These days, it’s more common for moms-to-be to be breathing deeply into a downward dog in prenatal yoga class than taking it easy at home with their feet up. But an estimated 20 percent of expectant mothers are still put on bed rest during their pregnancies, despite evidence that it may do more harm than good.
In a 2013 review of studies on bed rest, obstetricians at the University of North Carolina, Chapel Hill, argue that physicians should no longer advise pregnant women to take to their beds for various pregnancy complications including preterm birth and multiple gestations unless it’s within a formal clinical trial.
“’Therapeutic’ bed rest continues to be used widely, despite evidence of no benefit and known harms,” they write in the June issue of The American Congress of Obstetricians and Gynecologists (ACOG’s) Green Journal. They also propose an “ethical argument for discontinuing this practice.”
One of the review’s authors, David A. Grimes, M.D., Clinical Professor, Department of Obstetrics and Gynecology, UNC School of Medicine, tells FitPregnancy.com there are “no established benefits to bed rest and clear harms,” for pregnant women, including a sharp increase in the risk of clots in the legs, which can travel to the lungs and even be fatal, he says.
Additionally, for a well person, bed rest can be uncomfortable, emotionally and financially difficult and may cause muscle and bone loss, he says. It can be nearly impossible if you have other children, and it’s also been linked to increased stress and anxiety, he adds.
Bed rest also hasn’t been proven to do anything to prevent preterm birth. In the latest study, Dr. Catherine Spong, a maternal-fetal medicine specialist at the National Institutes of Health, and colleagues looked at women with a short cervix who were prescribed varying degrees of “bed rest” in their first pregnancies to prevent premature birth, including cutting back on work, sex and non-work activities, and women with the same condition who did not curtail activity. About 37 percent of women in the bed rest group went on to have a premature baby, compared to 17 percent of women who did not limit activity, the researchers report in Obstetrics & Gynecology.
However, this does not mean that bed rest causes more harm than good. “We cannot conclude from this study that bed rest increases adverse outcomes, only that the activity restriction did not reduce the rate of preterm birth in women in their first pregnancy at risk for preterm birth because of a short cervix,” Spong tells FitPregnancy.com. Plus, the women in the bed rest group may have been more likely to have a premature baby to begin with, she notes.
Nevertheless, it all adds up to something of a bed rest backlash. Earlier this month, new research presented at ACOG’s Annual Clinical Meeting concluded that pregnant women who are hospitalized and on bed rest should be assessed for depression and anxiety, as they may be at greater risk for both. ACOG does not indicate bed rest during pregnancy.
So why are so many pregnant women put on bed rest if it has no proven benefits and may even be harmful in some cases? Grimes says doctors—and patients—often just want to do “something,” even though “sometimes, the best thing to do is nothing at all.”
If your doctor prescribes bed rest, Grimes suggests asking her about the risks and benefits, so you can make a “truly informed decision” about what’s best for you and your baby.