Why Are You Put On Bed Rest During Pregnancy? An OB-GYN Explains The Conditions

When I worked in an office, I worked with quite a few pregnant ladies all at the same time. Something must have been in the water, because while I was there for three years, two of my coworkers got pregnant twice, and another girl was pregnant with her second child. One of my coworkers had to be put on bed rest, and while I don’t remember the reason, she said it was awful, boring, and kind of depressing. I asked an OB-GYN for some reasons why you would be put on bed rest during pregnancy, and he had some pretty insightful answers, including that more and more OB-GYNs may be moving away from recommending bed rest for their patients.

Dr. Jamil Abdur-Rahman, an OB-GYN and medical travel blogger, along with his twin brother for TwinDoctorsTV, says to Romper in an email interview that more OB-GYNs are moving away from recommending bed rest for their patients because, simply, “most research has shown that bed rest does not improve outcomes in people that have suffered pregnancy-related complications. What's more, bed rest has been shown in some cases to increase the risk of certain pregnancy-related complications — namely blood clots and depression. That being said, when doctors typically do recommend bed rest, it is for preterm labor, cervical incompetence, threatened abortion and miscarriage, preeclampsia and hypertension, and placenta previa." Here are some more details about these conditions and why bed rest may be beneficial.

Preterm Labor

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If you start to go into labor before the 37th week of your pregnancy, this would be considered "preterm" labor. And anything after 37 weeks is considered full term, according to Abdur-Rahman. What risks are involved with preterm labor? Abdur-Rahman says your baby can have underdeveloped lungs and bleeding of the blood vessels in their eyes, brain, or stomach. "Therefore, when women go into labor before 37 weeks, we typically give them medications like magnesium or procardia to stop the labor. If successful, when these women are sent home, their doctors may advise bed rest," he says. The doctor's thought behind the bed rest, according to Abdur-Rahman, is because the woman is less likely to get dehydrated. "Dehydration can sometimes lead to or worsen preterm labor," he says. Additionally, it's less likely your baby's head will press against the cervix if you're laying in the bed and not on your feet enough for gravity to run its course and push your baby downward. When this happens, it causes the "Ferguson Reflex," according to Abdur-Rahman. The Ferguson Reflex is when pressure applied to the cervix causes the uterus to contract. "Therefore by remaining in a bed, a less active woman is less likely to become dehydrated and less likely to undergo the Ferguson Reflex," he explains.

Cervical Incompetence/Insufficiency

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Cervical incompetence/insufficiency is exactly what it sounds like. "It's when your cervix weakens under the weight of an enlarging pregnancy," Abdur-Rahman says. Who is more at risk for this complication? "Typically this happens in women who have had damage to their cervix prior to pregnancy. This damage may have resulted from a cervical laceration during a previous pregnancy, a cervical biopsy, or a previous cervical surgical procedure to remove abnormal cervical cells. Once injured, the cervix can lose its structural integrity." When you're at about 20 weeks, the baby, placenta, and amniotic fluid can put some serious pressure on your cervix, and if your cervix was previously damaged, it could buckle under the weight, which will cause it to dilate and shorten. Unfortunately, this could lead to pregnancy loss, according to Abdur-Rahman. "For many of the same reasons that a doctor might recommend bed rest for someone who has had preterm labor, they might also recommended bed rest for someone with cervical incompetence. However, again, it has not been proven to lessen the likelihood of pregnancy loss."

Threatened Abortion/Miscarriage

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Just the name of this condition sounds incredibly scary and severe. What is happening to your body when this occurs? Threatened abortion/miscarriages typically happen in the first trimester, and it's when you bleed throughout the first three months of your pregnancy. When this happens to a pregnant woman, "they are said to be having a ‘threatened abortion’ or a ‘threatened miscarriage.’ Some will ultimately miscarry, while many will not," Abdur-Rahman says. When miscarriages do occur however, it's usually because the baby involved had a genetic abnormality, according to Abdur-Rahman. "Therefore, bed rest will not prevent these pregnancy losses if they are going to occur," he adds.

Preeclampsia/Hypertension

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Some women develop hypertension (high blood pressure) or preeclampsia at the end of their pregnancies, according to Abdur-Rahman. And both conditions cause your blood pressure to rise. "Elevated blood pressure can damage the placenta, decrease blood supply to the baby via the placenta, and place the mother at risk for stroke," Abdur-Rahman explains. So why do doctors recommend bed rest? He says they feel that the less the woman's heart and cardiovascular system has to work, the lower her blood pressure will be. However, Abdur-Rahman adds, "While not a totally inappropriate assumption, the problem with this assumption in pregnancy-induced hypertension/preeclampsia is in the fact that the elevated blood pressure in these conditions result from the blood vessels occasionally undergoing spasm. When they spasm, blood pressure increases. When they do not spasm, blood pressure is normal. This spasming is independent of physical activity and not prevented by resting."

Placenta Previa

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Abdur-Rahman says placenta previa is when your placenta grows over your cervix. You may have placenta previa if you experience heavy vaginal bleeding during your pregnancy because, "a great deal of blood flows through the placenta," Abdur-Rahman says. "While these episodes of bleeding frequently spontaneously resolve, if they do not, or if they result in significant blood loss, both the mother and the baby's life can be placed at risk."

While most all doctors will recommend being on pelvic rest when this happens, i.e., no sex or sex toys entering your vagina — since it can result in your cervix being "jostled" and cause hemorrhaging — some doctors will recommend bed rest, as well. However, again, Abdur-Rahman says, "it has not been proven that this provides any benefit."

Every case is different when it comes to being pregnant. If your doctor recommends bed rest, it's probably for a good reason, since they know your body and how your pregnancy has been going thus far. It doesn't hurt to talk about it with them and share your concerns however, and to bring up your own research you may have done on the topic. And if you notice any symptoms of any of these conditions above, call your OB-GYN immediately to be evaluated.

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