Bed Rest to Prevent Preterm Labor
Evidence Shows that Restricting Mother's Activities May Not Help
Oct 16, 2009
If you begin to get contractions or your cervix starts to change when you are not close to your due date, your care provider may recommend a restriction on your physical activity, also known as bed rest.
The reason bed rest has become a popular course of treatment to prevent preterm labor was that studies showed extreme physical activity and long hours of standing made it more likely for mothers to go into labor prematurely.
However, studies have not been able to prove that the opposite is true. In other words, restricting a mother's activity or confining her to bed does not slow labor or prevent preterm labor from occurring. So what should you do if your care provider recommends that you go on bed rest?
Review and Discuss Research on Bed Rest
In some cases if you are having preterm labor symptoms and your care provider advises that you go on bed rest, you may need to be prepared to discuss related research on the effectiveness of bed rest with your provider at your prenatal appointment.
Remind your care provider that according to the latest research, bed rest should not be routinely recommended as a prevention for preterm labor. One of the best resources for up-to-date, reliable research is the Cochrane Review.
Request Fetal Fibronectin (fFN) Test
More evidence is now available that can shed light on whether or not bed rest should be recommended. Not only can the fetal fibronectin test help to identify the mother's chances of preterm labor, but the test results are reliable enough to cause a change the mother's treatment plan.
Before the fFM test, mothers were placed on bed rest anytime they showed possible signs of preterm labor such as frequent Braxton-Hicks contractions or cervical change. This often resulted in unnecessarily restricting the mother's activities and more often than not, mothers would not go into labor and might even pass their due date.
Now providers know that if the mother has a negative test result on the fFN test, her chances of going into labor within the next two weeks are only about 1%.
Request that You be Re-evaluated in a Week or Two
If bed rest is still being recommended to you despite a negative result on the fFN test, ask to be re-evaluated again in a week or two. You might find that with continuing discussion about your symptoms, you and your care provider may recognize that bed rest may not be the most appropriate treatment for you.
References:
Bolt, LA. "Does fetal fibronectin testing change patient management in women at risk of preterm labour?", European Journal of Obstetrics, Gynecology and Reproductive Biology, October 2009.
Sosa, C. "Bed rest in singleton pregnancies for preventing preterm birth," Cochrane Review, January 2004.
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