Bed Rest For Pregnant Women May Be Harmful

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Each year about 1 million pregnant women in the United States are put on bed rest or restricted activity to treat or prevent pregnancy complications, but now research indicates this practice may actually be harmful to both the mother and her child.

Bed rest for pregnant women needs a second look

For more than three decades, bed rest and/or restricted activity during the latter part of pregnancy (referred to as antepartum bed rest, or ABR) has been the main way used by physicians to help prevent preterm birth for women in the United States, even though, as is noted in the new study, “perinatal morbidity and mortality has not been reduced since this treatment became widespread.”

According to a new report by Judith A. Maloni, PhD, RN, FAAN, professor in the Bolton School of Nursing, Case Western Reserve University, her more than 20 years of research indicate that bed rest can be detrimental. Details of this report are important to consider, given that the preterm birth rate is 12.7 percent in the United States, an increase of 9 percent since 2000, and efforts to prevent it and its consequences need to be both safe and effective.

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Maloni reviewed all available research concerning bed rest, preterm labor, high-risk pregnancies, and how these factors relate to side effects. She found that in addition to bed rest being largely a negative experience for pregnant women, it also introduced problems such as bone loss, fatigue, boredom, loss of muscle function and muscle atrophy, sleep problems, sore muscles, weight loss by the mother, lower fetal weight, depression both during pregnancy and postpartum, nasal congestion, reflux, indigestion, and back and muscle aches. Relationship conflicts with partners and other family members also are often an issue.

The author noted that further research is needed to determine the risks and benefits, if any, of bed rest for pregnant women at risk for complications. She also pointed out that in Canada, the Society of Obstetricians and Gynaecologists issued new guidelines that state strict bed rest is not recommended for pregnant women with preeclampsia and that there is not enough evidence to recommend it for women with hypertensive disorders of pregnancy.

An alternative, notes Maloni, may be to utilize nurses. “Nurses can challenge bed-rest treatment by functioning as advocates for women and educating them about the evidence for bed rest treatment as well as the risks and benefits.” She emphasized that reducing preterm births may come about only “when we, as researchers and providers, reconceptualize prenatal care as only one part of a lifelong effort to optimize women’s health, beginning at birth.”

SOURCE:
Maloni JA. Biological Research for Nursing 2010 Oct; 12(2): 106-24

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