As someone who was prescribed bed rest in the last few weeks of both my pregnancies, I read with mixed feelings Sarah Biltson's Op-Ed piece in today's New York Times, positing that American doctors overprescribe bed rest for their pregnant patients.
"It is a standard means of treating just about any pregnancy-related problem in the United States. Women at risk of preterm labor, women with too much or too little amniotic fluid, women with placenta previa (where the placenta implants on or near the cervix), women with pregnancy-induced hypertension, women whose fetuses are judged to be growing poorly, women with multiple fetuses and women with chronic health problems are all likely to find themselves on bed rest," writes Biltson, who was prescribed bed rest during her own pregnancy. "Indeed, doctors prescribe it for about one in five of all pregnant women, or around 750,000 women a year."
According to Biltson, who ascribes a range of ailments and aches and pains to her stint on bed rest, the prescribing of bed rest is far more common in the United States than in other countries. She cites research conducted by Case Western Reserve University nursing professor Judith Maloni, who finds that American obstetricians "tend to discount both the side effects of bed rest and to believe in its value" despite some evidence that it may be ineffective or, in some cases, countereffective in helping a mother carry a fetus safely to term.
Comparing bed rest to the madness-inducing "rest cure" evoked in Charlotte Perkins Gilman's "Yellow Wallpaper," Biltson notes that Gilman, who was being treated for postpartum depression, managed to rebel against her doctors' advice, but that women today, concerned for the health of their babies, may "feel they have little choice but to follow the advice they are given by their doctors." She concludes, "The profession needs to recognize the profound psychological and physical costs of this modern rest cure, and to thoroughly research its putative benefits, before yet another generation of women finds itself staring blankly at the wallpaper."
But for all her examples and statistics, there's one throwaway line in Biltson's Op-Ed that I think speaks to the heart of the issue: "Frankly, I would have stood on my head if there was a chance it would save my daughter's life," she writes.
That's just how I felt when the doctor overseeing my first pregnancy found that my amniotic fluid level was perilously low, when I saw the patchy, frightened pallor of her skin as she told me, five weeks before my due date, to go straight home, pack my bags, and meet her in the hospital. And when, after reclining in my hospital bed for a week, hydrating like crazy, I was allowed to go home and recline on my own couch for the remaining gestational weeks, well, I was ecstatic. Delighted to be sprung and profoundly relieved that my baby would likely make it safely through.
Like Biltson, I was bored off my gourd on bed rest. Like her, I got weaker, my joints got creakier, my muscles flabbed out, right when I most needed my strength for childbirth and parenting. Like her, I couldn't wait for my time on the couch to be over. But unlike her, it seems, I found that bed rest also had its rewards: It gave me no choice but to slow down, to direct my focus to the life growing inside, to bond with my little baby-to-be in a way that all the active preparation of the previous months could not. Bed rest may not have prepared me physically for the rigors of giving birth and toting my new baby around, but it did help me ready myself mentally for that very thing (a luxury I acknowledge may have felt quite different had it come earlier in my pregnancy and curtailed my income longer). It also, I believe, may truly have helped head off a real threat to my baby's life.
But I think there's a greater concern here, and that is that women like Biltson continue to feel that their health, mental and physical, is not being adequately considered by their obstetricians during pregnancy. Sure, the baby's health is paramount. But surely the mother's needs must be considered as well. And if she doesn't really need to lie on her side, rising only to brush her teeth, by all means, let the poor woman get up off the couch.