Why Bed Rest
Mamas on Bedrest: Don’t Miss the Boat! There is no shame in “Assisted” Childbirth
November 14th, 2011
Click to take the postpartum depression survey conducted by Case Western Reserve University http://filer.case.edu/~axp335/postpartdep.htm Thank you very much for your consideration.
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A man was advised to leave his home as a storm was coming and everyone was to evacuate. He refused, but as the storm swelled, he found himself trapped. In an effort to “go above the rising waters”, he climbed up on his roof and begged God to help him. Not long after, a boat came by. The driver told the man to climb in and he’d take him to safety. The man refused saying, “God is going to save me.” The man in the boat continued on. After another couple of hours with the water reaching the eaves of his roof, the man again pleaded, “God, Please Save Me!” Then Emergency rescue personnel arrived and offered to help the man down and take him to safety. Again, he refused stating, “God is going to save me.” Shortly thereafter, the man perished. When he arrived in heaven, he asked God, “God, I begged and pleaded for you to save me. Why didn’t you?” God replied, “I sent you a man in a boat and a rescue squad, what more did you want?”
As humans, we often question and wonder why things happen the way that they do. When I was struggling to have my children, I often cried out to God, “Why can’t I have my children normally like every one else?” Normal is a very relative term.
There is a movement within the birth world to “return birth to its natural state”. I’m all for that. But not all women are going to be able to have the picture perfect pregnancy and birth. Some of us will require medication to become pregnant. Some of us, like me, will require medication (progesterone in my case) to remain pregnant. Others will require assistance to deliver their children. For example, my sister was a preemie born at 6 1/2 months. When she was having her children, she never went into labor. Her obstetrician “learned” (and I have no idea how they figured this out) that she did not receive the “signals” from her babies that would initiate labor. They summized that due to the fact that she was born early certain systems didn’t develop. (She was also born without a common Bile duct, so when she had her gall bladder out, they had to “reconstruct” one for her!) No matter what the reason, she has two healthy grown men now, thanks to “God’s provision” in the form of obstetrical care.
Sometimes life just doesn’t go as planned. I am so thankful that there are skilled physicians because without them, I would not have my children. While I wonder about the effects of bed rest on a mama’s body, I also know that in certain cases, it is the one thing standing between life and death for both mother and baby. We do far too many cesarean sections in this (United States) country, yet, had I even tried to deliver my daughter, she likely would not have survived, I likely would have hemorrhaged to death and my son wouldn’t exist either. Three people now live and are able to bless this world because there are skilled physicians who intervened on our behalf. They were blessed with skills. We are blessed with life.
Recently I posted a message about classes that I am offering for mamas on bed rest. I got this response from a CPM (Certified Professional Midwife):
I don’t believe in bedrest, so none of my clients would be on it. I believe it only prolongs the inevitable. Barring an incompetent cx, if the baby is healthy, it will stay in until its ready, if its not, might as well let nature take its course and get it over with.
Wow. That’s all that I can say. According to this woman, nature will always work and when it doesn’t, we should just let it go. I am here to say that I wholeheartedly disagree!! For me, the difference between having two healthy children and losing two pregnancies was progesterone. The difference between hemorrhaging to death and surviving were the skillful hands of my obstetrician who was able to manage my bleeding so that I live today! The difference between many women having children and not is the skills and care that many obstetricians and reproductive endocrinologists provide for them. So now it is wrong, somehow “unnatural” for those of us who need that assistance to forgo it, demanding instead “God’s provision in the form of a “natural” pregnancy and birth?
Every one is entitled to their opinion and this CPM is certainly entitled to hers. But I want to reach out to Mamas on Bedrest and to mamas who may not be on bed rest, but needed “a little help” to conceive or to deliver. There is no shame in assisted reproduction or in assisted childbirth! I am sure that like me, many of you prayed long and hard for your children. Are we now to refute them or the methods used to get them here? Of course not!
This woman’s words struck a cord in me because I have had many people comment that I am helping or encouraging women to go against nature. I totally disagree! I believe that if there is a path to your heart’s desire that is legal and effective, Take it! If I can help a woman to have a healthy child by supporting her through the tough patches, then I am going to do it. I see this as no different than helping families with children with special needs or helping a person with an illness manage it so that they can live a quality life. I know that I am speaking to the choir here, but for those of you feeling “less than” because you did not conceive naturally or deliver vaginally, look at it this way,
At least you didn’t miss the boat!!
Please share this with mamas who may be feeling “less than” because they had “help” having their children. If you liked this post, subscribe to this blog via the RSS feed button in the upper right hand corner of this page. Interact with us on Twitter (@mamas on Bedrest) and on Facebook.
Bedrest: What’s the Point?
May 5th, 2011This is podcast discusses the rationale for the bed rest prescription, indications for bed rest and new advances in the treatment of high risk pregnancy. Available as a download only.
Mamas on Bedrest, are you ready for change?
January 31st, 2011This is an addendum to my previous post, “Mamas on Bedrest: Don’t Get out of Bed!”, a response to an article on bed rest published in the January 30th Chicago Tribune.
I have been watching the chatter back and forth on The Chicago Tribune website, on twitter and on facebook. While I am smiling at all this recognition of bed rest, I am a bit surprised at some of the venom coming out in the comments. Ladies, (I’ve not seen any responses from men/dads) I think we all need to step back, take a deep breath and then consider what needs to happen next.
What I am most concerned about is how tightly we are holding onto bed rest. I don’t know if it’s because bed rest is connected to child bearing, something so visceral and intimate for a woman but I want to remind us all that bed rest is simply a treatment, a tool, to help us during pregnancy. Some of the responses I’ve read have elevated bed rest to a spiritual endeavor. Its as if women are wearing their bed rest experiences like badges of honor. Many women are stating, “Bed rest saved my baby.” To that comment I wince. We have no scientific evidence that bed rest cures or treats anything. As Judith Maloni Ph.D aptly put in her publication,
“It is possible that antepartum bed rest might decrease preterm birth but evidence has not yet been found to support that conclusion. Such evidence may be masked by the complex multi-causal and interrelated factors that contribute to preterm birth.”
It is likely that a combination of bed rest, medical treatment, support (and support is critical!) and factors that we don’t yet understand contribute to high risk pregnant women successfully giving birth to healthy babies. But what about the women who go on bed rest and don’t deliver healthy babies or even live babies? What then?
I want to put this out there for everyone’s consideration. Back in the middle ages, physicians used leeches to “bleed out” infection/poison from sick people. If you were ill today and went to your doctor and he/she recommended bleeding with leeches as your treatment, you’d consider them crazy as you sprinted out of their office. We don’t do that anymore because somewhere along the way a physician or researcher either realized the practice didn’t work or, more likely, found something that was more effective.
Likewise, from the 1940’s to the early 1970’s Diethylstilbestrol (DES), a synthetic estrogen, was given to women of child bearing age with the mistaken belief that it would prevent pregnancy complications and miscarriage. We now know that DES not only does not prevent pregnancy complications and miscarriage, but it also damages the reproductive organs of the babies in utero. I have friends whose moms took DES. One has no uterus. One had a bicornate uterus (a skinny uterus with two separate sides, not able to hold a pregnancy). I have a male friend who is infertile (makes no sperm) and the origin was traced back to his DES exposure in utero. DES was a product approved by the US Food and Drug Administration in the 1940’s and was finally ordered off the market in 1975. As new evidence became available, we had to change our thinking and our treatment methods.
Wouldn’t it be nice if the same could be said of high risk pregnancy? The Sidelines Support Network was founded in 1991. Better Bedrest was established in 1995. The work that these organizations have done for high risk pregnant women is nothing less than phenomenal, supporting thousands of high risk pregnant women in 20 years. But it is also a sin and a shame that we can’t say that much else has changed in the care of high risk pregnant women in the 20 years since these organizations were established. In what other medical discipline has there been such slow progress? Not heart surgery. Many bypasses are now being done via incisions in a person’s left side and using arteries from breast and upper arm muscles as opposed to the bone cracking open chest surgeries formerly performed as standard. Breast cancer no longer requires the mandatory, disfiguring radical mastectomy but is often treated with lumpectomy, (much less disfiguring and tissue sparing surgery) chemotherapy and precisely focused radiation. Prostate surgeries today are more frequently performed via minimally invasive DaVinci Robotic surgery than open abdominal surgery. And what about Diabetes? Today many patients receive insulin via minipumps which provide pulses of the medication enabling more evenly sustained blood sugar levels as opposed to half a dozen or sometimes more individual shots daily. Even birth control pills have been radically redesigned and the dosages and release of hormones manipulated such that some only need be taken quarterly or once a year. I could go on with the advances in arthroscopic orthopedic surgeries and Automatic Implanted Cardiac Defibrillators (AICD’s) (which are now so small and compact they fit virtually unnoticed in the small depression below one’s collar bone) and other medical advances but you get the picture. Despite all these amazing medical and technological advances in other medical disciplines, high risk pregnant women are still being treated with bed rest, with no new treatment options proposed or offered in more than twenty years, no improvements in outcomes and no reduction in maternal and infant morbidity and mortality. Isn’t it time for a change?
Bed rest has been shown to have some fairly major negative consequences and yet no one can definitively say that it is helpful. I believe that the truth about bed rest in pregnancy is yet to be elucidated. Until then, I humbly request everyone who is on bed rest, who supports women on bed rest, or who endured bed rest for one or many children:
- Let’s at least be open to the fact that bed rest may not be what we think that it is; it may be better than we believe, it may be more harmful than any of us could have ever expected.
- Let’s be open to the fact that there are likely treatments out there-some sitting idly on a shelf or currently being developed-that may be much better than what we are using now to manage high risk pregnant women.
- Let’s not hold so tightly to our own experiences and to our own work (those of us who support high risk pregnant women) that we resist changes and advances.
Finally, I hope that we can find alternatives to bed rest and that we can vastly improve the way we manage high risk pregnant women. I say this selfishly because I have a beautiful 8 year old daughter and I am concerned about how much of my physiology is in her (i.e. will she experience the same or similar problems I had trying to have children). I certainly hope that in 20 or so years if/when she is having children, if she does have complications, we have something more to offer her than the same inconclusive bed rest prescription that was offered to her mother 28 years earlier.
