prenatal wt gain
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.
Gestational Diabetes: A Particular Problem for Mamas on Bed Rest
January 29th, 2010
Gestational Diabetes (GD) can be particularly problematic for mamas on prescribed bed rest. Previously a common indication for bed rest, with all of the medical advances and therapies most pregnant women who develop GD are easily managed as out patients. Unfortunately, women who are prescribed bed rest for another medical condition are at increased risk for developing GD as a result of inactivity and weight gain. Women who develop GD are at increased risk of developing Type II diabetes later in life as well as Metabolic Syndrome.*
Gestational Diabetes is defined as impaired (improper) glucose metabolism during pregnancy. Some women become insulin resistant, meaning that the insulin their bodies produce does not properly carry glucose from the bloodstream into the body’s cells as it should. Sometimes GD develops because a woman has gained too much weight, a common cause of insulin resistance. Other times the increased hormones of pregnancy interfere with glucose metabolism. Finally, a woman with a genetic predisposition to diabetes may manifest her first symptoms during her pregnancy. This woman is at increased risk of developing Type II diabetes later in her life.
Testing for gestational diabetes is typically done between 20 and 28 weeks of pregnancy. The normal ranges of blood glucose are:
- 70-95 mg/dL Before breakfast (fasting)
- 70-140 mg/dL 1 hour after eating a meal
- 70-120 mg/dL 2 hours after eating a meal
Women who have blood sugars that fall above these ranges during testing will be diagnosed with GD. It is essential that women diagnosed with Gestational Diabetes are treated aggressively and that they achieve and maintain tight blood sugar control. Blood sugar control is essential to ensure the health of both mother and baby. When blood sugars are not controlled during pregnancy, Some unfortunate complications can result such as:
- High blood pressure in the mother caused by preeclampsia
- Excessive birth weight (exceeding 9 pounds, 14 ounces)or Macrosomia
- C-section delivery
- Hypoglycemia (low blood sugar) in the baby at birth
- Jaundice (yellow skin) in the baby at birth
- Respiratory distress syndrome (breathing difficulties) in the baby at birth
- Low blood calcium levels in the baby at birth
- Red blood cell disorders in the baby at birth
- In very rare cases, stillbirth of the baby at 28+ of pregnancy
- In very rare cases, death of the baby in infancy
- Increased risk for type 2 diabetes in both mother and baby later in life
Treatment of Gestational Diabetes is actually quite simple. From many women, adherence to a “diabetic diet”, a regular exercise regimen and regular blood sugar testing are all that is needed. However, for many other women, blood sugar cannot be adequately regulated and controlled with diet and exercise alone, so they are prescribed oral medications or Insulin injections.
Unfortunately most pregnant women on prescribed bed aren’t able to exercise enough reduce insulin resistance with diet and exercise alone. However it is still very important, perhaps even more so, that they follow the dietary instructions from their OB or a nutritionist and that they stretch and do some muscle strengthening and toning while in bed. If women on bed rest are diagnosed with gestational diabetes, they should request a referral to a physical therapist or exercise specialist** so that they can learn safe exercises that they can do while on bed rest.
It may seem unfair to be diagnosed with gestational diabetes while on bed rest for another condition. Try not to become too discouraged. Gestational Diabetes is easily managed and with careful adherence to your obstetrician’s directions, you and your baby can be just fine.
**Bedrest Fitness is a set of simple yet effective modified prenatal exercises that a pregnant woman on prescribed bed rest can do from her bed with her obstetrician’s approval. Order Bedrest Fitness here.
Please share your comments or questions on this post below.
7 Ways Exercise Benefits Pregnant Women and Their Babies
January 18th, 2010After rereading my last post I realized it’s unfair of me to bash a study and not state my reasons why. I came out strongly against the Madrid study which found that low resistance exercise in previously sedentary women didn’t affect the type of delivery that they had. Essentially these researchers took a a group of sedentary pregnant women with uncomplicated pregnancies, set them up with a very low intensity work out for the second and third trimesters of their pregnancies and then looked at modes of delivery.
While the study seems to be carried out properly, my objections are that the women had not been adequately challenged, i.e. made to exercise with enough intensity, to be able to reap the benefits of prenatal exercise. As I mentioned in the last post, the exercise parameters that I use are those put forth by James Clapp, III, MD and Ann Cowlin, MA a Dance and Movement Therapist who have both done extensive research in exercise during pregnancy. They both advocate moderate intensity exercise 3-5 times a week for 20-30 minutes per session. By exercising at this frequency and intensity they both observed less maternal weight gain, lower incidences of gestational diabetes and hypertension, fewer aches and pains of pregnancy, shorter times in active labor (dilation from 4cm to 10 cm) , fewer interventions in delivery (i.e. forceps, vacuum, c-sections) a quicker return to pre-pregnancy weight.
But how exactly does moderate intensity exercise create these benefits? Let’s look at the effects of moderate intensity exercise on a pregnant woman’s anatomy and physiology. I promise not to get too geeky on you, just bear with me because this is important information.
Increased Muscle Tone
Just as in the non-pregnant state, exercise that includes strength training exercises maintain and/or increase endurance and muscle tone, creating more stamina, lean muscle and less body fat. For a pregnant mama, this means increased metabolism (muscle burns more calories than fat) and increased energy to perform the her activities of daily life. Most mamas who have engaged in regular, moderate exercise during pregnancy experience fewer of the common aches and pains of pregnancy, have shortened durations of active labor and subsequently need fewer pushes to deliver their babies. Post partum, they return to their pre-pregnancy weights sooner.
Increased Skeletal Stabilization
This goes hand in hand with increased endurance and muscle tone. A mama with well toned muscles will have more stability in her frame. Strength training enables Mamas to have better posture; a straighter back, less rounded shoulders and less neck strain. More skeletal stabilization leads to more hip and pelvic stability and less pain. Overall Mama will be less uncomfortable as her pregnancy progresses.
Improved Metabolism
Just as in the non-pregnant state, exercise increases metabolism by increasing the number of energy centers within muscles to utilize the nutrients we eat to create energy. Food mama eats will be used more fully for energy and development of her baby and less will be stored as fat. As a result, mama will be less likely to develop gestational diabetes or high blood pressure (hypertension).
Improved Circulation
Mamas who exercise also increase their blood circulation despite the increase in overall body fluid volume. Blood and body fluids are well circulated and don’t readily pool leading to swelling and increased of blood clot formation. For pregnant mamas who exercise, this means less swelling in the hands and feet and a lower risk of developing a blood clot in one of her legs that could dislodge and travel to her heart, lungs or brain and be potentially fatal.
Better Sleep
Ever notice that you sleep better when you exercise regularly? Well, exercising during pregnancy has the same effect. Some women note difficulty sleeping while pregnant. If this is the case, try adding a brisk daily walk or some strength training to your daily routine and see if you are able to get a better night’s sleep.
Improved Placental Growth and Functional Capacity
This was an unexpected finding that Dr. Clapp found in his research. Prior to Dr. Clapp’s research obstetricians and researchers believed that exercising during pregnancy would somehow impair the growth and development of the placenta. Dr. Clapp and his associates, using a special ultrasound machine, measured placental growth in his study subjects. Dr Clapp found that exercise didn’t stunt growth of the placenta, it actually increased its growth rate during the mid portion of pregnancy. Additionally, these larger placentas had more functional capacity, i.e. increased ability to nourish the babies, because they had more blood vessel development. This was a fantastic finding because at the end of pregnancy, when babies are growing rapidly, the larger, more vascular placenta is able to deliver more nutrients to the baby.
“Lean Mean Babies”
After establishing that exercise is good for mothers, Clapp set out to see what effect moderate exercise had on the growing babies. Clapp found that babies born to mothers who exercise are not at risk of being of low birth weight. They may weigh less than babies born to non-exercising mothers, but they are still of normal, acceptable birth weights and sizes. These babies also had less body fat than their counterparts. (Remember, they were being well fed by a highly functional placenta!) These babies also adapt well to stimuli and if there are complications during labor and delivery, they are better able to adapt and compensate giving clinicians a bit more time to assist if necessary.
This research has significant implications for women who exercise during pregnancy. But what happens if a woman stops exercising late in her pregnancy? Clapp found that women who stopped exercising late in pregnancy, say at 32 weeks lost all the benefits they had developed. They began gaining weight, experiencing the aches and pains of pregnancy, swelling in their hands and feet and they tended to have larger babies.
If women are going to exercise during pregnancy, they need to exercise at a moderate intensity (12-14 out of 20 on Borg’s Scale of Perceived Exertion) 3-5 times a week for 20-30 minutes and, as much as possible, they should continue exercising as close to delivery as possible.
Do you exercise or did you exercise while you were pregnant? Share your experience in the comment section below.
Mamas on bed rest, you may not be able to engage in cardiovascular exercise, but you can strength train using exercise bands. A simple, yet effective set of exercises is waiting for you in Bedrest Fitness. Even if you are unable to do all of the exercises, your body will appreciate the movement. Get your copy of Bedrest Fitness Here
