The Bed Rest Controversy
When Wendy Zang started bleeding heavily at 31 weeks, she spent four days in the hospital and the next three weeks on bed rest. Zang went on to deliver a full-term, healthy baby boy and doesn't regret spending one minute cooped up. "I had no doubt it was medically necessary," says Zang, of Sewickley, Pennsylvania. "I was so freaked out by the bleeding episode that I was afraid to do anything."
Sharyn Frankel was assigned hospitalized bed rest after contractions started 30 weeks into her pregnancy. She delivered a healthy boy via c-section just short of 34 weeks. She, too, believes in the value of bed rest: "I think it helped me to make it further in my pregnancy to where it was safe to deliver," says the Millbury, Massachusetts, mom.
But did bed rest really stop their preterm labor? Studies would say no. In fact, the American College of Obstetricians and Gynecologists (ACOG) advises that bed rest "does not appear to improve the rate of preterm birth, and should not be routinely recommended." Active contractions, bleeding, ruptured membranes, and placenta previa are the most common reasons that doctors call for bed rest in as many as one in five of their patients. But the treatment's popularity has not stopped the rate of preterm births from rising, accounting for 11 percent of all pregnancies in 2005, up from 9.7 percent in 1990.
The Bed Rest Controversy
Because ACOG does not have a firm recommendation, doctors have to make the call. Some, like Robin de Regt, MD, medical director of Evergreen Hospital Maternal-Fetal Medicine Program, in Kirkland, Washington, believe bed rest helps. "Patients who are on limited activity contract less, so they feel better," she says. And it can reduce a woman's anxiety about her pregnancy and in some cases stop or slow cervical dilation.
But other physicians, like Laura Riley, MD, medical director of labor and delivery at Massachusetts General Hospital, in Boston, prescribe bed rest reluctantly. "I'm fully honest with patients," she says. "I say, 'Get off your feet, and let's see if that will make any difference [in reducing your symptoms], but I don't really believe that it will.'"
Dr. Riley is well aware of the downsides to bed rest: "You've lost work. You lose all of your muscle tone if you sit around long enough, and you increase your risk of getting a blood clot in your leg or your lung, which can be pretty significant." And that's why she may try to steer her patients toward alternative measures.