In the face of a potentially risky pregnancy, the prescription that was administered was very clear: absolute bed rest to avoid any fall or inappropriate movement that could cause an abortion. But this is something that today is no longer the norm, since staying still during pregnancy not only does not prevent the premature birth of a baby, but it can be very harmful.
You have to move. Here, institutions as important as the Mayo Clinic are quite blunt in their guidelines when pointing out that there is no evidence that bed rest is effective in treating preterm labor. To reach this conclusion, they logically turn to different clinical studies within the Cochrane Library.
In this case, they point out, for example, that in singleton pregnancies, routine bed rest does not prevent premature births and, in fact, the adverse effects of being immobilized outweigh the supposed benefits. In the situation of being in a multiple pregnancy, hospitalization and strict rest do not reduce perinatal risks and, ironically, an increased risk of spontaneous birth has been observed.
What dangers does it have? Lying in bed may be something that a priori is seen as completely harmless, but the reality is that science advises against it for different reasons. The first of them is that immobility increases the risk of venous thromboembolism if one is not properly anticoagulated.
In addition, it causes bone demineralization, where an estimated loss of bone mass is 2% to 3% per month, muscle atrophy and weakness, orthostatic hypotension, and is also associated with low neonatal birth weight and a higher rate of cesarean sections.
Beyond the physical. Having complete rest isolates the pregnant woman in a bed watching television all day, and this only causes increased emotional stress, anxiety, and can lead to depression. In studies, this is something that currently affects 20% of pregnant women subjected to this isolation in countries like the United States.
What is recommended. The objective of the different international guidelines to treat these pregnant women has taken a great turn in recent years. The SEGO guide from Spain, for example, recommends aerobic activity for these women for 3-5 days a week, avoiding routine rest. If we cross the ocean, in the United States 150 minutes of moderate exercise a week is recommended, also to reduce the rate of cesarean sections and gestational diabetes.
There are exceptions. Generalizations are never good, and that is why you cannot ask all pregnant women for absolute rest, but neither for a lot of activity. Here the most current guidelines establish that there are very specific and documented cases, such as premature rupture of membranes, where this rest is necessary. But these cases are very few.
What we must stay with here is that immobility during pregnancy is not the best, and we must stay active as much as possible with activities logically adapted to the pregnancy situation.
Images | Anna Hecker
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