Bed rest: When is it necessary? (2023)

There are many recommendations for pregnant women that have little scientific evidence to support them. For example, eating dry saltine crackers followed by a sip of water to prevent and treat morning sickness. Or playing classical music to soothe the unborn baby. Or not lifting one’s hands over their head to prevent umbilical cord entanglement. These are unproven recommendations, but have little risk and are inexpensive, so many pregnant women will embrace them during their 40 weeks of pregnancy.

Modern obstetricians are trained to practice “evidence-based medicine.” That means that a study will be performed to test a certain intervention’s effectiveness in treating or preventing a pregnancy condition, and if there is statistical confirmation that the intervention is helpful, then that intervention could become a standard of care.

Bed rest in pregnancy to prevent a premature delivery is an interesting topic, and although the data is not conclusive, I do have certain views on this topic.

The Cons of Being on Bed Rest

Increased risk of blood clots

Bed rest: When is it necessary? (1)

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First, could it be a risk? The answer is yes. We know that pregnancy changes a woman’s ability to coagulate blood. This occurs to help control the bleeding at, and after, delivery. When a pregnant or recently delivered woman is at bed rest, the blood in the deep veins in her legs can lose the flow pattern, and thus form a clot.

While this can be dangerous, there are things that can help prevent clotting. Many hospitals apply compression stockings to women who spend a long time at bed rest. Sometimes, they also receive a small shot of blood thinner daily. If the pregnant woman is on bed rest at home, she can help move the blood through her veins by frequently “wiggling” her legs and toes to activate her legs muscles. She can also slightly elevate her legs to help prevent clotting.

Bed rest can be expensive

A large number of pregnant women are employed, and if she goes on bed rest, she will inevitably have to leave work.

Lack of exercise

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If a pregnant woman is on bed rest, she cannot exercise, which is proven to be helpful during pregnancy.

Decrease in social interaction

There are also social variables that could raise concern. The pregnant woman on bed rest is not engaging in her usual routine and could become bored, depressed and/or feel guilty.

Even though the evidence for bed rest in pregnancy to prevent a premature birth is controversial and there are risks, I personally believe there are certain times when prolonged bed rest may be beneficial and I recommend it at this time.

When Bed Rest may be Necessary

Incompetent Cervix

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The process of a preterm birthis not unlike a term birth, it just happens earlier. The mouth of the womb (cervix) softens, opens and flips upward, the uterus begins to harden rhythmically (contract) and the lower part of the uterus thins. There is very little we can do about the softening process with the exception of inserting a suture (shaped like a shoestring) around the cervix at 13 weeks. Of course, we have to know the cervix will soften before it actually softens and dilates. That is where the patient’s past history becomes important. If she has previously delivered a baby early the doctor will ask specific questions and possibly perform cervical length measurements. The condition that we are looking for is called “incompetent cervix.”

Prevent abnormal/increased contractions

Bed rest: When is it necessary? (2)

The other part of delivering a baby that occurs after and simultaneously with the softening and dilating of the cervix is the contractions. Every pregnant woman contracts throughout the second and third trimester, which is normal. It is not normal, however, if the cervix is already dilated, or the contractions are persistent. This is where bed rest along with adequate hydration, in my opinion, is beneficial. Most pregnant women will tell you that if she is active during the last several months, she will begin to contract much more frequently in the evening. That is why most obstetrical triages become busy around 10:00 pm. My theory is that the skeletal muscles that are in use during the daytime activity are actually “borrowing” oxygen, and that the placenta is reclaiming that oxygen later that day by using the contractions. The placenta is like a sponge, and when the uterus contracts, it is essentially squeezing the placenta. This process is a lot like when you wash your car using a big sponge and then squeeze it to get out the “used and dirty water.” The uterus is squeezing out the old blood and is quickly replacing it with new, well-oxygenated blood. These contractions will stop as suddenly as they start, regardless of what anyone does, and are what we call “false labor.” This is where bed rest can be useful.

Pregnant women who already have a softened cervix should contract as little as possible. These include women with an incompetent cervix, or women who may have what is called a “fusion defect” of their uterus that could cause the cervix to be weak. Also, many women who are carrying twins or triplets may have a cervix at risk for early dilation.

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Added protection

Another benefit of bed rest is that women can’t trip, fall and hit their uterus if she is in bed. Hitting the uterus can frequently result in breaking the placenta off (abruption).

Decreased risk for high blood pressure

Also, many pregnant women develop high blood pressureduring the late second and early third trimester, and bed rest can help prolong these pregnancies safely.

Early water break


Finally, some women will break their water early, and modified bed rest in the hospital may be recommended.

If you have any questions concerning bed rest, don’t hesitate to ask your OB/GYN.


When is bed rest necessary? ›

Why Is Bed Rest Prescribed? Some doctors suggest bed rest for conditions like growth problems in the baby, high blood pressure or preeclampsia, vaginal bleeding from placenta previa or abruption, preterm labor, cervical insufficiency, threatened miscarriage, and other problems.

What are the rules for bed rest? ›

Limit practicing to relaxation and birth techniques. Do not exercise or practice “pushing.” Ask your doctor about educational videos. Is it safe to have sex while on bed rest? While you are on bed rest: • Do not do any nipple or breast preparation.

What is the purpose of bed rest? ›

Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of a health impairment which physically prevents leaving bed.

Does bed rest mean you have to stay in bed? ›

Full bed rest usually means you need to lie down most of the day except when you go to the bathroom or take a bath or shower. But every woman and every pregnancy is different. So the amount of activity you can do will depend on your doctor's recommendations.

When would a doctor put you on bedrest? ›

What is bed rest? If your pregnancy care provider recommends bed rest, it means they're concerned about a health condition that could cause pregnancy complications or premature labor. Your provider may put you on bed rest for a few weeks or several months.

Can I request bed rest while pregnant? ›

Bed Rest During Pregnancy. Bed rest is commonly prescribed during pregnancy to alleviate certain pregnancy complications. Some women know it is coming because of their medical history, whereas others are surprised during a routine checkup. Bed rest is common, so don't be alarmed.

Is bed rest the same as bedridden? ›

Being bedridden is a form of immobility that can present as the inability to move or even sit upright. It differs from bed-rest, a form of non-invasive treatment that is usually part of recovery or the limitation of activities.

How long can you be on bed rest? ›

Preterm labor: Moms-to-be who begin to contract regularly before week 37 of pregnancy or show other signs of early labor can expect to be placed on bed rest. The goal generally is to try to delay delivery by at least 48 hours so that steroids that speed the baby's lung development can be administered.

Can doctors prescribe bed rest? ›

In some cases, the doctor may recommend periods of rest at home during pregnancy. In other cases, the doctor may prescribe bed rest because of a specific complication. Rarely, a doctor may prescribe a period of bed rest with monitoring in hospital.

Why are sick patients advised to take bed rest? ›

Doctors advise to take bed rest for sick patients so that they can conserve their energy which can be used for healing of their body organs which were affected due to certain disease.

What does bed rest mean in medical terms? ›

bed rest. noun. : confinement of a sick person to bed.

What are the consequences of bed rest? ›

Bed rest can cause several complications that may delay or prevent recovery from critical illnesses including disuse muscle atrophy, joint contractures, thromboembolic disease, and insulin resistance.

Can I sit during bed rest? ›

Partial bedrest usually means it's usually okay to sit, stand, or walk around for short periods of time. It is sometimes called modified bedrest. Full bedrest usually means you need to lie down most of the day except when you go to the bathroom or take a bath or shower.

Is pelvic rest the same as bed rest? ›

Being on pelvic rest doesn't have to mean you can't do any physical activity during your pregnancy. Pelvic rest is different than bed rest, so you are still able to do all of your normal day-to-day activities. You just want to be careful to avoid having sex or placing any unnecessary strain in the pelvic area.

Can you be put on bed rest for high blood pressure? ›

Bed rest can help control your blood pressure and may help keep your heart from beating too fast. If your heart rate slows down, less blood will be pumped into your arteries which helps keep your blood pressure stable. As long as your blood pressure remains mild, you can take care of it outside of the hospital.

Can I reduce my hours at work while pregnant? ›

Yes, you can ask your employer if you can reduce your hours on a temporary basis but it will mean a reduction in your pay and this may affect your maternity pay. Make sure any change is confirmed in writing and that it is agreed for a temporary period.

How many hours should a pregnant woman work on her feet? ›

Standing for prolonged periods while pregnant can not only be dangerous, but it can also be difficult or painful. It is recommended that pregnant women stand for no more than four or five hours while taking frequent breaks throughout the workday.

How long can you lay on your back when pregnant? ›

Back sleeping is no longer safe after 28 weeks gestation, but there are a few other comfortable positions for you to safely doze in.

What are 5 potential complications of bed rest? ›

Problems Due to Bed Rest
  • Blood clots. A leg injury, leg surgery, or bed rest may prevent people from using their legs. ...
  • Constipation. ...
  • Depression. ...
  • Pressure sores. ...
  • Weak bones. ...
  • Weak muscles and stiff joints. ...
  • Prevention of Problems Due to Bed Rest.

How much is too much bed rest? ›

Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only won't help but it may, in fact, actually delay your recovery.

What do hospitals do on bed rest? ›

Whether it's an old-fashioned crossword puzzle or sudoku, a spirited game of bananagrams with a family member, candy crush on your phone or a video game; playing games can be both a great way to keep your mind active and lose yourself in something for a little while.

How often should a patient on bed rest be turned? ›

Changing a patient's position in bed every 2 hours helps keep blood flowing. This helps the skin stay healthy and prevents bedsores.

How long does it take to recover from bed rest? ›

It typically takes about four weeks to recover from the disuse atrophy caused by immobility, which is slower than the recovery from direct muscle trauma (Halar, 1994). Loss of muscle mass and strength can have negative psychological effects on patients, contributing to fatigue and low mood.

How do you get through hospital bed rest? ›

How to Get Through Hospital Bed Rest
  1. Read a lot. ...
  2. Meet all the personnel at the hospital. ...
  3. Get a pedicure done. ...
  4. Take long showers (sitting down). ...
  5. Online shopping is very helpful to feel better, especially if you haven't done any baby clothes shopping at all!
  6. Massages! ...
  7. Sleep! ...
  8. Make friends with other patients.

Should you rest or be active when sick? ›

Don't exercise if your signs and symptoms are "below the neck," such as chest congestion, a hacking cough or upset stomach. Don't exercise with people if you have COVID-19 or other contagious illnesses. Don't exercise if you have a fever, fatigue or widespread muscle aches.

How long does it take to regain strength after being bedridden? ›

Dramatic change in muscle mass occurs within 4-6 wk of bed rest, accompanied by decreases of 6 to 40% in muscle strength. Immobilization studies in humans suggest that most of this lost muscle mass and strength can be regained with appropriate resistance training within several weeks after a period of disuse.

What are the side effects of lying down too much? ›

Summary. Sitting or lying down for too long increases your risk of chronic health problems, such as heart disease, diabetes and some cancers. Too much sitting can also be bad for your mental health. Being active is not as hard as you think.

Can bed rest increases cervix length? ›

Based on these results, we conclude that therapeutic cerclage with bed rest increases cervical length and that bed rest alone has a variable but, on average, negligible effect on cervical length.

Can bed rest stop dilation? ›

The Bed Rest Controversy

"Patients who are on limited activity contract less, so they feel better," she says. And it can reduce a woman's anxiety about her pregnancy and in some cases stop or slow cervical dilation.

Can heavy lifting in early pregnancy cause miscarriage? ›

Prolonged standing or heavy lifting can cause an increased chance of miscarriage or preterm delivery (premature birth). Changes in a pregnant woman's hormones impact ligaments and joints in the spine to accommodate the developing baby.

What are the side effects of lying in bed all day? ›

Prolonged bed rest affects the amount of fluid in your body and the pressure at which blood is pumped, making it difficult for the body to adapt to activity again. It causes changes in the size of the heart, too, and the body's ability to replenish blood.

What positions put pressure on cervix? ›

When you are upright—standing, sitting or kneeling—the weight of your baby presses on the cervix, encouraging it to open. An upright position may also help get your baby into the best position for birth.

What causes cervix to shorten early? ›

Causes of a short cervix

trauma to the cervix area (such as during a procedure like a dilation and curettage — but note, this is rare) damage to the cervix during a difficult birth. exposure to the hormonal drug diethylstilbestrol (that is, if your mom took it while she was pregnant with you) cervical rupture.

When should cervix start to shorten? ›

Between 16-24 weeks, the cervical length is usually between 35 and 48 mm. A short cervix is defined as being less than 25 mm in length before 24 weeks. By 32-34 weeks, the cervix normally starts to soften and shorten, so by the mid-to-late third trimester, it's normal to have a cervical length of less than 3 cm.

Can sleeping help progress labor? ›

Results: Controlling for infant birth weight, women who slept less than 6 hours at night had longer labors and were 4.5 times more likely to have cesarean deliveries. Women with severely disrupted sleep had longer labors and were 5.2 times more likely to have cesarean deliveries.

Can bed rest slow down labor? ›

Is bed rest recommended? There is no evidence that bed rest during pregnancy — at home or in the hospital — is effective at treating preterm labor or preventing premature birth.

What is overdoing it when pregnant? ›

If you feel completely drained or increasingly fatigued long after a workout, you're probably overdoing it. Exercise shouldn't hurt. You may feel a bit sore during or after a workout, but the soreness shouldn't linger. If it does, you probably overused your muscles or joints.

Can bending over hurt baby? ›

You might wonder whether bending over when pregnant can squish your baby. The chances of something happening to your baby as a result of you bending over are next to none. Your baby is protected by amniotic fluid during pregnancy.

What can accidentally cause a miscarriage? ›

Several factors may cause miscarriage:
  • Infection.
  • Exposure to TORCH diseases.
  • Hormonal imbalances.
  • Improper implantation of fertilized egg in your uterine lining.
  • How old you are.
  • Uterine abnormalities.
  • Incompetent cervix (your cervix begins to open too early in pregnancy).
Jul 19, 2022


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3. Do I need bed rest after Cervical cerclage or Cervical stitch? - Dr. H S Chandrika
(Doctors' Circle World's Largest Health Platform)
4. Pregnancy journey: Nine months on bed rest
5. Activity Restriction / Bed Rest During Pregnancy | Dr. Stephanie Martin - MFM
(Southern Colorado Maternal Fetal Medicine)
6. How much bed rest is too much?
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