My sister is on bedrest - update post #39, she had the baby!

My sister is 23 weeks pregnant (she was exactly 20 weeks behind me when I was pregnant) and has been put on bedrest. She has a full placenta previa, has had cramping at various times through pregnancy, and was put on bedrest at 22 weeks due to bleeding. They took her out of work (she's an ICU nurse), and said that when she's not actively bleeding she can do things as long as it's nothing strenuous, but if she's actively bleeding it's bed or couch and only up for the bathroom. Apparently she had to go in for monitoring the other night because she was having contractions every 10 minutes and more mild bleeding, but they sent her home. She's been having more contractions but they're not always regular. The short-term goal is to make it to 24 weeks (next week on Wedndesday), when the baby/fetus could be viable outside the womb. Obviously, she doesn't want to deliver that early though. If she makes it, they will schedule a C-section for 37 weeks. She had a section with my nephew too (age 4.5) because he was breech.

Anyway, my sister either has the worst luck with medical stuff or is a hypochondriac, or a drama queen. I'm tempted to say it's all of the above. Obviously she can't fake a previa or bleeding, and her contractions did register on the uterine monitor, but I wouldn't be surprised if she's making a bigger deal about some symptoms than other women would.

I wish I could help her out a bit more while she's on bedrest, but I've got a newborn myself (plus my 2-year-old). My nephew goes to preschool and before/after care, so she doesn't have to take care of him during the day. Her husband normally travels a lot for work but has been trying to only take local cases so he can stay in town. I've offered to bring over dinner, and will probably try to do so once a week until the baby's born (and a few weeks after as needed).
Faith, 3Aish redhead
Mama to two wild superheroes and a curly-headed baby boy

Last edited by PixieCurl; 04-16-2010 at 05:49 AM.
Lots of women seem to love the pregnancy bedrest thing...they probably love the attention of being "at risk" or "sick". There's no real medical benefits to bedrest either...neither fetal or maternal outcomes are significantly improved with bedrest. There are significant risk to the woman though. Bloodclots from inactivity are potentially deadly. You would think your sister, being an ICU nurse, would have seen a fair amount of deaths from bloodclots and pulmonary embolisms in her patients and wouldn't want to risk that herself. But...I have found that nurses (and female OB's) are probably the most compliant OB patients, and seem to go for every intervention and gizmo available. It's the medical mindset...they think doctors can fix everything.

I wish her well. I hope she goes a lot longer than 24 weeks.
I am sorry about your sister. I also hope she makes it much farther than 24 weeks.

I think it is really nice of you to make her dinner once a week.

But...I have found that nurses (and female OB's) are probably the most compliant OB patients, and seem to go for every intervention and gizmo available. It's the medical mindset...they think doctors can fix everything.
Originally Posted by RedCatWaves
This describes my mother perfectly.
I questioned my peri about bedrest because I'd read it didn't improve outcomes in most situations. He agreed but wanted me to continue anyway so I could listen to my body without distractions.

Taking food to her will be greatly appreciated. Maybe a few books as well. Fluff though. I found that the medicine to control contractions made it hard for me to focus on anything complex.


"Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind." -- Theodor Seuss Geisel
Thanks for the replies. RCW, I was really interested to hear your opinion on this. My sister has always been a listen-to-the-doctor-without-really-researching-or-thinking-for-herself type. And while I'm sure she doesn't enjoy being on bedrest, I know she enjoys the attention that comes along with it. To be fair, though, most women wouldn't think to second-guess their doctor if they were put on bedrest.
Faith, 3Aish redhead
Mama to two wild superheroes and a curly-headed baby boy
I questioned my peri about bedrest because I'd read it didn't improve outcomes in most situations. He agreed but wanted me to continue anyway so I could listen to my body without distractions.
Originally Posted by DarkAngel

That's a good line. Sounds a lot better than you're-less-likely-to-sue-me.

And that's not to disparage you. Really. I understand women are scared when complications develop during pregnancy. And I will agree that bedrest might help a very few women/babies. But OB's know that bedrest is way overprescribed and puts women at significant risk for little-to-no benefit, but they keep prescribing it anyway...because they're afraid not to. It's become standard-of-care, without evidence to back it up, and OB's know they will get sued if something goes wrong and they didn't adhere strictly to standard-of-care. The first thing a lawyer is going to say is "well, why wasn't she put on bedrest, that's standard of care", and there goes their malpractice insurance premiums through the roof.
RCW, since I know she'll adhere to bedrest because her doctor said so, is there anything I can suggest my sister do to reduce the risk of complications?
Faith, 3Aish redhead
Mama to two wild superheroes and a curly-headed baby boy
RCW, since I know she'll adhere to bedrest because her doctor said so, is there anything I can suggest my sister do to reduce the risk of complications?
Originally Posted by PixieCurl

She needs to encourage venous blood return in her legs. Pumping her ankles periodically can help. She knows this. And she should stay well hydrated...which will enable many trips to the bathroom, which also helps venous return.

It's counter-intuitive, because you would think that low/no activity would increase weight gain, but women on bedrest during pregnancy tend to have low weight gain, so she needs to eat well.
Thanks, I'll pass that info along to her.
Faith, 3Aish redhead
Mama to two wild superheroes and a curly-headed baby boy
I questioned my peri about bedrest because I'd read it didn't improve outcomes in most situations. He agreed but wanted me to continue anyway so I could listen to my body without distractions.
Originally Posted by DarkAngel

That's a good line. Sounds a lot better than you're-less-likely-to-sue-me.

And that's not to disparage you. Really. I understand women are scared when complications develop during pregnancy. And I will agree that bedrest might help a very few women/babies. But OB's know that bedrest is way overprescribed and puts women at significant risk for little-to-no benefit, but they keep prescribing it anyway...because they're afraid not to. It's become standard-of-care, without evidence to back it up, and OB's know they will get sued if something goes wrong and they didn't adhere strictly to standard-of-care. The first thing a lawyer is going to say is "well, why wasn't she put on bedrest, that's standard of care", and there goes their malpractice insurance premiums through the roof.
Originally Posted by RedCatWaves
I'm an attorney. Almost everything my doctors do is lessen the impact if I decide to sue.

My bedrest wasn't strict but it did keep me out of court (read: high stress) for a few weeks which very likely did help.


"Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind." -- Theodor Seuss Geisel
As someone who is on week 17 of bedrest with my second pregnancy, I beg to differ that bedrest does not have an impact. I was on bedrest for 12 weeks with my first as well and delivered her at 39 weeks. I will be 36 weeks tomorrow and believe that without this intervention I would have lost my baby (even after having a rescue cerclage placed).

Now, every situation is different....each & every one. But, not all medical intervention is bad. Not all women are attention seeking in this realm (your sister might be, I don't know her). If you're faced with potentially losing your baby, you'll think LONG & HARD about your options and would do most anything to ensure their safe arrival. Does that mean you go into the process ignorant and not try to educate yourself - heck no. But if a woman trusts her doctor (which she should!) then that's what matters.

I've been wearing anti-embolism stockings while on bedrest. I'd do daily ankle rolls & leg stretches, but obviously being immobile is harsh on your body. My restrictions have become less strict in recent weeks because of the gestational age we've reached, however up until about 32 weeks I was only getting up to use the restroom & shower every few days. Plus I had weekly appointments.

Obviously she should stay well hydrated & eat well during this time, but she should be doing that while pregnant anyway. She should keep in mind that the inactivity may have an effect on her gastrointestinal functions & she may need a little help in the bowel movement department. Eating well & staying hydrated will help this, but she may need stool softeners or something of that nature to assist.

Best of luck to your sister. I hope she makes it full-term and these complications go away.







As someone who is on week 17 of bedrest with my second pregnancy, I beg to differ that bedrest does not have an impact. I was on bedrest for 12 weeks with my first as well and delivered her at 39 weeks. I will be 36 weeks tomorrow and believe that without this intervention I would have lost my baby (even after having a rescue cerclage placed).

Now, every situation is different....each & every one. But, not all medical intervention is bad. Not all women are attention seeking in this realm (your sister might be, I don't know her). If you're faced with potentially losing your baby, you'll think LONG & HARD about your options and would do most anything to ensure their safe arrival. Does that mean you go into the process ignorant and not try to educate yourself - heck no. But if a woman trusts her doctor (which she should!) then that's what matters.
.
Originally Posted by kimberly j
I don't think anyone on here would say that "all medical intervention is bad." But when used inappropriately, medical interventions can and do cause harm to mothers and their babies. There is a lot of evidence to back this up. Yes, women should be able to trust their doctors but the sad truth is that a lot--a LOT--of doctors don't practice evidence-based medicine and have to balance the medical needs of their clients with protecting themselves from malpractice, which often means that the patient's needs may come second.

Pixie, I hope things turn out well for your sister and her child.

As someone who is on week 17 of bedrest with my second pregnancy, I beg to differ that bedrest does not have an impact. I was on bedrest for 12 weeks with my first as well and delivered her at 39 weeks. I will be 36 weeks tomorrow and believe that without this intervention I would have lost my baby (even after having a rescue cerclage placed).

Now, every situation is different....each & every one. But, not all medical intervention is bad. Not all women are attention seeking in this realm (your sister might be, I don't know her). If you're faced with potentially losing your baby, you'll think LONG & HARD about your options and would do most anything to ensure their safe arrival. Does that mean you go into the process ignorant and not try to educate yourself - heck no. But if a woman trusts her doctor (which she should!) then that's what matters.
.
Originally Posted by kimberly j
I don't think anyone on here would say that "all medical intervention is bad." But when used inappropriately, medical interventions can and do cause harm to mothers and their babies. There is a lot of evidence to back this up. Yes, women should be able to trust their doctors but the sad truth is that a lot--a LOT--of doctors don't practice evidence-based medicine and have to balance the medical needs of their clients with protecting themselves from malpractice, which often means that the patient's needs may come second.

Pixie, I hope things turn out well for your sister and her child.
Originally Posted by iris427
Sure, there are doctors who aren't putting the needs of their patients first, which leads to horrible outcomes at times, I totally agree with that. Medical care is about protecting yourself and educating yourself, but if you don't have a physician that is trustworthy of providing sound care then you absolutely should seek alternate care.

Aside from that, Pixie's sister needs to educate herself on the diagnosis she's been given and only she can determine if the recommended course of treatment of bedrest is necessary for her. Having the support of family and friends, as Pixie is providing, is crucial and she's lucky to have a sister that is concerned.







As someone who is on week 17 of bedrest with my second pregnancy, I beg to differ that bedrest does not have an impact. I was on bedrest for 12 weeks with my first as well and delivered her at 39 weeks. I will be 36 weeks tomorrow and believe that without this intervention I would have lost my baby (even after having a rescue cerclage placed).

Now, every situation is different....each & every one. But, not all medical intervention is bad. Not all women are attention seeking in this realm (your sister might be, I don't know her). If you're faced with potentially losing your baby, you'll think LONG & HARD about your options and would do most anything to ensure their safe arrival. Does that mean you go into the process ignorant and not try to educate yourself - heck no. But if a woman trusts her doctor (which she should!) then that's what matters.
.
Originally Posted by kimberly j
I don't think anyone on here would say that "all medical intervention is bad." But when used inappropriately, medical interventions can and do cause harm to mothers and their babies. There is a lot of evidence to back this up. Yes, women should be able to trust their doctors but the sad truth is that a lot--a LOT--of doctors don't practice evidence-based medicine and have to balance the medical needs of their clients with protecting themselves from malpractice, which often means that the patient's needs may come second.

Pixie, I hope things turn out well for your sister and her child.
Originally Posted by iris427
Sure, there are doctors who aren't putting the needs of their patients first, which leads to horrible outcomes at times, I totally agree with that. Medical care is about protecting yourself and educating yourself, but if you don't have a physician that is trustworthy of providing sound care then you absolutely should seek alternate care.
Originally Posted by kimberly j
I agree completely. Unfortunately, it can be hard to tell if your provider is trustworthy or not. No one tells you "This isn't in your best interest, but I don't want to get sued so I'm going to push you to have a cesarean/induction/bedrest/et cetera." They have valid sounding medical reasons, that they themselves might even believe. I don't think doctors are evil or out to get their patients. It can just be really hard to find good care.

Like you said, that's why it's so important to educate yourself about your situation.

I had a grade 4 placenta praevia with my second son and would agree with kimberleyj in that you you do think very long and hard when you're at very real risk of losing your baby (and your own life) so please don't think your sister's making a bigger deal of it than it should be. I was terrified.
That said, I'm a nurse too and worked until I was 33 weeks, I was told that although bedrest was what they used to recommend it wasn't the case now and that it really didn't make any difference in the long run. Everyone's case is different though and I didn't have any contractions or cramping at any stage and didn't have a bleed until I was 35 weeks (and what a bleed, if I wasn't terrified before I was after that).
I don't really have any advice, just a pov from someone who's been there.
3b in South Australia.
So now she's in the hospital. Apparently she was having cramping and contractions so they told her to come in to be monitored. Baby is doing fine and the uterine monitor is in fact showing contractions, so I know she's not faking those. They had the NICU team come talk to her just in case, and they are going to do steroids. She'll be 24 weeks tomorrow and they're keeping her at least 48 hours, until Thursday. Their new short-term goal is to get her to 27/28 weeks.
Faith, 3Aish redhead
Mama to two wild superheroes and a curly-headed baby boy
I'll be keeping her in my thoughts.
To Trenell, MizKerri and geeky:
I pray none of you ever has to live in a communist state.

Geeky is my hero. She's the true badass. The badass who doesn't even need to be a badass. There aren't enough O's in cool to describe her.
I hope baby stays in a while longer. Let us know how she is.
I am sorry to hear that. I hope baby stays in till new goal.
I hope he/she stays in a bit longer. How is your sister doing emotionally?

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