Q: Will I be placed on bed rest during my multiple pregnancy?
A: Bed rest is a very common recommendation and can occur at 16 weeks gestation at later in higher-order multiple pregnancies: in some specific cases earlier. Bed rest for the average multiple pregnancy begins around the 20th week when a doctor may recommend an expectant mom to limit activity or spend part of her day on bed rest.
To insure you understand exactly what your doctor means by “taking it easy” or going on “bed rest,” you may want to periodically review a list of activities with your doctor to determine exactly what you are allowed and not allowed to do at any given point in your pregnancy.
Types of Bedrest:
- House Arrest – Restrictions like no sexual intercourse, exercise or heavy lifting (mom needs to get specifics on what is considered “heavy”). This is not really bedrest, just activity restriction so the mother can rest more. Patients need to ask their physicians EXACTLY what is restricted.
- Partial or Modified Bedrest – Physician instructs the mother to spend some part of each day either laying down or resting. She may be able to work at desk a few hours per day. This type of bedrest also prohibits sexual intercourse, exercise, and heavy lifting. The mother needs to find out exactly what is limited, including simple details like how long can she be up and walking, driving, or grocery shopping in a day.
- Strict Bedrest – On strict bedrest, the mother must stay in bed or a chair with feet elevated all day except to go to the bathroom, eat meals, or shower. The mother should clarify how many times a day she can get up and how long she can stay up each time.
- Complete or Hospital Bedrest – This type of bedrest usually requires hospitalization and the mother must use a bedpan and have bed baths. Some mothers on complete hospital bedrest are in a position called Trendelenburg where their head is lower than body to decrease pressure on the cervix.
Why the Left Side?
Lying on the left side can actually improve the outcome of the pregnancy because it allows the uterus to move away from the two major blood vessels, the aorta and inferior vena cava, so that blood can move more freely through them. The aorta delivers blood from the heart to the organs, and the inferior vena cava returns blood to the heart from the pelvis and legs. As the uterus grows, it presses on the aorta and inferior vena cava.
Two hours a day on the left side is typically recommended, but more time on the left side may be prescribed if one of the fetuses is not growing well, or the mother has a condition that compromises blood flow, like high blood pressure. Lying on the left side can also minimize some pregnancy discomforts like varicose veins and swelling and ensures that the expectant mother will not get light-headed, like she might experience lying on her back.
Possible Side-Effects of Bedrest:
- Blood Clots -Support hose help with circulation. Ask physician if you can do isotonic exercises in bed
Some physicians will prescribe bedside physical therapy or hydro-therapy/
- Muscle Atrophy – Proper protein intake will minimize muscle loss
- Joint Stiffness – PT may be ordered. Mom may want to ask about range of motion or isotonic exercises
- Boredom, Isolation, Depression, Loss of Control – If there are other children, not being able to see them or control their schedules adds to loss of control
- Constipation – May need dietary changes. May need prescription medication