pregnancy without being placed in lockdown. Can bedrest be “prevented?” I’m not so sure. Whether you know it or not, your body may be prone to preterm labor, you may have cervix issues, or any number of other complications. But to whatever extent you can take care of yourself and help your pregnancy go smoothly, then I’d say go for it.

The key, in talking to many people, is to listen to your body and take it easy. Even if you exercise regularly, by the end of the first trimester, you’ll likely want and need to cut back at least on the intensity level. You’ll likely notice a slight (or huge) decrease in energy and endurance, so don’t push it. If you were a runner, maybe cut back to the elliptical machine. If you did power yoga, switch to prenatal. Low-impact, slow, easy.

I was not exercising much when I became pregnant, and was really too paranoid to start. But I cut back on other things. I noticed myself becoming easily tired around 20 weeks, so I elected to send my husband to the grocery store instead of going by myself, and made him carry the laundry up and down the stairs. Could I have done it longer? Sure. But why not take it easy for a few months? By about 28 weeks, my ankles were swelling and I was winded and getting contractions if I walked (slowly) more than a 2-3 blocks, so I stopped doing that.  I spent more time lying down (on my side, drinking an unnatural amount of water, of course) in my 3rd trimester.  I noticed I was getting more braxton-hicks contractions if I was on my feet too long, if I was too active, or if I didn’t have enough water.

Working is the same kind of thing.  If things are going well, you may be comfortable going to work right up to 38 weeks if you have a low-stress desk job and coworkers who don’t mind that you get up to go to the bathroom every 10 minutes.  If you have a job that requires long hours, time on your feet, or other stress and strain, you may want to cut back sooner, maybe around the end of the 2nd trimester.  I kept working (well, I kept going to work, though perhaps not super productive…) until 34 weeks, at which point it was just too uncomfortable to be in the car for my commute or sitting at my desk.  Plus, I was having twice-weekly NST/BPP at the hospital, so who had time to work?  Some of the HDYDI moms worked longer than that, others stopped closer to 28 weeks or earlier.

There are some doctors who recommend/insist on routine bedrest for all twin pregnancies, starting at a particular week (I’ve heard 28, 30, 32, etc.).  But most of the time, I would say that doctors mainly recommend that you just take it easy as long as things are going well, and only insist on bedrest if there is a particular indication to do so.  One relatively universal restriction, though, is on travel.  By about 24-28 weeks, most doctors will insist that you stop traveling (I traveled at 22 and was plenty uncomfortable), and especially after about 28 weeks, they probably want you to be within 30-60 minutes of the hospital pretty much at all times.  Around 28-32 weeks is a particularly touchy time as far as preterm labor goes, as it’s a somewhat more common time for preterm labor, but a difficult gestational age with regard to NICU times and good outcomes for the babies.  Not the time to be several hours out in the countryside… just in case.

The Bad

Things can and do happen to indicate bedrest, either modified, complete, at home, or in the hospital.  LauraC had her first pre-term labor scare at 21 weeks, and was on some version of rest for the remainder of her pregnancy.  Cynthia already had a history of pre-term delivery, so was watched extra carefully and when pre-term labor hit at nearly 28 weeks, was on full bedrest for the next 7 weeks until her boys were born.  Our resident triplet mom (a new contributor you’ll be hearing from soon!) takes the cake, with modified bedrest at home at 16 weeks, and hospital bedrest at 21.  Others had bouts of restrictions after an episode of bleeding or contractions, or were otherwise just told to stop going up and down the stairs, or lifting heavy things (like a toddler!).  “Modified bedrest” is a tricky phrase, and can mean anything from “stop working 12-hours shifts as a nurse” to “only use the stairs once a day.”  Often the restrictions are just an important illustration of how “easy” you should be taking it.  Complete bedrest generally means that you have to be lying down nearly the entire day, only getting up to go to the bathroom (or sometimes not even that, if you’re in the hospital).  The range of possibilities is all over the map.

While there are arguments to be made about the effectiveness of bedrest in some situations, our general feeling is to err on the side of caution.  Is it fun?  No.  But if it means your kids have a chance to be born at 35 weeks instead of 32, then we’re all for it. I’ve heard it said that every extra day they can spend in your belly is worth 3-7 days in the NICU.  It’s worth it to keep them in there as long as you can. You can survive bedrest.  Make sure you have a good stash of food and water.  Plenty of books and trashy magazines.  A laptop and wireless internet access.  A TV, DVD player, and a subscription to Netflix.  Call old friends, hit the Babycenter bulletin boards, start a blog.  Have a schedule of friends and family to come visit you and bring lunch.  Just try to restrain yourself from shopping online all day long.  It can get expensive. :-)

The Ugly

A word on multiple-pregnancy intimacy (yeah, it’s not a pretty image).  Unless your doctor has instructed you to be on “pelvic rest”  (boy, do I love that phrase!), there’s often no reason that you have to avoid sex during pregnancy.  There are sometimes reasons to avoid it, such as cervical issues or placenta previa.  But if your pregnancy is going smoothly, it is not generally recommended that you must avoid sex.  If you’re feeling good and are game for a some interesting physical logistics (what with the enormous belly in the way and all), more power to ya.

You never know how this one’s going to go.  Some people are hideously uncomfortable and the thought of sex could not possibly be less appealing.  Some people are all aglow with life, and discover the fabled 2nd trimester sex drive (I swear it’s a myth, but my friend said it happened with her, and my husband kept waiting for it to happen with me… and waiting… and waiting…).  Some men are a touch freaked out by the fact that there’s a person (or two or three) inside your belly, or have conflicting feelings about this new body of yours.  Some think a pregnant wife is the most gorgeous and appealing thing he’s ever seen (and might be kind of grateful for the pregnancy boob fairy).

We’ve all heard the stories of women past their due date being advised to try sex to stimulate labor, which is generally enough to freak out those of us who lived in fear of going into labor too early.  Every respectable thing I’ve read, though, says that sex itself will not spontaneously bring on labor if your body isn’t already inclined to do so. Though I will say that I… know someone… who was late in her twin pregnancy, whose body was clearly changing and getting ready to deliver for a week prior, and who may or may not have knowingly agreed to sex with her husband half-hoping it would get the show on the road, and and who may or may not have immediately afterwards started contracting every six minutes, and who may or may not have delivered her babies the next morning.  As I said, sex won’t just start labor if your cervix is closed and you’re not contracting and all of that.  But maybe, if you’re near the end, and have been contracting for a week, and the babies have dropped….

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What about you, dear readers?  Were you on any kind of bed rest or restricted activity?  Did your doctor have a set date at which (s)he’d send you to the couch, or more of a wait-and-see attitude?  If you did spend a lot of time lying around, how did you survive the boredom and loneliness aspect?

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17 thoughts on “Ask the Moms, part 17 – bed rest”

  1. Thankfully, I was never on bedrest and carried my twins to 37w1d without complication. During my pregnancy, I was not working and had no other children to take care of, so I could take it very, very easy — and I did. All along, but especially in my third trimester, I spent a lot of time lying on my left side, drinking lots of water, and generally doing whatever I could to keep the babies inside for as long as possible. I really cut back on all activities after about 32 weeks, and after 35 or so, I barely left the house! I did get really, really bored and uncomfortable by the end — but looking back at it now, it was such a peaceful time — and one which came to an abrupt end once my twins arrived :)

  2. i was on bedrest for a couple of months…modified, which meant laying on the couch but i could get up to eat, pee, take my dog out (but not on a walk), etc. i hate daytime tv so i turned to my laptop. internet shopping. WAY too much internet shopping. bedrest was peaceful, yet boring. even though it was boring i was just focused on keeping the babes in as long as possible so i didn’t get grumpy about it. (37 weekers, induced). it sounds nice now but i think even now i could only do a couple of days 😉

  3. I saw an MFM early in my pregnancy who recommended bedrest from 24 to 34 weeks (“If I can go to McDonalds to pick up dinner, so can your husband” was the direct quote). I spoke to my OB who did not agree with this extreme perspective. But then I went to the local hospital at almost 24 weeks with contractions (not my first hospital visit for contractions) and they were 2 minutes apart. An ambulance ride, 2 night hospital stay at a hospital with a Level III NICU, and much anxiety later, I decided that modified bedrest would work the rest of my pregnancy. That got me to 33 weeks (contracting all the way), when I was diagnosed with extreme preeclampsia, another ambulance ride, 5 more nights in the hospital, and babies born at 34 1/2 weeks. By c-section, because despite 18 weeks of contractions, I apparently had the “cervix of steel.”

    I watched a lot of TV; read a lot of pregnancy books (I wish I had read more PARENTING books at that point… nursing, sleep, etc.); watched a lot of TV; web; phone; online shopping; ate; peed. It was both boring and exhausting, but so, so worth it!

  4. I can even beat Rachael :(
    I started bedrest at 14 weeks when I started bleeding and delivered my twins at 35 weeks, when my placenta started to deteriorate. It was a whopping total for 6 months on my butt.
    Just awful!
    But, in the end, so worth the sacrifices made by my whole family, esp. my husband & other kids.
    We have SO many blessings to count (especially on this day. PLEASE see my blog. We are so excited today! My little boy who has cerebryl palsy took his first unassisted stps!!!)
    :) Debi

  5. I had a just over a week of bedrest, but had I been a bit smarter, I think I could have avoided it all together. I was put on bedrest during my (almost) 32 week checkup – I was 3 CM dilated and contracting, without even feeling it. We were able to stop labor, but I had to stay in the hospital and on Procardia to control the contractions. I was able to hold on for a while, but my body was too far gone after about a week, and I delivered the twins just shy of 33 weeks.

    I really think that I could have avoided the early delivery and bedrest had I taken it easier during my pregnancy. I like to be tough, and didn’t want to be “useless” so I pushed myself.

    Bedrest wasn’t so bad, since the hospital had wi-fi. I actually worked for three days from my hospital bed, but it was hard to be on conference calls when there were constantly nurses in and out!

  6. I was put on bedrest at 16 weeks, when during my first cervical length measurement by the MFM, they found it to be at 0.2cm. I was put in a wheelchair, wheeled up to L&D, admitted, and had an emergency cerclage the next day. They gave that just a 50% chance of working given the extremely short length I was at (with contractions I did not feel) but it did work and got my length back to 3.5cm.

    I was kept on bedrest at home, since I had been so short so early. Up for just the bathroom and to grab myself something quick to eat or drink (no sitting to eat). Luckily I work from home so I could continue to work to curb my boredom.

    At 24 weeks I was admitted to hospital bedrest because my cervix had shrunk despite the cerclage, and I spent 4 weeks on hospital bedrest. The food was awful! And I had to go on leave once I was put on hospital bedrest. Lots of computer time, still a little work, and lots of TV filled my days. Nothing made me happier than someone bringing me outside food!

    I delivered my girls at 31w0d due to PROM on baby A, my cervix was still holding strong. But she was trying to push her cord out with her foot, so they delivered me. They spent 5 and 6 weeks in the NICU.

    My best advice is just to say that although the bedrest is so hard and you are so tempted to just get up and do something, don’t do it. In the end, the bedrest is so worth it. The only thing harder than the bedrest was having babies in the NICU, so every day you can keep them in you means less (or even no) NICU time.

  7. I’m 26 weeks or so (maybe 27, I can’t keep it straight) and to be honest with my demanding job sometimes I think I want bed rest but I don’t really since I have so much to do to get ready for their arrival. Someone told me that they knew someone who was put on modified bed rest – could have lunch with friends but couldn’t work so got paid disability to be a stay at home wife. That has got to be a myth – right?

    My mom was on bed rest starting around week 16 with the 3 of us and delivered at 30.5 weeks. She actually wants my doctor to put me on bed rest because of my work schedule but they tykes really don’t seem to mind it at all. He doesn’t prescribe best rest without a reason – premature labor, cervix issues, blood pressure, etc. I see him on Tuesday so hopefully all is still going well!

    I have decided that the BBC Jane Austen adaptations are a must buy if I end up on bed rest. I also think renting TV shows from Netflix will help anyone getting sucked into Discovery Health or TLC baby shows to stop the madness.

  8. I’m 24w2d with boy/girl twins, and am on modified bedrest. You are right…there’s no strict definition to what that means.

    At 12 weeks, I went on strict bedrest due to a placenta separation (4cm) with lots of bleeding. After 4 weeks the bleeding stopped, and a couple weeks later the separation appeared to have corrected itself. From that point on, the doctor had me on modified rest.

    I can’t get a clear definition of what that means. My MFM says “no more than necessary” but my OB says it’s okay for me to go to the grocery store or out to lunch with friends. I just try to limit my activity and rest when I need to. I keep my feet up most of the day, don’t carry anything up and down the stairs, limit my trips, and am to the point where I probably will stop driving, too. I *think* I have a good feel for my limits, and so far things are holding up. (knock on wood)

    This was a great post…thanks!

  9. Bedrest is horrible. Bedrest combined with excessive fear and worry is even worse. I was put on bedrest at 19 weeks for Twin to Twin Transfusion Syndrome. I spent 11 weeks total on strict bedrest, the 8 weeks at home and the last 3 in the hospital. I have started a list of tips for surviving bedrest on one of my websites. It is a work in progress and I hope to add more information.
    http://twicethelove.googlepages.com/tipsforsurvivingbedrest

  10. My first visit to the MFM around 18 weeks revealed a shortened cervix that continued to shorten throughout my pregnancy. At first we did the “let’s wait and see” but 2 weeks later I was on bedrest at home….up for the bathroom and to grab a quick bite to eat, but let’s face it…..that’s ALL I wanted to do so I felt like I was getting up all the time. I had a quick trip to the hospital to start meds and then had home monitoring for my contractions. Luckily I was able to work at home (wow….I never thought I’d say that in the same sentence….luckily and work!!) which really helped the day go by, but 3 weeks later I found myself in the hospital with contractions ~6 minutes apart……and I never left until our twin girls arrived — 6 weeks after my admission and at 29 1/2 weeks gestation. I filled my days with puzzle books, reading, napping (I got really good at napping!) and thank goodness for the internet – I was able to keep or get back in touch with many friends and family through e-mail. I also pre-ordered envelopes to the birth announcements we picked out so I could address them while in the hospital……….the girls arrived just a few days later so I’m still working on those, but hey – it was a good thought!! Luckily our girls are doing well and we hope to have them home soon…….bed rest helped me get to 29 weeks and I’d do it all over again if I had to!

  11. Thankfully, I managed to avoid bedrest, but spent my entire pregnancy in fear of it, and now looking back, perhaps should have insisted I be on modified bedrest because I delivered my girls at 34, 2 (not bad, but not great either – they spent 3 weeks in the NICU). I had contractions (BH?) starting around week 20 and my doc at MFM told me to accept that as my “new normal”, so I did. I hated it though – everytime I stood up, I would have a contraction. I worked right up until I delivered, but had a makeshift bed in my office so I could lay down when I needed to, then worked part time at the office and part time at home, and at week 33 worked full time at home (mostly on my side with my laptop because if I sat in a chair, the blood flow to my legs was restricted and my feet would swell). I am so happy to have 2 healthy toddlers, but I wouldn’t want to repeat a twin pregnancy (and I’m told if I get pregnant again, I have a 1 in 5 chance of having twins again – NO THANKS LOL) because I was simply SO uncomfortable and anxious the entire time.

  12. this post came at a great time for me … i’m 33 weeks and went in yesterday for my weekly nst and exam to find out I was 2 cm dilated & contracting. we were admitted to the hospital yesterday for monitoring. I’ve received steriod injections & meds to stop the contractions. So far so good and I hope to go home tomorrow and will more than likely be on bed rest at home. If I can keep the babies in for a few more weeks, it’s so worth it.

  13. I have 2 sets of twins. My 1st set were born at 32 weeks, after being on bedrest from week 28 and on. I had been working full-time up to that point and my OB kept encouraging me to go on maternity leave but I kept thinking I could hang in there. I wish I had listened to him because right at week 28 is when things started going haywire with pre-term labor. I was in and out of the hospital constantly for the 4 weeks after that and on complete bedrest. The only good thing about that was I got to know all the nurses pretty well before I actually delivered!

    With my 2nd set of twins, they were born at 34 weeks but I was on bedrest from week 20. Yes, 14 weeks of bedrest but it was so worth it to keep them in that extra 2 weeks that I couldn’t give my 1st set of twins. And what a difference that extra 2 weeks made…our experience between the 1st set of twins and the 2nd set in the NICU was like night and day.

    For bedrest, I spent a lot of time reading books. I happen to love books so I got to read everything under the sun that I had been wanting to read. I also started a blog at that time. I called friends and caught up with what was going on in their lives. There was a point in each pregnancy that I was beyond bored and I would cheat every once in awhile (taking longer than the 3 minute daily shower I was allowed or walking up and down the stairs more than I should have). There’s also a great support board for women on bedrest during their pregnancies (can’t remember the name of the board now but maybe someone else here does…maybe it’s sidelines or babycenter…I wish I could remember) and those ladies were great…just knowing there were other ladies on bedrest helped me get through another day!

  14. My Dr. told me all along that it was up to me. When I had had enough, let him know. He wouldn’t insist on bed rest unless there was a problem. I was teaching elementary school and on my feet all day, including during lunch. Also, my school was built on an incline, and I had to walk up and down ramps all day. I was miserable, and my back ached horribly. I felt like such a wimp, but I didn’t feel like I could continue working, and I was concerned about the well-being of my babies. I finally asked for modified bedrest at 33 weeks. I worked double the few weeks prior to bed rest getting sub plans ready. My last official day was on a Friday. I worked at school all day Saturday completing my sub plans. I finished typing some instructions late Sunday night into early Monday morning. My husband took them to school Monday morning for me. I slept in and enjoyed my first day of much needed rest. I wasn’t scheduled to deliver for another 3 1/2 weeks. Later that afternoon, I went in for a routine ultrasound and Baby B was IUGR. Things happened quickly after that. I was admitted and had my c-section only a few hours later. I was 33 weeks, 3 days. I was concerned about my babies, but my dr. had done a good job of reassuring me throughout my pregnancy, and I had received the steroid shots a week earlier, so I was pretty confident that the babies were okay. Mostly, I was BUMMED that I didn’t get that bed rest that I had been coveting almost my entire pregnancy! I know bed rest could have become difficult and boring, but I was so exhausted from teaching and planning for 8+ weeks of a sub that I just wanted to put my feet up and SLEEP!

  15. My girls are 2 months old today and they are our first. I spent 3 weeks on hospital bedrest but prior to that was not on any restrictions from my doctor. At 32 weeks, I started getting pre-eclampsia. Due to the fact preeclampsia can progress so rapidly in multiple pregnancies they weren’t comfortable sending me home. My husband was deployed to Iraq from week 6 until week 32. Hospital bedrest got him home about week before his return date. I was able to get a huge room that at one point was intended for 4 patients. There was an extra hospital bed in there so my husband was able to sleep somewhat comfortably in the hospital every night with me. This unit was equipped with mini fridges in each room so we could keep food/drinks etc.. which made it a lot better. We got internet access, blogged and relaxed watching movies every night.He also got me food every night so I didn’t have to eat the not so great hospital food. It was boring and towards the end I felt like total crap as the preeclampsia worsened but the rest helped me. I would not have been able to release control at home like I did in the hospital. There is still laundry to do,dishes have to be put away, etc…when you’re in the hospital everything is done for you. Looking back in the moment I was pretty miserable but now I would give anything for a night of bedrest, so if you’re in that position, soak it up…there are plenty of sleepless nights to come. I will say that if we had other children prior to this pregnancy, hospital bedrest would have a whole new aspect and probably would have been a lot more stressful. My girls were born at 35 weeks bc my water broke. My preeclampsia was bad enough that they were going to deliver me the next day anyways but my body knew when it had enough. Baby A spent 2 weeks in the NICU and baby B spent 1 week.They are healthy and thriving now!

  16. I have advised many to truely listen to their own body. I am an elementary school teacher and also always on my feet (I can sympathize with Plus 3 above). At about 20 weeks I started feeling cramping and NO (not just decrease) energy. I barely had energy for my then 2 yr old. I called and spoke to my nurse who said that was normal for twins. Went for appt at 22 weeks, but my dr was out on emergency. The nurse again reassured me. I spoke with my principal who was extremely understanding and I began shortened days – all on my own. I knew I could not do it anymore. when I went in for my 26 week appt, an ultrasound and conference with me had the dr a little worried. A NST showed contractions every 2-3 minutes and exam showed shortened cervix. To the hospital for a couple of days, then an ambulance ride to another hospital. Home after a week – strict bedrest. Another week later back to hospital 1, ambulance ride to hospital 2, and a hospitalized bed rest until 34 weeks and delivery. We were so lucky to hold off so long. The hardest part for me was being away from my 2 yr old, but I have wonderful family to help. The meds also kicked my butt, but it is amazing how it is so hard to think about that 2 years later. If nothing else, those of you pregnant now, listen to your own body. I never wanted to complain, but if I would have stressed to the drs a little more about how I felt, I may have prevented some of this. good luck!!!

  17. I was never put on bedrest, but my doctor did ask me to stop working at 32 weeks. I was beside myself at the suggestion. What would I do all day? How would my projects get completed? (Granted, I documented everything I did at work just in case I did go into labour and someone needed to finish up for me … which they did!)

    My manager offered me the opportunity to telecommute half time, and my doctor thought it was a great idea. I balanced my laptop on my massive belly and typed away while lying on the couch, every necessity (except the bathroom) within arms’ reach.

    The arrangement lasted a week. I delivered my 3 lb-something girls at 33 weeks. They’re two now, and I’ve never gotten over the guilt of it. Perhaps if I’d taken taking it easy more seriously, they would have gestated longer? In retrospect, prematurity hasn’t held them back in any way, they were and are the healthiest preemies I’ve ever heard of! Still, I wonder if telecommuting was really the best choice; there was no physical toll on my body, but work does bring its own stresses.

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