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Multiple Pregnancy and Bed Rest

Historically, bed rest has been a common treatment for a variety of pregnancy ailments. With fewer side effects than drugs, it can prevent or diminish many problems that would otherwise result in the loss of one or all of the babies. When you're carrying multiples, the goal is to keep them in your womb as long as possible in order to ensure optimal health and development. Usually, women carrying higher order multiples have a greater chance of going on bed rest, have to stay on bed rest for a longer period of time, and have to endure a stricter regimen of bed rest than mothers of singletons.

E Fact

About 20 percent of pregnancies require bed rest, or about 700,000 women per year. However, it's much more likely in a multiple pregnancy. A 1992 survey from the National Organization of Mothers of Twins Clubs found that it's a factor in 70 percent of multiple pregnancies.

As the pregnancy progresses, the combined weight of the babies strains the cervix. Gravity increases the pressure. Alleviating the pull of gravity and the pressure on the cervix can help prolong the pregnancy. That can be accomplished by staying off your feet and lying horizontally in bed.

There is much dissension among the medical community as to whether bed rest should be routinely prescribed in multiple pregnancy. Some physicians argue that preventative bed rest should be mandatory for moms of multiples. At one time, bed rest at twenty-eight weeks was the standard for moms of multiples. Fortunately, that's not the case now. Most doctors acknowledge the emotional and psychological toll on the family of a pregnant woman, as well as potential physical deterioration for the mother.

Blood Pressure Benefits

Another common problem in multiple pregnancy is hypertension, or high blood pressure. It can be a symptom of preeclampsia, a serious disorder that, if left untreated, can be fatal for the mother and the babies. Bed rest can be very effective in lowering blood pressure in pregnancy by taking the pressure of the uterus off the vena cava, a large vein that runs along the right side of the body. Usually mothers who are undergoing bed rest to reduce their blood pressure are advised to lie on their left side to improve circulation.

E Alert

Be wary if your doctor routinely prescribes bed rest at a particular point in the pregnancy without regard for your individual circumstances. Except in the case of extreme higher order multiples, bed rest should not be mandated without specific conditions that necessitate it.

Placating the Placenta

Dizygotic or multizygotic multiples each have their own placenta, maximizing the surface area of the uterus that is covered by placental matter. This increases the chances of complications, including placenta previa, a condition that occurs when the placenta covers the cervix. The resulting hemorrhage can be dangerous for the mother and impede development of the babies. Bed rest and reduced activity can help diminish the bleeding.

Bed rest also allows more blood and oxygen to flow to the placenta(s), enhancing the growth of the babies. If you're experiencing complications such as preterm labor or placenta previa and your babies will likely be delivered early, a period of bed rest accompanied by treatment with steroids may give them a developmental boost.

Good for Mom

Although bed rest is usually prescribed to benefit the babies, it can be just as beneficial to the mother's well-being. A multiple pregnancy places a tremendous strain on the mother's organs, which work overtime to keep up with the demands of nurturing multiple fetuses. Sometimes rest and relaxation in bed are required to minimize a mother's activity and give her body a break. Often bed rest becomes a last resort for women who can't seem to slow down otherwise.

From The Everything Twins, Triplets, and More Book Copyright © 2005, F+W Publications, Inc. Used by permission of Adams Media, an F+W Publications Company. All rights reserved.

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