Dr Colin Walsh has recently published an article on bed-rest in the Australian New Zealand Journal of Obstetrics & Gynaecology.
The idea of placing pregnant women on “bed-rest” dates back more than a century. We now know that it doesn’t prevent obstetric complications and actually causes harm. Despite this, bed-rest is still being used widely in Australia.
Over the years, bed-rest has been proposed as a ‘treatment’ for everything from threatened miscarriage to high blood pressure. Most commonly, it’s prescribed to prevent premature birth in at-risk women. This is a myth that persists amongst patients and, sadly, many doctors who should know better.
There is very clear evidence, gathered from multiple large studies, that bed-rest does not reduce the chance of premature birth. In fact, in many of these studies, bed-rest actually increased the chance of premature birth.
The Society for Maternal Fetal Medicine in America, a globally respected organisation for high-risk obstetrics, released a statement on bed-rest this year. The Society recommended against any type of activity restriction for pregnant women with a short cervix, threatened early labour, twins, or a variety of other complications.
Bed-rest also causes other problems. Prolonged inactivity reduces your physical fitness and increases the chance of blood clots, infections and a low birthweight for your baby. It also increases your risk of anxiety and depression. It can cause serious disruption to your family, work and finances.
There are proven treatments that reduce the chance of premature birth, such as checking your cervical length, progesterone for appropriately selected patients and treating some infections. I have unfortunately met women who were not prescribed appropriate proven treatments and yet ended up on bed rest – the complete opposite of what should happen. If you are at risk of premature birth, it’s very important to see a Maternal Fetal Medicine specialist to work out the best plan.
Bed-rest does not prevent premature birth. It increases the risk of physical, psychological, social and economic harm to women. Bed-rest should be left in the past, where it belongs.
Author: Dr Colin Walsh is an Obstetrician and Maternal-Fetal Medicine Specialist (expert in high-risk obstetrics). He runs a busy practice in St Leonards and delivers babies at North Shore Private Hospital. He has published more than 90 scientific publications, written chapters for major medical textbooks, been a reviewer for international medical journals and holds a PhD from the UNSW.