Bedrest In Pregnancy… Part I
By Rochelle Nazarian, RN, MSN, FNP, CS, Triplet Mom
Originally printed in April 2003

I know that many of you reading this may be pregnant and possibly on bedrest.  Everyone 
experiences a different pregnancy with different issues.  Being pregnant with triplets or 
more, there is a likely probability that one of those issues may be that fact that you will 
be put on bedrest at some point.  There are many reasons why: maybe as a precaution, 
maybe because you have experienced pre-term labor, or maybe because you're just too 
tired and uncomfortable to get up.

The following, PART I, is a guide explaining issues relating to bedrest.  Next month, 
PART II will follow, providing tips for surviving bedrest.  Many of the survival tips will 
be those sent in by our members.

I've had three pregnancies and was ordered on bedrest each time, for different reasons 
and different time frames.  With my first singleton pregnancy, I was put on modified bed 
rest at 28 weeks as a precaution.  For my second, a triplet pregnancy, I was put on 
modified best rest at eight weeks and strict bedrest at ten weeks.  For my third pregnancy, 
a singleton, I was put on modified best rest at 28 weeks.  Each pregnancy was more 
difficult, mostly due to the fact that I had more children I needed to care for.  But in the 
end, I made it and so will you!!!

The following information is a collaborative effort of my own experience, and 
Dartmouth-Hitchcock's medical website.

What does bedrest mean?
Being on bedrest means decreased activity may be prescribed by your obstetrical provider 
to improve pregnancy outcome in a number of obstetrical problems.

How will being on bedrest improve pregnancy outcomes?
?	If you have experienced uterine contractions, decreased activity may decrease 
uterine contractions.
?	If you have experienced high blood pressure, decreased activity may decrease 
fluctuation of blood pressure.
?	If you have been diagnosed with an incompetent or very dilated cervix, bedrest 
may improve the pregnancy outcome by removing the effect of gravity.

What effects may I experience if I am put on bedrest?
?	Physical changes: Bed rest may cause muscle and bone loss, loss of extra body 
fluid added for pregnancy, worsening of pregnancy discomfort (heartburn, reflux, 
constipation, low back pain, insomnia), and disruption of circadian rhythms.
?	Emotional changes: Bed rest can cause depression and anxiety, lower self-esteem 
and less satisfaction with body.
?	Cognitive changes: Bed rest can impair recall, decrease verbal fluency, decrease 
perceptual motor skills, and decrease concentration.

What coping mechanisms can I use to help deal with bedrest?
?	Avoid isolation, get together with friends and family
?	Wear street clothes in the daytime
?	Get out of the bedroom
?	Massage
?	Physical therapy
?	Distraction- reading, crafts, etc.
?	Support groups

The specific recommendations for amount of time to rest and what activities are okay 
to do will be made by the patient's obstetrical provider.  Two common sets of 
recommendations are listed below:

If I am ordered to DECREASED ACTIVITY by my obstetrical provider, what can I 
expect this would entail?
?	Rest: Lying down, one hour in AM, two hours in afternoon, settle for bed by 9:00 
PM 
?	Housework: Light housework only 
?	Walking: May walk short distances such as from car into clinic or store for short 
shopping trip 
?	Strenuous exercise: None 
?	Sexual activity: Okay unless contractions are caused

If I am ordered to STRICT BEDREST by my obstetrical provider, what can I expect 
this would entail?
?	Rest as much as possible, lying down
?	Housework: None
?	Walking: Back and forth to bathroom and kitchen
?	Strenuous exercise: None 
?	Sexual activity: Abstain

Here is a good book: Pregnancy Bedrest - a Guide for the Pregnant Woman and Her 
Family by Susan H. Johnston, M.S.W. & Deborah A. Kraut, M.I.L.R.

Bedrest In Pregnancy… Part II
Survival Tips
Originally printed in May 2003

As explained in Bedrest, Part I, there are many reasons why your health care provider 
may order you on bedrest.  So, now that you have the orders, how can you survive?

The following tips were submitted by members of Triplets, Moms, and More as well as 
from a website that I found very helpful.  Thanks to these Moms for their submissions.  
You can also find lots of helpful tips online by searching under "bedrest in pregnancy."  
One site I found very informative is done by Luanne O'Loughlin 
(http://hometown.aol.com/luanneo/Bedrest.html), a mom from Fairfax Station, VA.  
Although not a mom of multiples, she was on bedrest while caring for another child.  I 
found her tips on what to do if you already have a child/children very informative.

I have tried to break down the tips into categories so that they may be more helpful.  If 
you are ordered on bedrest, take care of yourself and those babies.  Use these tips to help 
you through.  Every difficult moment will cease with the delivery of your little 
miracles!!!

What can I do for myself, my peace of mind, my health, and my sanity?
?	Accept the way things are being done by spouse, family or friends, i.e. laundry or 
loading the dishwasher.
?	Try and follow all your doctors' advice to possibly help from being admitted to 
the hospital.  Many moms are happier at home.  They find the food better, better 
access to television, less hectic without the constant traffic of medical personnel 
and visitors, and sleeping at night is much more comfortable in your own bed 
with your spouse nearby for company.
?	Adapt an attitude that allows you to do anything for your babies that they cannot 
do for themselves.  Be sure that you do your very best so that no matter what 
happens, you'll know you did your very best.
?	Listen to your doctor - stay in bed!  It's all temporary!
?	Stay on your left side.  Rotate every now and then to minimize bed sores.
?	Have a chair in the bathroom so you can sit to get dressed, brush teeth, etc.
?	Keep a positive mental attitude and avoid as much stress as possible.
?	Set up your bed or a guest bed if you have one in the living room of your house 
and live there during the day.  The change of scenery does amazing good and 
sitting in the most open, airy atmosphere as possible will be so beneficial to your 
mental well being.  Also, it makes it easier for some visitors -- co-workers and 
casual friends can feel uncomfortable visiting you in a room as personal as your 
bedroom.
?	Take a shower and make your bed EVERY DAY! Otherwise, you feel gross, 
unattractive and your bedsheets get stale... neither of which will make bedrest a 
pleasant thing (this is assuming you're spending your time in bed, not on the 
couch).  Instead of sitting under the sheets in your bed, sit on top of it with a 
blanket over your legs if needed.  The more clear transitions you can make to 
define day and night, the better.
?	Get into a routine.  It's much easier to deal with all this time you have on your 
hands when you're in a routine.  I woke up around 10am, had my shower and 
breakfast by 11am, played on the computer until around 1pm, and read until my 
husband came home at 3pm.  After that, it was his job to entertain!  I can honestly 
say I was never bored and the time I was alone flew by fast!
?	Planning to breast-feed?  Connect with local breast-feeding support groups, either 
by phone or online.

What can I do so that my pregnancy is not all a blur after the babies are born?
?	Create a journal on how each day of your pregnancy goes, write down your 
thoughts - because when you get busy when the babies come, it's nice to look at it 
and remember when all you had was time.
?	Write a journal to your babies

How can I ensure proper nutrition while on bedrest?
?	Keep a stocked cooler/small fridge next to your bed
?	Have someone prepare snacks for you to keep nearby
?	Get a hot pot for soup, etc.
?	Drink as much water as you can
?	Ideas for your cooler/small fridge: wrapped half-sandwiches (turkey, ham, 
cheese), salad greens, cottage cheese, peanut butter, melon, apples, cheese, 
yogurt, cups of ice, fruit juice, cherry tomatoes, cucumber (peeled), carrots, celery 
and other raw veggies, cold leftovers (pizza, steak, chicken), an artichoke, bean 
salad, rice salad, pasta salad, potato salad, etc.
?	Get cups with lids and straws

Are there things that my community can do for me?
?	Contact your local library to see if they deliver to elderly/shut-ins.  Have some 
authors or titles of books you may want to read for them to deliver.
?	Hook up with other pregnant moms through TMM
?	Order postage stamps by mail or through the web at the postal service website
?	Connect with local churches for volunteers both for now and when the babies 
come

What kinds of projects & crafts will keep me busy?
?	Crossword puzzles
?	Paint your nails, have spouse paint toenails
?	Rug hooking
?	Painting
?	Thank-you notes and Christmas cards are the perfect time-passers
?	Put stacks of photos in photo albums
?	Read light things like magazines that aren't too much for weary brains
?	Crochet little hats and other things for your babies
?	Read catalogs... order presents that you'll need for the next few months
?	Update your address book
?	Mend clothes and sew on buttons (you could even do this for friends)!

I have family and friends that are willing to help.  What can they do?
?	Let people do for you.  This can be so difficult, but try and let go and focus on the 
babies.  Everything will be waiting for you afterwards!
?	Let people from work or your church bring meals.  They want to and it helps!
?	Have a friend or family member borrow videos from the library (or rent from the 
video store)
?	Invite friends to bring lunch/dinner over and have a picnic in bed with them
?	Get extra keys for friends and neighbors
?	If you place orders, ask if the delivery will require a signature.  If so, send the 
package to a neighbor. Otherwise, ask that the signature requirement be waived so 
the package can be left at your door.
?	Have friends/family toss in a load of laundry and stick around to fold it
?	Have a neighbor bring in the mail each day
?	Ask a friend to be your personal shopper for things you may need
?	Ask a friend to be your grocery shopper

I have another child/children.  How can I take care of him/her/them while on bedrest?
?	Contact your insurance company to see if your plan includes any type of help for 
childcare.
?	Have a big bedside table next to your bed so you can play board games, do easy 
crafts, or sticker books
?	Read books
?	Watch TV and videos (have favorites nearby)
?	Try and set up playdates
?	Line up people your children will feel comfortable going with so you can rest
?	If you don't have an older child already, borrow one.  Put towels under your legs 
and feet and give the child a bottle of lotion.  Let him/her finger paint on your legs 
and feet.  These are areas you most likely won't be able to reach yourself and it 
feels so good to have those little fingers writing on your tired/un-used muscles.
?	Ask school-aged childrens' school about extended day or after school programs
?	If family or friends can take them, sign kids up for programs in 
community/YMCA.
?	If your child is interested in taking swimming, gymnastics, karate or (fill in the 
blank here), find out what classes the other local kids are taking, and coordinate a 
schedule with their parents to transport your child when you can't.
?	Give the school a list of people you may have pick up your child in an emergency 
ahead of time.
?	Send frequent notes to the teachers and school director, so they are aware of 
childcare and transportation arrangements.  Provide lots of phone numbers.
?	Have spouse or someone set out the next day's clothes each evening.  Since you'll 
have all day to watch TV, know what the weather will be.
?	Go through the child's school bag each evening to check for homework or notes.  
Since you can't get out of bed, you can't run around for things the next morning.
?	Contact your child's pediatrician to discuss how you will obtain medical care for 
your child while you are on bedrest.  Make sure that he/she understands that you 
may need to have a friend bring your child in for appointments.
?	Plan in advance for school vacations
?	Ask close friends or relatives to substitute for you at school functions
?	For summer, scour the camp listings
?	When the seasons change, have someone carry your child's dresser drawers to 
your bed.  Sort out the clothes, determine what you need, and use catalogs or the 
web, to order new clothes.
?	If your school publishes a list with kids' birthdays, review this to get an idea of 
how many birthday parties will be scheduled during your time on bedrest.  Don't 
forget to stock up on treats for your child, as well.
?	Call your spouse at work & put events on his calendar.  There are some events, 
which truly require the presence of a parent, so if he needs to be there for the first 
or last day of school, put it on his calendar.

What can the latest technology do for me while on bedrest?
?	A lap top computer may help you work from home or provide entertainment by 
playing games, going online to shop or browse, or even to learn a new language.  
You can also participate in discussion boards, and email friends and family.  
Some lap tops may be able to play DVDs for listening to music and viewing 
movies.
?	Electronic hand held games
?	Have a portable phone nearby, charged.  Have call answering hooked up or an 
answering machine to answer calls if you don't feel like picking up.
?	Watch TV/VCR
?	Limit your TV watching -- especially daytime TV.  There is just way too much 
trash on TV during the day
?	Listen to relaxation tapes
?	Use online banking
?	Call baby product companies or locate them on the web.  Register for freebies.  
Request catalogs.
?	Grocery shop online

Anything else?
?	Have wet ones nearby
?	Have waste basket nearby

I have a pet.  How can I take care of it while on bedrest?
?	Ensure that you are stocked up on pet food.
?	If you need anything like kitty litter, shavings or treats, ensure you are stocked up 
on these as well.
?	Set up vet appointments so that your spouse or a friend can take them.
?	Have a neighborhood child walk, bathe, play with your pet as needed.

If finances allow, what are the best resources?
?	Hire a cleaning service
?	Hire a lawn service