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A Restless Rest

Yael Klein

Pregnancy. A glowing, miraculous time. Except it doesn’t seem that way when you’re lying on your back. How women on bed rest make it through

Monday, June 11, 2018

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"My husband had to constantly remind me that I was doing the most important job of all. But it was so, so hard to remember that"

Y affa didn’t think her third pregnancy would be different from her two previous uncomplicated, full-term pregnancies. But at her 20-week ultrasound, the technician furrowed his brows at the screen: Yaffa had excess amniotic fluid, a risk for preterm labor.

Immediately flagged as high-risk, Yaffa began seeing her obstetrician twice a week. Her OB sent the expectant mother for more extensive testing and blood work; everything turned up negative.

But at 32 weeks, Yaffa began vomiting blood. She was commanded to go straight to the hospital, where they monitored her closely for several days, and was finally discharged on one condition: complete bed rest. What did that mean? Her doctor summed it up succinctly: “Lying horizontally 24/7, except when you need the bathroom.”

She stayed in that position for the next four weeks.

 

Why Rest

Approximately one in five pregnant women in the US are ordered to go on some form of bed rest for varying reasons: multiple gestation, threatened preterm labor, premature contractions, threatened miscarriages or a previous history of recurrent miscarriages, and maternal conditions such as bleeding, hypertension, or heart problems during pregnancy. Other conditions generally requiring bed rest are internal changes that signal early delivery and intrauterine growth retardation, in which “the baby does not grow well inside the uterus,” explains Dr. Hava-Yael Schreiber, senior physician at Bikur Cholim Hospital’s labor ward in Yerushalayim.

How is bed rest supposed to help? “It depends on the condition for which we’re recommending it, but most of the time it’s a matter of pure gravity,” explains Dr. Jessica Jacob, an obstetrician-gynecologist in New York who has been servicing women in private practice since 1987, and who has delivered the babies of more than 15,000 women.

“Increased activity — too much moving around in general — can cause preterm contractions, which can cause preterm births, especially in someone with a weak cervix. If bed rest is prescribed to enhance fetal growth, then the horizontal positioning on one’s side enhances blood flow to the placenta and maximizes growth.”

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Thankfully, not every woman on bed rest is as restricted as Yaffa. There are several degrees of bed rest. “How high is the risk of preterm labor? That’s what determines the level of bed rest for the mother,” says Dr. Jacob.

The mildest type means taking it easy — just resting. This is what Dr. Schreiber advises for women who experience first-trimester bleeding: “Avoid running around or exerting yourself, but you don’t need to lie in bed the whole time.”

“I tell moms, don’t host for Shabbos, don’t entertain, don’t exercise,” adds Dr. Jacob. “You can go to work and resume activities of daily living, but don’t go shopping on the way home.”

Absolute bed rest, however, restricts all activity. Yaffa was placed on such bed rest for four weeks. Her last two weeks were downgraded to mild bed rest.

Mindy, though, was an extreme case. Her condition was so severe that even she recognized her need to be on absolute bed rest — which turned into a four-month ordeal, starting in her third month. “I was so weak each time I got out of bed that I just wanted to sleep the whole day,” says Mindy. (Excerpted from Family First, Issue 596)

 

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