(This article was published in American Baby magazine in 1993)

When I became pregnant, bedrest was the furthest thing from my
mind. I was healthy, I felt fine... besides, nobody I'd ever known had
needed to bedrest before. Surely bedrest only happened to the frail and
sickly.

I was wrong. In my 24th week of pregnancy, still healthy and feeling
fine, I was suddenly confined to my bed, doctor's orders. I spent one week
at home on bedrest and six weeks in the hospital. And I was not alone.
The antepartum (pregnancy bedrest) unit of my hospital was surprisingly
busy during my stay. Bedrest was not so rare as I'd thought.

The chances are good that bedrest won't happen to you. Since
doctors are not required to report statistics concerning bedrest, the
number of women needing to bedrest each year is unknown. However, one
out of every four or five pregnancies is labeled "high risk," meaning the
possibility of complications is higher than normal. This calculates out to
nearly one million women in the United States each year for whom the
risk of pregnancy complications is high, and for whom bedrest is one step
closer to reality.

I knew none of this during my pregnancy. I went into bedrest totally
naive (not to mention frightened and confused). I had to discover on my
own how to bedrest. I learned a lot in those seven weeks on my back;
through trial and error, I've become an expert in bedrest survival. While I
hope you never need it, here's more information and some advice should
you find yourself on bedrest for a few days, weeks or (groan!) months.

Bedrest makes sense: while lying down, your body focuses on your
baby, since your activities don't require as much energy. Blood- and
oxygen-flow to the baby is optimal while lying down, and bedrest babies
often gain weight faster. Also, your body doesn't have to deal with the
sometimes harsh effects of gravity. For a pregnancy with complications,
these positive changes can make a world of difference.

It did for me. Since I was pregnant with twins, I was considered
high-risk for a number of complications. Only one occurred: preterm
labor in week 24. Bedrest (combined with medications) enabled me to
carry my babies to week 31. I credit bedrest with helping them grow
strong; even though two months premature, my son and daughter had few
difficulties and came home one month before their due date.

In addition to preterm labor and multiple gestation, bedrest is
commonly prescribed for a number of pregnancy complications. This list
includes intrauterine growth retardation, placenta previa, malformed
uterus, incompetent cervix, pregnancy-induced hypertension
(preeclampsia, eclampsia), edema (fluid retention), placental separation
and premature rupture of the membranes. Bedrest may also be advised for
women with a history of miscarriage, spotting or bleeding early in
pregnancy, or with bleeding in the last trimester.

Whatever the complication, it's important to get detailed answers
from your doctor concerning your situation. After all, there's more to
bedrest than just lying down. For starters, where will you bedrest? If
your complications are minor, you may be able to bedrest at home. When
IV medication is needed or the complications become threatening,
hospitalized bedrest will be necessary. You'll also want to know-- how
long? Some women bedrest only a few days, others for weeks or months.
Medications? Your doctor will certainly discuss your need for them; find
out how they may affect you physically and emotionally. How should you
lie down? You may be allowed to sit up partially, or may have to lie flat
or on your side. And when can you get up? Trips to the bathroom, daily
showers and eating meals at the table may be permitted. If you have
young children at home, you may not be able to fully comply with bedrest
orders. This too should be discussed with your doctor.

The Bedrest Environment

My husband and I reacted to the news of my bedrest in different ways.
While I worried and froze, he channeled his concern into creating the
"perfect" bedrest environment for me. While I was at home, he rearranged
our living room so everything I needed was near our sofa. At the hospital,
he created a home-away-from-home, bringing in all sorts of comfort
items, electronics and entertainment equipment. His creative worry paid
off in a more pleasant bedrest experience for me.

Give some thought to the space you'll bedrest in. If you'll be at home,
first decide where you'll bedrest. The living room sofa, a day bed or the
bedroom are all options. Then, consider how you could rearrange the room,
or what could be brought in to create the most pleasant, convenient and
comfortable space possible. Carts, low tables, trays or shelves will keep
things handy and provide a space for work or eating. Plan on a chair or
two for visitors and a phone with a long cord. Don't forget entertainment
equipment such as a TV and VCR with a remote control, a tape or compact
disc player, and a radio. Such items are necessities for a bedrester;
borrow or rent what you don't own.

If you'll be alone during the day, reduce the temptation to get up, even
"just for a drink of water." Have someone prepare a cooler of food for you
daily. Keep this near your bed or sofa, along with pitchers of water and
juice. For instant coffee, tea, or cocoa, keep hot water in a thermos.

If you'll bedrest in the hospital, think creatively about that space too.
Your stay needn't be as bleak as a prison sentence (although it may feel
like one). Arranging a hospital room to your liking is more difficult, but
do what you can. Request extra bed trays for your room to keep things
handy. Comfort items from home can help you feel better. Bring your own
bathrobe, nightgowns (though you may prefer hospital gowns; bedrest can
be surprisingly messy), your own pillow (with extra pillowcases),
slippers, a fancy water pitcher and drinking glasses, nail polish and files,
perfume and scented soaps, or framed pictures of your family.

For entertainment, I had a VCR (hooked up to the room TV), tape
player, radio, and a portable CD player. I found it uplifting to put on my
favorite music or a good movie whenever I felt low. Should you choose to
bring in your own equipment, check with the hospital maintenance
department to be sure your extra wires won't pose a hazard. (Note: most
hospitals have VCRs for educational purposes and you may be able to
borrow one.)

Some additional items can be useful whether you are in the hospital
or at home. Lying down will be more comfortable with lots of pillows
(ask your nurse for extras). A bolster is helpful if you must lie on your
side; one can be made using masking tape to hold four rolled blankets. For
additional comfort and to avoid bedsores, use a foam egg-crate mattress
on top of your mattress (available at medical supply stores or your
hospital may provide one). A lap-top desk will make writing easier. If
you can't buy one, use a clip board or a cookie sheet taped to a pillow.
And don't forget to decorate your room brightly. If you don't have any
colorful posters, try calling travel agencies. They will often give travel
posters for free. Put all wall hangings at eye level.

Buy paper plates and cups for your family members to eat from while
you bedrest. They'll appreciate not having to wash them. If your family
isn't used to cooking, buy or borrow a crock pot. A simple meal can be
made by putting meat and vegetables in the crock pot in the morning, to be
ready at dinner time.

If you worry that your husband/birth coach might be hard to reach
when needed, obtain a pager from the hospital. Because my husband isn't
always near his phone, I often used the pager while I was on bedrest in
non-emergency situations. Since he already knew my phone number, we
devised codes to alert him to the urgency of the call (111-1111 for "just
want to talk;" 999-9999 for "get to the hospital now!").

Bedrest and Them

As difficult as bedrest is for you, don't forget that it also affects the
others in your life. Your husband has now taken on the triple burden of
caring for you, the entire house, and still working full-time. He is
undoubtedly under stress, not to mention extremely concerned for you and
the baby. Be kind and don't take him for granted. Show your appreciation
by doing something special for him. Send a card or love letter to his
office, buy tickets for him and a friend for a night out or ask a friend to
take him out for an evening.

If you have children at home, this time will be difficult for them.
Depending on their ages, they may not even understand why "mommy can't
get out of bed." If you're bedresting at home, make space for children in
your room by placing tables and chairs near your couch or bed. Have games
and toys there, or make up a second bedrest spot for you in their play
room. Some mothers have the impossible situation of caring for very
young children while bedresting. If this is you, realize that you may be
forced to get up for them now and then (but avoid it as much as possible).
Plan activities to keep them busy by your side and get any outside help you
can.

If you're in the hospital, call your children often, write them letters
and let them visit. Sending home tapes of you reading their favorite
stories is often a comfort for younger children. If older, allow your
children to feel "part of the team" by discussing how much their help is
doing for the family, or talking about the new baby with them.

In times of trouble, people often want to reach out a helping hand. If
anyone asks how they can help, never say, "no, thank you." You and your
family are in a difficult situation, and soon you will have the challenge of
a new baby to care for. There is plenty to help with... a hot meal for your
husband, taking the kids for an afternoon, housecleaning, yard work,
laundry, etc. Accept help guiltlessly. Wouldn't you do the same for them?
Let them do it for you.

For hospitalized bedresters, one final group of "others" to consider is
your medical staff. On hard days, it's easy to take out your frustrations
on those nearby. While no one expects you to be Ms. Sunshine, be as polite
as you can. These people will be by your side for the next days, weeks or
months. They can make your life more comfortable, and they will be more
apt to give you the respect and care you deserve if you return that respect.
Also, if for any reason you are uncomfortable with the care you're
receiving, talk to your doctor or one of the lead nurses. You are a paying
customer.

Taking Fun Lying Down

Lying down and getting all the rest you want sounds like a dream
come true for some people. In fact, I had several visitors tell me they'd
gladly switch places with me. I knew that after a day or two of being
uncomfortably pregnant with tubes and monitors attached to their body,
legs aching from inactivity, hospital food and nothing on TV, they'd be
dreaming of switching back!

Bedrest is boring. Especially when time looms out before you, weeks
and months to stay in your bed. You can spend the entire time feeling
sorry for yourself-- that's an option. But you can also use your creativity
to make this as pleasant as possible. Think of how many times you've said
to yourself, "If only I had the time..." Now you do. So do it.

Getting outside is a real morale booster. Discuss this option with
your doctor. If you're in the hospital, ask if you can have a half-hour
wheel chair ride. Getting outside in the warm summer air always made
my day. If you're at home and it's nice outside, have someone set up a
lawn chair in the yard and spend the afternoon there. When your entire
world is reduced to one room, being outdoors can make you feel whole
again. Take any chance you get.

A TV and VCR are good, convenient sources of entertainment that can
also help you feel connected to the outside world. If you don't have cable,
consider subscribing for the period you're in bed to have a little more
variety. Have someone rent video tapes for you or borrow from a friend's
collection.

Learn a new craft, or practice one you already know. While I'm not big
on crafts, I learned cross-stitch and enjoyed the productive feeling of
finishing baby bibs while watching TV. If you're in the hospital, ask for
the occupational therapy staff. Their job is to keep you "occupied," so
they can teach you a craft and supply you with projects. One roommate of
mine industriously finished a baby step stool-- sanding precut wooden
pieces, painting and varnishing it, all while laying in bed! If you're at
home, find someone who can teach you, or learn the craft from a book or
kit. Try rug hooking, make Christmas gifts, learn to draw, paint by
numbers...

If you enjoy reading, catch up on all you've been meaning to read.
Read books, magazines or the entire newspaper. Try books by one author,
books in a series, books that will help your career. Borrow books from
friends, have someone buy them, or phone the local library and see if they
deliver to the homebound. Don't forget books on tape (great while working
on a craft project). Having someone read to you can be nice as well.

How about all those letters you've been meaning to write? Write
letters to old friends, far away relatives or letters to the editor. Writing
in a journal can help get your feelings out. Write a letter to your unborn
baby. Write a love letter to your husband. Write thank you's now for any
gifts you've received.

Have your partner set up a special "date" once a week. Whether you're
in the hospital or at home, have him pick up some special food, bring
candles and sparkling grape juice. Or try a picnic lunch. You can watch a
movie together, snuggle together as best you can, play soft music, or just
talk.

Another possible activity is working from home. Many jobs can be
accomplished with the aid of a lap-top computer and a phone. Since
stress can often be work-related, such an option should be discussed with
your doctor.

If you've tried all the previous and are still bored: get someone to
play games with you, learn a foreign language, have your hair cut, put on
makeup, blow bubbles, color with crayons or markers, organize a photo
album, or enter every contest that is advertised in magazines or on cereal
boxes. You might win!

Handling the Hard Days

A friend of mine sent a small pile of gifts with instructions to open
one gift every other day for a week. At that time I'd been in the hospital
nearly a month and was having many hard, tear-filled days. I looked
forward to opening those small trinkets just like it was Christmas. This
friend knew how to blast the bedrest blues away.

One way to handle hard days is to add morale boosters to your daily
routine. Give yourself something to look forward to (little things can
mean a lot). Paste a wall full of yellow post-it notes, one for each day on
bedrest. Rip one off each day and smile as the mass grows smaller. Or
get a large calendar so you can cross the days off.

Plan weekly rewards. Passing into another week is a real
accomplishment, so treat yourself. Slice a favorite cake into sections,
one for each upcoming week of bedrest. Wrap and freeze the slices, then
every week defrost a slice and eat it as a special dessert.

Flowers or balloons bouquets are a cheap way to brighten your room
and can really lift your spirits. Order some for yourself.

Moral support from current or former bedresters is important-- such
women truly understand. If there are other bedresters in your hospital,
see about getting together, or at least get their phone numbers so you can
talk. When I was in the hospital, we had a meeting of five bedresters, all
wheeled down to the family lounge for our "antepartum club." There are
also bedrest support organizations in some cities. Find out from the
hospital staff or your doctor if there's one in your area.

If you're short on visitors, notify your church that you are on bedrest
and going through a difficult time. Most will send out visitors and offer
whatever support they can.

If you've tried all the previous and are still depressed: call someone,
read cartoon books, rent a funny movie, or just cry. Sometimes you just
need to get it all out.

Keep in mind that even the hardest of days can be turned around with
a little forethought. My hardest day of bedrest was when my sister got
married and I couldn't attend. While heartbroken, I didn't want to spend
the day crying. Instead, I asked a friend to pass the day with me; we
talked and ate special food. On my request, the wedding party came out to
the hospital for a brief visit, and my husband videotaped the day's
festivities. I actually have pleasant memories of that day. If you find
yourself in a similar situation, consider the alternatives. If it's a holiday,
birthday or shower, perhaps you could have the event in your hospital room
or home. If that's not possible, plan your own special day and have
someone videotape the event (cameras can be rented from video equipment
stores for reasonable rates).

The best news about bedrest is that it does end. The days, weeks and
months will pass, you will bring your baby home and your life will be full
again. In my blackest moments, when my hospital stay seemed endless,
people would tell me, "When you hold those two healthy babies in your
arms, it'll all be worth it." I'd nod my head but I really wasn't sure.

Now I can look at my toddling one-year olds and the pain of those
bedrest days has faded. I see bedrest as one of my first gifts to my
children. And yes, it was worth it!

SIDEBAR: PREVENTING PREMATURE BIRTH

Every year, 9% of women giving birth in the United States experience
preterm labor leading to premature birth. Unfortunately, babies born more
than three weeks before their due date can have serious problems
breathing, eating and keeping warm. The good news is that any woman
who knows the signs and symptoms of preterm labor and monitors herself
for them daily has an 80% chance of avoiding premature birth. Should you
experience any of the following, notify your doctor immediately.

*A sudden increase or change in vaginal discharge.

*Any vaginal bleeding.

*Five or more contractions in an hour. (Be aware that contractions
may not be painful; some involve only a tightening and relaxing of
the uterus.)

*Menstrual-like cramps or pelvic pressure.

*A low, dull backache that doesn't improve with rest.

*Persistent diarrhea or intestinal cramps.

*A general feeling that "something is wrong."

[Copyright 1993, Theresa Jarosz Alberti; do not reproduce without permission.]