Anybody's Doc NOT do Bedrest?

I went to the regular 30 week appointment today and got some crappy news. After being healthy the whole pregnancy, but uncomfortable (hip pain & PUPPS) my cervix went from 4 centimeters 2 weeks ago, to 2.3 centimeters today. Apparently the OB I saw (not my peri week) thought it was serious enough to get me the first of the steroid shots today & I have to go get the other one at the hospital tomorrow.

I asked her if I should restict my activity any and she said no intercourse. Ok, we can handle that. She doesn't think bed rest does any good- there are no studies proving it helps. However, earlier in the appointment, she said that the cervix could change if I've been resting. WTF!

Does anybody have any experience with docs like this? I don't mind restricting myself, but from everything I've seen on the TS forum, most people have some sort of bedrest.

Michelle

30 weeks 2 days with di/di boys.

 

Michelle, I'm sorry the doctor gave you conflicting information. :wacko: Can you call your peri and see what they have to say about it? :hug: If I were you, I'd definately restrict my activity, and not just intercourse. :hug:

 

The Peri we see does not believe bed rest does any good. Like you were told he told us "there is no studies proving it helps". But he also followed that up with, "we will follow what your OB says since she is your primary care giver.." I asked my OB and she said yes if she feels it's necessary we will do it.. So basically I guess it just depends on the dr's preference. Good luck...

I think there is no harm in you choosing to limit your activities..

 

i've had prodromal labor since the 14th of june (i remember because it was jason's birthday) which is basically a lot of contractions, sometimes VERY regular, usually rather painful, but they do NOTHING to the cervix..i have the opposite issue with my cervix...it doesn't move...i've been induced 4 times, all overdue, and each time it's taken more and more and even more to get my body to go "fine, all right, i'll do it!"...the midwife agreed with me today that odds are not in my favor AT ALL that i'll go in to spontaneous labor...that being the case, no i have NOT been put on bedrest, or even restricted on sex...however, i also do not have a cervix that is actually DOING anything either...is this an ob you usually see or was it a "sub" of some sort? i say that if you feel more comfortable restricting your activity, then do it...i told all of my family that i wasn't "allowed" to drive more than 1/2 an hour out of town...that's not quite accurate, however there are lots of reason i wanted to avoid going out of town, so it worked...

 

At 30 weeks your in a good spot for short cervix.I was down to 1.6 @ 25 weeks,and put on STRICT bedrest because it was such a dangerous time.Im 32 now andback up to 2.1,and my DOCS have increased my activity.My boys were just under2 lbs when we found out.

Now that Ive said that...I too have heard alot of conflicting stories about bedrest .Belive me Im glad I did it,but 7 weeks in bed did crazy things to my body,and now that I have more privileges I cant do much because Ive lost so much muscle tone,and I get weak easy.

I think at 30 weeks you should slow it down alot,but strict bedrest is very hard to do ,and if they arent reccomending it they arent too worried,plus the steriods will give you peice of mind about your babies lungs.

Listen to your body,and stay off your feet when you can...Thats what Im doing,and we made it another 7 weeks when they were convinced my labor was iminent!

 

My OB put me on bedrest for frequent contractions (at 27 weeks or thereabouts) but peri said it wasn't necessary as the contractions weren't affecting my cervix and because bed rest has NOT been shown to prevent pre term labor. I did some research myself (easy for me to do since I'm a prof at a University and can get the articles directly) and it's true. Some of the studies have gone so far as to say that bed rest should not be prescribed anymore unless good research can prove its usefulness (there was one study that showed a negative effect on maternal mindset....no big surprise). When I got the conflicting info, I basically made a decision on my own to restrict myself to whatever extent I felt comfortable. In my case, it meant that I was pretty quiet, stuck around home, didn't go out, etc. I've actually since increased my activity, but still pretty quiet.

 

This is kind of what I got out of what your doctor said. Rather than sounding like conflicting information, to me it sounded like she was saying that bedrest won't help with the pre-term labor, not that it won't help with a shortening cervix. But I agree that her delivery sounds a bit confusing. I would definitely ask her to clarify.

Good luck to you Mama.

 

Here is the concluding paragraph to one of the articles I was referring to:
"One might wonder how and why an internvention such as bed rest became so widely used with so little demonstrated proof of effectiveness. The answer is not clear, but we suspect that bed rest is used frequently because it is perceived as inexpensive and noninvasive, and it seems that it should work. Furthermore, because most pregnancies end in the delivery of a normal fetus, and because bed rest is used frequently, there may well be an apparent association between bed rest and good outcomes. However, the history of obstetrics is replete with widespread adoption of interventions that at first glance seemed reasonable, were adopted without sufficient testing, were later proved to be ineffective or harmful, and ultimately have faded from clinical use. In these days of limited resources and increasing demands for proof of effectiveness, each obstetric intervention should be reevaluated for efficacy and risk- and cost-benefit determinations. Interventions that fail these tests should be curtailed. Bed rest, whether in the hospital or at home, used to treat or prevent potential miscarriage, spontaneous preterm labor, edema, growth retardation, or nonproteinuric hypertension, appears to be an example of one of these interventions."

 

I have very regular non-painful contractions, am dilated to 1cm and am 80% effaced and still not on bedrest. My doctor is super laid back and just told me to take it easy. He says I know what my body can handle. Since I have not dilated any more since 32 weeks, his advice seems to be working. Just rest as much as possible! Good luck

 

For my first twin pregnancy, I started having a lot of BH contractions at 29 weeks, to the point where they put me on Bretherine every 6 hours. But not on bed rest. I chose on my own to slow down a bit, but I never went strict about it ... just took it easier than normal. I delivered at 36w3d, no NICU time.

This time, no bedrest, no meds, nothing. I'm 35 weeks and doing great. My doc also said they stop measuring cervixes of twin pregnancies around 32w as they are going to start shortening just due to the weight of two babies.

Like others said, no harm in taking it easy. But I wouldn't take it to the extreme.

 

An update: I went in to L & D to get my second shot & feel a little better about things. The boys, true to form, were not cooperative AT ALL to being on monitors- the poor nurse was practically begging them to be still for a moment or two to get a good reading! :escape: Plus, I wasn't having any contractions that they could pick up, so I figure that's a good sign.

I think that I will call the peri on Monday and get a follow up this week. I'm really not comfortable waiting until my next scheduled appointment (next Tuesday- 9 days) to figure out if everything's good as it changed pretty dramatically in the last 2 weeks. I kind of would like another cervical measurement and that ffn test that many people get just to be super safe.

On the upside, the steroid shots have really helped the PUPPS- all I have to do is slather on the Hydrocortison cream a few times a day- which is so much more tolerable!

The only thing about not doing bedrest which doesn't make sense to me is this: when in labor, they encourage you to move around, squat, stand, everything to hurry up your cervical dialation... why wouldn't not moving as much, not putting pressure on your cervix at least preserve what's left of it? Just a thought.

Thanks to all of you- this forum is awesome!

Michelle

 

hmmm...good point. :unknw: My OB told me early on in pregnancy he didn't believe in bedrest either. He said it can be more harmful than good. He said it can cause blood clots. I read that same thing in one of my books. Maybe that is why some are hesitant to put women on bedrest.

 

My OB also does not proscribe bedrest. My cervix has been monitored with each ultrasound, but at the last one, which was at 32 weeks, they stopped measuring length, and instead just attended to whether it was opening (fully closed). My OB has encouraged me throughout this pregnancy to take it easy, to take naps, and to generally listen closely to my body. My body has been telling me of late that it's exhausted, so I've seriously curtailed my activities, and DH has taken up the slack in watching our 2 year old and picking up the house. So, not bedrest, but I'm not very active!

 

My peri flat out said bedrest has not been proven to prolong a pregnancy. But he put me on it, because he also said it's never been proven to hurt. But I was put on it at 16 weeks with basically no cervix and an emergency cerclage.

They stopped measuring my cervix at 28 weeks, and did just internal exams with sterile gloves after that. So they may not be as concerned because you are pretty far along and your cervix will naturally start to shrink. I'd take it easy and just check in with the peri again.

 

My Dr says the same thing, that studies are popping up everywhere that bedrest has no real benefit. So though thru another Dr I would be on bedrest I'm not. He says that getting up and walking around is beneficial for my circulation.

I too had my cervix thin out and shorten to 1, with contractions, and lost my mucous plug. Truth is I don't think there is too much I could do at this point. My body is forcing me to relax wether I want to or not.

Good Luck!