Surviving bed rest
What Exercises Can I Do With an Incompetent Cervix?
July 1st, 2010I recently received an-e-mail from a mama who had just gone on bedrest with an incompetent cervix at 30 weeks.”What exercises, if any, can I do with an incompetent cervix,” she asked?
An incompetet cervix is one of the more common reasons pregnant mamas are prescribed bed rest. While the rates of incompetent cervix are thought to be low, no one is exactly sure how many women are affected by incompetent cervices during pregnancy. An incompetent cervix can manifest in one of three ways:
- Opening of the cervical os more than 2.5 cm during the second trimester
- Thinning and shortening of the cervix (effacing) in the second trimester or early third trimester
- Thinning or opening (funneling) of the cervical opening closest to the baby
The treatment for incompetent cervix is cerclage (surgically placing a stitch through the cerix to hold it closed), bed rest, or a combination of the two.
Being prescribed bed rest puts a mama at risk for blood clots in the legs, muscle atophy and overall loss of strength and cardiovascular conditioning. Most women who are prescribed bed rest should also be prescribed-or at least advised about-exercises that they can do to maintain muscle strentgth and tone as well as to reduce the physical effects if prolonged inactivity. However, it has been my experience that many women prescribed bed rest receive little or no instruction on what they can do to exercise their bodies while on bed rest. This is due in part because many obstetricians don’t know what types of exercises are safe for women on prescribed bed rest. A lucky few mamas will have a consultation or two with physical therapists. But the vast majority of mamas who go on prescribed bed rest will receive no exercise instruction. For this reason I produced Bedrest Fitness when I was pregnant during my second pregnancy.Bedrest Fitness is a set of modified prenatal exercises designed specifically for pregnant women on prescribed bed rest.
A mama with an incompetent cervix should avoid any movements or exercises that put pressure on the cervix and many women will be instructed to remain recumbant in bed or on the sofa. But if you think about it, that leaves your arms and legs free to move. Mamas on bed rest with an incompetent cervix should perform a variety of arm and leg exercises daily to maintain steady bloodflow and adequate circulation back to the heart-especially from the legs. Leg exercises should include:
- Leg Ab/Adduction exercises
- Passive double knee raises (provided Mama can do them using an exercise band or towel to draw her knees up and not engage her abdominal muscles. If mama feels any pressure in her lower abdomen, these should be avoided!)
- Point/flex of toes to exercise the calf muscles
- Ankle circles
Upper body exercises should include (using a towel or exercise band):
- Modified flies
- Shoulder extensions with arms extended forward and to the sides
- Upright rows
- Bicep curls
- Triceps extensions (if allowed to sit up)
On Bedrest Fitness I included Cat/Cow stretches. Women with incompetent cervices can
actually do these stretches, but in my experience they often are unable to gauge how much pressure they are putting on their cervices. So unless a physical therapist or fitness professional is present, I don’t recommend that mamas with incompetent cervices perform these exercises.The same is true of the modified crunches.
Bed rest can have a profoundly negative (albeit temporary) effect on a mama’s overall physical condition. Depending on how long she was on bed rest prior to delivery and the restrictions she’d been given, a new mama can find herself unable to hold herself upright or to even hold her newborn. But if she engages in a few very simple but targeted exercises while on bed rest, mama will find that she will be less deconditioned after delivery and recover more quickly.
If you or someone you know has been prescribed bed rest during pregnancy, order a copy of Bedrest Fitness. Even if Mama can’t do all of the exercises, she will preserve muscle strength and tone in the areas she does exercise. Mama can also download a free set of lower body exercises, stretches and Kegels when she signs up for the Mamas on Bedrest e-mail list.
Resources To Support Those Supporting Mamas On Bedrest
June 3rd, 2010I wanted to follow up on the podcast interview that I had with Robin Elise Weiss a couple of weeks ago. While we were talking the discussion turned to families and friends of mamas on bedrest and the difficult road they walk; trying to support the mama who is on bed rest and calm her nerves and fears about her pregnancy and unborn child while also being concerned for their daughter (and/or son), sister (and/or brother), their children and their friends.
The conversation caused me to reminisce about how my father in law was such a huge source of support for me when I was going through my first high risk pregnancy, and yet it never dawned on me to ask him about how he was coping with his own worry. I’ll never get the chance to talk with him or to even thank him because he passed away the year after my daughter was born. However Robin’s words in passing and the kindness of my father in law have motivated me to seek out supports for families and friends trying to support Mamas on bed rest.
One thing that Robin and I agreed on as we chatted is that there is a lot of information on the web about high risk pregnancy and the myriad of conditions that make a pregnancy high risk. However, if you read any of the websites on pre-eclampsia or placental issues for examples, you’ll likely come away with more fears than hope. Theses sites are great for facts but sorely lacking of you are looking for guidance on how to help and support your loved one.
Likewise, you can’t go and simply ask your loved one’s clinician. Ever since the passage of the HIPPA act (The Health Insurance Portability and Accountability Act (HIPAA) of 1996) no medical information can be divulged about an individual unless they give expressed permission, usually in writing. Sometimes Mamas on bed rest will allow clinicians to speak with other family members, but more times than not, this doesn’t happen, so concerned family members and friends are left wondering and worrying about their loved one.
These are a few resources to which family members can turn for information and for help with their own worries and fears. Most are web based, but there is one that has telephone counseling. Most all of them have additional links of resources for information and support.
Sidelines is a comprehensive website dedicated to the support of high risk pregnant women. They offer one on one peer volunteer counseling (via phone and e-mail) for expectant mothers and will answer questions from people needing information or helping to support women on bed rest. Established in 1991, the website has nearly 20 years of information and resources available. If it has to do with high risk pregnancy and bed rest, it’s most likely listed on this website.
This website was started by Dr. Judith Maloni, a leading researcher of bed rest and associate professor at The Frances Payne Bolton School of Nursing at Case Western Reserve University. In her over 20 years of research, Dr. Maloni has learned what women on bed rest and their families need to make it through and has compiled a thorough list of resources.
KeepEmCookin.com is a website that hosts a large forum comprised of women on bed rest sharing their stories and information. Started by Angela Davis, a bed rest veteran, it also houses informative articles on bed rest and the latest research and advances. While most of the women on the forum are on bed rest, I have interacted with many of them and they are willing and eager to share their stories and any and all information to help a mama on bed rest.
Storknet.com is another website dedicated to assisting women and their families navigate a high risk pregnancy. Started and maintained by Maribeth Doerr, Storknet has an abundance of resources for women and the family members and friends supporting them through this difficult time.
While all of these resources are listed on our resources page with several other support organizations, I am emphasizing these here because they offer specific assistance to family members and friends who may be feeling overwhelmed as they try to assist their loved one on bed rest.
These lists are in no way exhaustive, quite the contrary. Whenever we learn of an organization that supports mamas on bed rest and the families and friends who support them, we will certainly add them to our list. If you know of any support organizations that specifically support high risk pregnant women and their families, please send the information to info@mamasonbedrest.com so that we can share with others who may be in need.
If you enjoyed this blog post, be sure to sign up to receive notifications of blog posts via our RSS feeds. We add blog posts twice weekly. Please share your comments in the comment section below, and definitely share this information with any mama on bed rest and/or family member coping with a mama on bed rest.
Mamas on Bedrest: Survey Says….
May 6th, 2010At the beginning of April I sent out a survey to see just what do Mamas on bed rest need? I wanted to survey women 
who are on bed rest as well as “veterans” who have moved past bed rest into motherhood to see if the products and services that Mamas on Bedrest & Beyond are offering are what mamas really wanted.
First and foremost, A huge THANK YOU to everyone who responded to the survey. Your answers are greatly appreciated. I will use the information make improvements to the website and to seek out services and alliances with other providers and to make sure that when women on bed rest come to my website or seek services, they can get exactly what they need and don’t need to look any further.
The survey consisted of 6 (actually 5 questions. The last question was for their name and e-mail address to follow up) questions ranging from what sort of physical problems women are having to what one thing made being on bed rest better. While many of the responses were expected, there were a few that were a surprise. Below are the questions and the tabulated responses.
1. What has been the hardest part of being on prescribed bed rest?
By far the most difficult thing for mamas on bed rest was not being able to care for their existing children, not being involved in their day to day care and having to surrender that care to someone else. This was followed closely by boredom and a feeling of isolation. Other common worries were:
- inability to care for themselves, being dependent on others to care for them
- inability to care for their homes and families
- not knowing if being on bed rest would help-prolong the pregnancy or keep baby safe/healthy.
- Loss of muscle tone/body aches/becoming deconditioned
Inability to work or to prepare for being out of work, worrying about what would happen with the pregnancy and anger/frustration at husband who was able to go about freely and work were each felt by one women.
Interestingly, most of the mamas in this survey were strong ladies and were not spending time worrying but just focusing on making it through and having a healthy baby.
2. What are your biggest physical challenges (body aches, stiffness, weakness,etc…) being on bed rest?
Pain and stiffness in the back, hips/butt and legs was by far the greatest physical challenge reported by two thirds of the respondents. The next most common problems were:
- Inability to sleep comfortably/insomnia from laying around all day
- generalized fatigue
- shortness of breath.
The shortness of breath at first surprised me, but given that women on bed rest more than 2 weeks become quite decondititoned, and when one is on prolonged bed rest, one doesn’t take deep breaths to expand the lungs, I’m not surprised shortness of breath became an issue. Cervical pressure, a rash and chest pain all received one vote.
3. What is your greatest fear about being on bed rest?
The greatest fear of being on bed rest is that in the long run, it wouldn’t help. By nearly 2:1 over the next most common answer, mamas were mostly afraid that even being on bed rest would not be enough to have a healthy, term infant. The second most common concern, was losing their baby and/or dying themselves! The next most common worries:
- Being too weak to care for their babies post partum
- Being too weak to have a normal vaginal birth
- Excessive weight gain
- A long post partum recovery
4. What is THE ONE THING that if you had it/knew it beforehand/could do right now would make bed rest infinitely more bearable?
In this age of technology, having cable tv/NetFlix was the number one way women passed the time. This was very closely followed by having a computer or smart phone to surf the web and to watch movies. Other must haves:
- Housekeeper and support services like a chef/meal planner
- Exercises/Physical therapy
- Visits from friends and family
I was happy to see that one participant would have liked to have seen/toured the NICU. This was something that I had wished I could have done given that my daughter ended up there for 10 days. I think this participant is right in that there should be some sort of video available to help prepare parents. Another interesting response was that one respondent felt that being on bed rest at home would have been better than being on bed rest in the hospital. We’ll have to investigate that!
Women also noted that doing projects/crafts, keeping a positive attitude, remembering that bed rest is a finite situation and being comfortable (one woman recommended a bed rest pillow while another recommended getting a recliner) made bed rest bearable.
5. What can Mamas on Bedrest & Beyond do (better) to help?
This had to be the most gratifying section for me. The number one response was having the Mamas on Bedrest & Beyond website!(Honestly, I didn’t pay anyone for their responses!) It beat out all the other answers 5:1!
Interestingly, when I started this business I was sure that women would want support services; massages, laundry, housekeeping services, errands, etc… But that’s not what mamas want. Here’s what I have found in business and now from this survey:
- They want their existing children well cared for
- They want activities to pass the time
- They want support – They want visits from friends and relatives. They want to interact with other women going through the same process (I highly recommend the KeepEmCookin’ forum for this!). They need reassurance that it’s all going to be okay.
- They want to learn more about bed rest; indications, how effective it is, what are alternatives and what they can do to be at their best when their bed rest journey is over. They also want to hear from women who have made it through the bed rest journey successfully.
This was HIGHLY informative to me. As the owner and founder on Mamas on Bedrest & Beyond, my mission, my goal and my passion is to serve women on bed rest and to make sure that they have all that they need to get survive bed rest, transition safely and healthily to motherhood and to remain strong-physically and emotionally. In the coming months I’ll be integrating the suggestions from this survey into products, services and resources on the website.
In the meantime, As per request, please share your bed rest testimonials. Women need to hear that you can go on bed rest and have a normal pregnancy and healthy baby. They also need to hear that even if things don’t go as planned, it’s still okay. Please share your bed rest survival stories at info@mamasonbedrest.com.
