Sidelines Frequently Asked Questions
- What are the warning signs of preterm labor?
- Why bed rest?
- How can I find out more about high-risk pregnancy? My baby books provide only one or two sentences about pregnancy complications!
- I'm not sure my doctor is doing everything possible. What should I do?
- My pregnancy has reached 30 weeks. Can I just deliver now and let the intensive care unit care for my baby?
- What's the difference between preterm labor and Braxton-Hicks contractions?
- What kind of tests and medications might be prescribed and what are the side effects?
- What can I expect from being on extended activity restriction?
- What things can I do while I am on bed rest?
- Will being on bed rest make it harder for me to recover after the baby comes?
- What can I expect from Sidelines? What kind of support do you offer?
- My good friend is on activity restriction. What can I do to help?
- Why is it called Sidelines?
1. What are the warning signs of preterm labor?
- Tightening in the abdomen in a regular pattern, such as one contraction every 10 minutes for an hour
- Fluid leaking or gushing from your vagina
- Menstrual cramp-like pain with or without diarrhea
- Pressure in your pelvis or vagina
- Flu-like symptoms, such as vomiting and diarrhea, fever and/or extreme fatigue
- Dull backache in your lower back, lower abdomen, thighs or pelvic area that does not go away
- Increased vaginal discharge or bleeding
- A feeling that something is not right
Acting quickly can make a big difference. Call your health care provider right away if you have any of these symptoms. Some of these may hard to identify apart from the normal symptoms of being pregnant, such as backache. Never hesitate to call and report warning signs and get them checked out as soon as possible.
Your doctor or health care provider may prescribe some degree of bed rest or activity restriction when complications in pregnancy take place. Bed rest reduces normal daily activity and increases the probability that you continue with a healthy pregnancy. Bed rest may also reduce stress, increase blood flow to the placenta, and relieve pressure on the cervix. Some common reasons bed rest is prescribed:
- Multiple gestation
- High blood pressure
- Placenta complications such as placental abruption or placenta previa
- Premature labor
- Cervical incompetence
- Intrauterine growth retardation (IUGR)
- Bleeding
- History of pregnancy loss, stillbirth, or premature birth
The best place to get the most accurate information about high-risk pregnancy is directly from your physician or caregiver. She knows your medical history, your body, and can give you straight answers. Your doctor can also provide you with other resources such as websites, pamphlets and books about your condition. Sidelines also recommends several excellent books on pregnancy complications that can be found on the Sidelines Amazon Store.
4. I'm not sure my doctor is doing everything possible. What should I do?
Be open and honest about your concerns with your health care team. Give them the opportunity to explain their plan of care. Seek out a second opinion if you have any unanswered questions or discomfort with the reasons/plan described. You are your baby's best advocate! If you feel that your care is substandard, don't hesitate to call your case manager or insurance company. Most insurance companies readily comply with second opinion requests. And if your doctor is doing everything possible, she should not hesitate to support you in your decision.
Nature has provided all the perfect conditions to grow your unborn baby in your uterus. Nourishment, temperature, and blood flow are all perfectly regulated in this amazing place. The uterus also protects the developing baby from environmental toxins, excessive noise and light. The NICU has the training and skill to care for your baby, but a premature birth may require a battalion of equipment, testing, and medications, including a cardio-respiratory monitor (CRM), plastic oxygen hood, breathing support including a ventilator, blood tests and x-rays. Depending on your diagnosis and the gestation of your pregnancy, you and your doctor will decide when is the best time to deliver your baby. But more often than not, the best place for baby is inside mom for as long as possible. Every day counts.
6. What's the difference between preterm labor and Braxton- Hicks contractions?
Braxton-Hicks contractions occur in most normal pregnancies, and are felt as painless and infrequent tightening of the uterus. These contractions usually don't occur more than once per hour and do not make any changes to the cervix. Preterm labor is most often felt as a vague, painless tightening of the abdomen, and may or may not be accompanied by one or more signs and symptoms of preterm labor. Preterm labor contractions usually occur in a regular pattern and may cause changes to occur in the cervix.
7. What tests and medications might be prescribed and what are the side effects?
Your physician may first treat preterm labor with bed rest, extra fluids, and pain medicine. Sometimes antibiotics are prescribed to treat any underlying infection. Further screening may include transvaginal ultrasound, fetal fibronectin (fFN) and testing for rupture of membranes (ROM).
If your contractions do not stop, tocolytic medications may be prescribed in order to delay delivery, even if it is for a short time. Tocolytic medications might include:
- Nifedipine
- Indomethacin
- Magnesium sulfate
Side effects can range from dizziness, insomnia, headache, and rapid heart rate. It is important to talk with your doctor about possible side effects and to understand why you are taking these drugs. Make sure to report all side effects to your doctor.
8. What can I expect from being on extended activity restriction?
Muscle pain and weakness, fatigue, backache, joint pain, dizziness, and insomnia are all side effects of activity restriction that can affect your body. Physical therapy is helpful to maintain some muscle strength and activity. Treatments may help improve circulation, body positioning, joint flexibility, and muscle strength. Therapists may also offer instructions on how to position yourself in bed, as well as how to use pillows, supports, and other devices for comfort. They may also help design a safe and individualized exercise plan. Ask your doctor for a referral as soon as you feel any of the symptoms listed above. Massage from a trained massage therapist can also be beneficial, and often helps decrease muscle pain, spasms, and inflammation. (Be sure to clear with your doctor, and find a professional who is trained to work with pregnant women.)
9. What things can I do while I am on bed rest?
You must discuss with your doctor, in detail, what activities she will allow you to do. Sidelines has a bed rest/activity restriction checklist designed to help you know what questions to ask. These questions can help make communication clearer for you, your family, and your doctor. It helps to be clear on what activities are and are not allowed! Use the checklist or a journal to write down questions and take notes.
10. Will being on bed rest make it harder for me to recover after the baby comes?
Yes, but it depends on how long you have been on bed rest and how inactive you have been. You may feel anxious to be up and active again, but your body will need time to heal and rebuild muscle strength. You might feel weak and notice changes in your strength and energy once you get out of bed. Recovering from both having a baby and bed rest is more complicated. Physical recovery will be slow but physical therapy or a mild exercise plan can help to get you back on your feet.
11. What can I expect from Sidelines? What kind of support do you offer?
We realize that pregnancy complications affect more than just your back and joints. You may experience depression, anxiety, hostility, loneliness/isolation, boredom, and guilt! We know all about that and genuinely care about what you are going through. Our desire for you is to have the best possible outcome with your pregnancy, to be well informed about pregnancy complications, and to feel supported and encouraged in your time of need. Our trained volunteers know first hand what it means to be sidelined, and want to "give something back" to other high-risk moms. We provide email and phone support to any mom that requests it and have supported thousands of families since 1991.
12. My good friend is on activity restriction. What can I do to help?
Moms that are sidelined can feel isolated and alone. It's hard to cut back on activity, especially if you feel normal in every other aspect! Visit her often (short visits are best) and remind her of what a great thing she is doing for her baby. If you can't visit, email, call or send cards. Think of creative ways to let her know you care. Precooked meals, babysitting, folding a load of laundry and fluffing up pillows are just some of the ways to show you care.
13. Why is it called "Sidelines"?
Anyone who has played sports knows how disappointing and frustrating it can be to be pulled out of the game and "sidelined". It's even harder when you aren't injured or don't feel sick! Pregnant women, confined to bed or restricted in their activity, often say they feel "stuck on the sidelines". The left side is also the recommended position for bed rest, aiding in circulation and making it easier on your heart. Just remember: when you find yourself on the sidelines, we're here to help. You can read about the Founder of Sidelines, Candace Hurley here.