Bedrest Compliance for Women with Pregnancy Problems

Abstract

Bedrest has long been recommended for high-risk pregnancies, but recent studies question its eflectiveness in improving pregnancy outcomes. To be eflective, the women for whom bedrest is recommended must practice it. This study examined degree of compliance and reason for noncompliance in women for whom bedrest was recommended, and outcomes of pregnancy among high-risk women who complied compared with those who did not. The subjects were 326 high-risk pregnant women who were prescribed bedrest for preterm labol; blood pressure problems, or bleeding problems. Of that group, one-third did not comply with the bedrest recommendation. These women had more children, were not currently married, had more stress, did not attend prenatal classes, continued drinking alcohol during pregnancy, and were not trying to get pregnant compared with women who complied. Reasons for noncompliance included the need to care for children, not feeling sick, household demands, lack of partner or family support, need to work, and discomfort. The pregnancy outcomes for the women who complied were similar to those of the women who did not comply. These findings support the importance of more research on the practice of prescribing bedrest to improve pregnancy outcomes. (BIRTH 22:1, March 1995) Bedrest has long been recommended for high-risk pregnancies. It can range from spending part of each day lying down at home to spending 24 hours a day in bed in a hospital. The goal of bedrest is to ameliorate the condition that places the pregnancy at risk. Implicit in the recommendation of bedrest is the assumption that the woman will comply with it; however, there is reason to question this assumption. One study reported a SO percent compliance rate among 30 women who were prescribed bedrest at home because they were at risk for preterm births (1). Reasons for not complying included women's need to care for themselves or their children, and not perceiving the need for bedrest.Conditions for which bedrest is recommended include multiple gestation, preterm labor, hypertension, bleeding, and fetal growth retardation (2,3). Recent evidence suggests that hospitalization with bedrest does not improve pregnancy outcomes among women carrying twins and may even increase the likelihood of their having preterm births (4). The effectiveness of bedrest to improve pregnancy outcomes is poorly documented (5), even though it continues to be prescribed.Despite this lack of scientific verification for effectiveness and the importance of complying with the bedrest recommendation, more information is required on the issue of compliance. We conducted a study that addressed the following questions: did women for whom bedrest was recommended comply with that recommendation; if they did not comply, why not; and was the outcome of pregnancy better among high-risk women who complied than among those who did not?

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…Definitions have varied widely, compliance questioned [279], and RCT data are limited. For preeclampsia, strict (vs. some) bed rest in hospital does not alter outcomes [297].…”

Feminism and Women’s Control over Their Bodies in a Neoliberal Context: A Closer Look at Pregnant Women on Bed Rest

“…Existing studies point to "either no effects or negative effects of bed rest on fetal outcomes" (Schroeder 1998, 47). In one study of 326 women with high-risk pregnancies, pregnancy outcomes proved similar for women who followed the prescription of bed rest and for women who did not (Josten et al 1995).…”

“…Pregnancy bed rest has received scholarly attention from health professionals (see, for example, Adler and Zarchin 2002;Aleman et al 2005;Allen, Glasziou, and Del Mar 1999;Heaman and Gupton 1998;Josten et al 1995;Maloni 2010;Maloni, Brezinski-Tomasi, and Johnson 2001;Maloni and Kasper 1991;Maloni and Park 2005;Richter, Parkes, and Chaw-Kant 2007;Schroeder 1998), but the subject is largely absent from feminist social science scholarship. Bed rest appears to be primarily discussed in connection to new reproductive technologies, particularly in vitro fertilization (IVF), and is mentioned in passing as part of the long path from infertility to fertility (Becker 2000).…”

‘To make it through each day still pregnant’: pregnancy bed rest and the disciplining of the maternal body

“…However, existing studies point to 'either no effects or negative effects of bed rest on fetal outcomes' (Schroeder 1998, p. 47). In one study of 326 women with high-risk pregnancies, pregnancy outcomes proved similar for women who followed the prescription of bed rest and for women who did not (Josten et al 1995).…”

“…The little research we have on pregnancy bed rest, which I discuss below, comes from nursing and other medical professions, not from feminist social science scholarship (see Maloni and Kasper 1991, Josten et al 1995, Heaman and Gupton 1998, Schroeder 1998, Allen et al 1999, Maloni et al 2001, Adler and Zarchin 2002, Maloni and Park 2005. This article presents a qualitative, non-medical perspective on pregnancy bed rest to contribute to feminist analyses of women's experiences of embodiment and reproduction.…”