Preventing Preterm Birth – Bed Rest

Your Baby
Weeks 22 to 27

At 25 weeks, your baby is 11 to 14 inches long and weighs 1 1/4 to 1 1/2 pounds. His skin is red, wrinkled, and covered with a protective coating. Your baby can smell, taste, see light, and hear your heart beating. His face and hands look much like they will look at full-term. After 25 weeks he will begin opening and closing his eyes. To exercise his muscles, he keeps practicing his breathing. The tiny sacs in his lungs are still not developed and if he were born now, he would need machines to help him breathe.

As he grows, the amount of blood he pumps to the placenta increases. His blood returns to his body with more oxygen and sugar to keep up with his growth and development. His body can’t store oxygen, and he depends on you for a constant supply.

Babies born at 24 weeks weigh about one pound, their eyes are still shut, and their lungs have not developed. Sadly, their chance of survival is less than ten percent.

Mom with newborn covered with vernix

Mom with newborn covered with vernix

If you are having symptoms of preterm labor, your doctor may put you on bed rest. Bed rest is meant to limit physical activity and mental stress that can increase your risk for preterm labor. Bed rest can lessen uterine irritability and stop uterine contractions by keeping the weight of your baby off of your cervix. While standing, gravity pulls the weight of your baby and uterus down onto your cervix. As a result, a weak cervix can begin to give way which can lead to preterm labor.

Also, bed rest takes work off your heart, kidneys, and other organs. As a result, your body can concentrate on your baby’s needs. Nothing improves the blood flow to your baby as much as real rest. And rest is even more important if you are carrying more than one baby.

Levels of bed rest

There are several levels of bed rest. You may be on:
~ limited bed rest: you may be able to be up and around for hours at a time. You may be allowed to sit when resting rather than lying in bed.
~ bed rest except meals and bathroom privileges: you may be in bed most of the time, but allowed to get up to go to the bathroom or eat meals at the table with your family.
~ bed rest with bathroom privileges only: you must be in bed except when you need to go the bathroom. You’ll have to arrange to have your meals in bed.
~ total bed rest: you must stay in bed at all times and use a bedpan when you need to use the bathroom. Sometimes, total bed rest may require you to be in the hospital. Total bed rest requires the help and support of everyone in your family and plenty of organization.

The level of bed rest determines your “level of activity.” Use the activity checklist to record your level of activity. Completing this checklist can help you understand exactly what you have to do to follow your doctor’s instructions. Understanding why you are on bed rest can make it easier for you to cope. Unless your doctor says otherwise, expect to be on bed rest until your baby is born.

To get the most from bed rest, it is important to lie in the correct position as much as you possibly can for as long as you are on bed rest. Your doctor can show you the position that is best for you based on the reason for your bed rest. You may have to lie on your left side, which helps the flow of blood to your baby, or with your whole body tilted so your feet are slightly higher than your head. Putting a few books under the foot of the bed will tilt the angle of the bed.

Getting your “nest” ready

Depending on how much time you are allowed to sit and how long you must lie down, you may be able to have two resting areas, one during the day and one at night. As you are planning your “nest,” keep in mind that making yourself as comfortable as possible and keeping items nearby will make it easier to cope with bed rest. The following tips may help.
~ Face your bed or chair and foot rest toward a window, for a view, or the door, so you can see who’s coming.
~ Have someone else move your bed or chair.
~ Get an extra-long extension cord (that has several outlets) and telephone cord so you can have things within reach.
~ Put grooming items in a plastic pail or fanny-pack to keep them with you.
~ If you have small children, “child-proof” the room and turn it into one big playpen.

Preventing side effects of bed rest

~ Shift positions every 30 minutes to prevent constant pressure on one part of your body and prevent pressure sores. Keep lots of pillows nearby.
~ Take a few deep breathes and wiggle your fingers and toes every 20 minutes. Ask your doctor about bed rest exercises and wearing support hose.
~ Avoid constipation by increasing your fluid and fiber intake. Eat lots of fresh fruits – which are easy to keep at bedside – and drink plenty of water.

Things to do

~ Keep the telephone and important phone numbers nearby.
~ Have visitors. Call friends, family, or members of your support group.
~ Keep books and “quiet” projects nearby. This can be a good time for reading, needlepoint, learning a new language, or watching videos.
~ Keep water nearby. Drink 10 to 12 eight-ounce glasses each day.
~ Keep a small basket nearby. Put in items that you want to keep with you in the basket. Have someone carry the basket up and down the stairs.
~ Shop using mail-order catalogs, TV, or the internet.

Things to plan

~ Be realistic about how much help you will need and can get. If possible, plan for childcare, meals, laundry, and shopping. Planning ahead is easier than managing from day-to-day.
~ Make a list of things to do for tomorrow.
~ Who can take you to your doctor’s appointment? Have them let you out close to the front door. If you have to walk a long way, call the doctor’s office and ask if they have a wheel chair you can use.
~ Get a calendar and plan doctor visits or tests and how you will get there.

Things to learn

~ Don’t close your mind to learning about cesarean birth and how to care for a baby born too soon – learning about it doesn’t make it happen. And if it does happen, your recovery will be easier and you will be prepared to give your baby the special care he will need. Keep in mind that what’s important is the health of you and your baby – no matter how or when he is born.
~ Learn and practice ways to relax and calm yourself.
~ Ask your doctor’s office or hospital about local or national support groups.

Temptations to avoid

~ Don’t make side trips on the way to or from your doctor’s appointment.
~ Avoid junk foods with empty calories. Fruits are great bed rest food.
~ Try not to worry about things you can’t change such as “too much” or “not enough” to do. Do what you can within your activity limitations; let everything else go.
~ Try not to keep your feelings inside; vent when you need to.
~ Don’t ignore your bed rest or activity limitations.

Coping with your feelings

~ Get dressed every day. Your mental outlook plays a very important part in your physical well-being. If you’re allowed, join in with the rest of your family instead of staying by yourself in the bedroom.
~ Keep a journal or diary for expressing your feelings.
~ It’s hard, but very important, to avoid emotional stress during this time. Worrying affects your blood pressure, heartbeat, and breathing rate.
~ Enjoy the good days, get through the bad ones. Remind yourself often that you are doing the best possible for your baby. Every day counts — every day “on the inside” is two less days in the hospital nursery.

To Learn More about Preventing Preterm Birth

To Learn More about Caring for Your Newborn

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