multiple gestation
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 creating a future Nobel Laureate?
November 22nd, 2010For many mamas, when they are told that they have to go on prescribed bed rest they see it as some sort of personal failing. They ask themselves, “If pregnancy is the most natural thing for a woman to do, any woman should be able to do it right? If millions of women will become pregnant and give birth each year without a glitch, why am I having all these problem?” Mamas, if this is you, you may have fallen prey to the myth of The Enjoli woman.
“I can put the wash on the line, feed the kids, get dressed, pass out the kisses and get to work by five of nine….’Cause I’m a woman-Enjoli! I can bring home the bacon, fry it up in a pan, and, never, never, never let you forget you’re a man..’Cause I’m a woman Enjoli!”
Some of you may be too young to remember this commercial that aired in the late 1970’s and early 1980’s. It was for a perfume called Enjoli by Charles of the Ritz. It epitomized the idea that women could do it all; take care of the house, the kids, work a full time job and still be the sex kitten that their husbands needed them to be. You may laugh when you watch this video, but this one commercial made Charles of the Ritz millions! Everyone knew the tune, the commercial and the product. Heck, some 20 years later, as I was preparing this blog, it immediately came to my mind.
Why would such a cheesy jingle come to my mind when thinking of mamas on bed rest? Because the advertising moguls of that time, like so many other societal and cultural influences, have created and promote unattainable perceptions of women; that we can do it all and be it all and when we realize that we can’t, we beat ourselves up about it. I was having lunch with a friend the other day and she mentioned that she tries to be like the woman in Proverbs 31 in the old testament of the bible, but just “isn’t there”. (Proverbs 31: 10-31. For those of you not familiar with this dynamo, she has her home if order, her kids call her blessed, she is somehow earning income and making her husband proud. But hey, no pressure!)
We could sit here all day and ask, where do these ideas come from and why do we women buy into them? But that isn’t really a productive use of time. The innuendos and influences are there. What we women have to do is to look at them, acknowledge their presence and then move on with our lives.
So how does this pertain to mamas on bed rest? I’ve said it before and I’ll say it again, your need to be on bed rest is not likely your fault! There are many reasons that women are prescribed bed rest; placental problems, cervical problems, preterm labor, pre-eclampsia and multiple gestation to name a few of the more common indications. Some women may chastise themselves saying, “If I hadn’t been working so much or moving this way or that…Then I wouldn’t need to be on bed rest.” In most cases, nothing could be further from the truth.
A brief literature search shows that nearly 20% of pregnant women will be prescribed bed rest at some point during their pregnancies. That’s 1 out of 5 women! So clearly the need for bed rest is more common than many of us realized. But what is distressing to me is that women blame themselves for having to go on bed rest. So right here and right now, I’d like mamas on bed rest to consider an alternative explanation for the bed rest prescription.
During pregnancy you grow a whole, complete human being. Think about it. Your body grows a whole other, fully functioning being. This takes an incredible amount of energy! Your body (your belly in particular) will expand to a size beyond what you may have ever believed to be physically possible. To support the pregnancy and the development of the growing baby, your body will increase it’s blood volume 45-50% by the end of the pregnancy so that it can deliver the necessary nutrients and oxygen to the growing baby while continuing to support your physiologic needs. Your musculoskeletal system will expand and adapt to support anywhere from an additional 20-50 pounds of pregnancy weight. Your kidneys and intestines will increase their efficiency to not only extract nutrients and wastes for and from mama, but also for and from the growing and developing baby. The adaptations that your body undergo during pregnancy are nothing short of miraculous.
The fetus that develops becomes a baby with the capability to see, hear, smell, taste, move and think. As the baby grows, he/she will grow not only is stature, but will gain gross and fine motor control, reasoning capabilities, communication skills and whatever other gifts and talents are bestowed upon them such as the ability to sing, draw, complete complex math equations, or to develop innovative products. All of these developments require energy, perhaps more energy than your body is normally used to expending to sustain yourself, let alone another being. By you slowing down, it gives your body the ability to divert energy from moving and sustaining you to making energy available for fetal development. Is pre-eclampsia (high blood pressure) your issue? Perhaps your blood vessels need a bit more energy and leeway to adapt to the increased blood volume and transport necessary to feed and nurture your baby, leeway that results from lowering your body’s needs so the energy can be shunted to your baby? Are you going to chastise and berate your body for needing a little extra energy to create something or someone brilliant? What if you are growing the next Albert Einstein, Mahatma Gandhi or Michael Jordan? If you are a mother of multiples, what if you are growing the next version of the Wright brothers and your children will revolutionize how we travel? What if…..
The work that your body is doing is more than a construction crew and/or scientists could do in many more months. They say that to house all the information and processes of the human brain would require several football fields. Yet mama, you are creating that complex organ that will fit perfectly inside your baby’s small skull right now. The best artificial limbs and organs are nothing compared to the originals we have and mama you are creating them-right now! Go ahead, sit back and marvel at your creative self, you deserve it! You’re awesome!
Bed rest is hard. You may feel achy, bored and lonely. Your hormones may make you feel weepy. You will need help with the most basic tasks and that may make you feel incredibly vulnerable. But just remember all the phenomenal things that your body is doing at this very minute. What may seem like “laying around” may be creating the next Nobel Laureate. What if…
The Preemie Primer: Recommended Reading for Mamas on Bedrest
September 2nd, 2010When you are pregnant, you are bombarded with information and advertisements for everything from infant swaddling blankets, to formulas, to cord blood banking, to strollers. Much of the information that I received in my bag at each of my first obstetrical visits was useless. They were simply little leaflets trying to sell me things that I didn’t really want or need. How much better it would have been if I had received a copy of The Preemie Primer: A Complete Guide for Parents of Premature Babies-From Birth Through the Toddler Years and Beyond.
The Preemie Primer was written by Jennifer Gunter, MD, a board certified obstetrician/gynecologist, who is also board certified in pain medicine and board certified in physical medicine and rehabilitation. At a first glance it seems like Dr. Gunter is yet another “expert” telling you what the “scientific evidence” says you should do for your baby. While Gunter offers comprehensive information on caring for a premature infant, the book is far from dry and overly ‘jargoned’. At its best it is a deeply personal account of how Jennifer Gunter, wife and mother, navigated the peaks and valleys of caring for her markedly premature boys Oliver and Victor (born at 26 weeks) while also grieving the loss of their triplet brother Aidan, born at 22 weeks. She is simply sharing what she learned and knows with other parents and has created a powerful resource for parents of preemies.
Now I don’t want to discount Dr. Gunter’s knowledge. She has done a great job of pulling together the necessary medical information pertaining to preterm labor, prematurity and caring for mom and baby (ies) post partum. But the honest truth is that much of the “medical” information is freely available-on the web and in books and texts. But The Preemie Primer is for parents of preemies who, at a time when this information is in critical need, they dont’ have a nanosecond to spare seeking it out. Part of what makes it such an excellent resource is that not only is the medical information readily at hand in one place, Dr. Gunter also includes information on self care for parents (asking for help with post partum depression for example, deep breathing, meditating…) and navigating the complex US insurance system to get the care premature babies and children desperately need. Yes, the chapters on “The Mind-Body Connection” and “Making the System Work for You” were really helpful and informative and a welcome departure from the sterile statistics, instructions and definitions.
But far and away the “precious jewel” of this book is that it is written by Jennifer Gunter, wife and mother to two 
navigated the peaks and valleys of caring for her markedly premature boys Oliver and Victor (born at 26 weeks) while also grieving the loss of their triplet brother Aidan, born at 22 weeks.premature little boys and an angel in heaven. The success of The Preemie Primer results from the fact that as I read it, I felt as if I was sitting across from Jennifer Gunter, drinking coffee and chatting as she tells her story. I think the most powerful parts of the book are the gray insets that tell her personal story, her personal struggles to care for her living boys while at the same time grieving her angel Aidan. The times she was so overwhelmed with emotions that all she could do was cry. At those times her credentials were irrelevant. She was a mom, struggling for herself and for her sons, and as vulnerable as the rest of us.
One of my favorite vignettes was her conversation with the hospital representative as she disputed charges for Aidan. Anyone who has ever had the frustration of speaking with hospital representatives who are insensitive, unyielding and basically ignorant to medical procedures will totally relate to this conversation. Gunter was arguing to have charges made for Aidan’s “care” removed from her hospital bill. You feel the pang in your own heart as you hear Gunter tell this representative that Aidan died and did not receive care as is indicated on the bill.
While I like and highly recommend The Preemie Primer (Remember, I said it should be in every new OB bag!), I realize it is a tough sell. In the same way that obstetricians don’t discuss the possibility of bed rest until a woman is having it prescribed, I doubt The Preemie Primer will become recommended reading for mainstream pregnancy. And this is unfortunate. Having had a late preterm birth, I would have loved to have had even an inkling of what to expect. As high risk as I was, no one ever even mentioned that I was at risk for preterm labor. I was never counseled about the signs and symptoms of preterm labor. When I delivered my daugher at 36 wks and 6 d, I fully expected to have her put on my chest, to nurse her and then to have her in my room. Instead she was whisked away from me by nurses and neonatologists and then admitted to the NICU (which is never mentioned or visited in hospital tours). I was completely blind-sided by the entire experience.
Our culture likes to “stay positive” and always “look on the bright side”. But turning a blind eye to potential catastrophe is just plain stupid. No woman wants bed rest, a premature infant or, heaven forbid, to have a stillbirth. But the reality is that these events happen. Just because we don’t talk about them or “don’t have that in my family or medical history” doesn’t mean that they can’t happen to us. Obstetricians and midwives should talk about them (at the very least) and give parents tools and resources that they can readily access in the event that the most awful and unexpected happens. So yes, I do think that The Preemie Primer should be put in OB bags-or made readily available in OB offices, hospital gift shops, family resource centers and the like.
We have to face the fact that not everyone has the picture perfect pregnancy, labor and delivery. But things needn’t spiral completely out of control. Research shows that patients who feel that their health care providers are honest and up front with them, explaining every test and treatment and potential outcome are far less likely to come away with ill feelings or to sue their providers. We have to have the hard conversations. But if OB’s and midwives don’t want to do that, or feel uncomfortable or as if they are “scaring” their patients, then have resources readily available. As Dr. Gunter said herself during our podcast interview, “Plan for the worst but expect the best”.
The Preemie Primer is available on this website via our Amazon.com store in the Infancy/Childhood section. We respectfully ask that if you decide to purchase The Preemie Primer as a result of reading this blog post or listening to the podcast interview with Dr. Gunter that you do so via our store as it helps to fund the operation of this website.
Share your stories of preterm labor and caring for a premature infant below.
