Coping and Surviving
by Kristine L. Jablonski, M.S., R.N., C.S.
Walking out of the hospital with empty arms was one of the most heart wrenching things I have ever done. Women who have had a high-risk pregnancy and/or birth often have to leave the hospital before their baby is ready. After five and one half months of bed rest with multiple complications, tocolytics and a lot of prayer, I went into labor at 31 weeks and my twins, Sarah and Michael were born. Walking through the experience of bed rest, premature labor, intravenous drugs, a difficult C-section was fraught with worry, fear, joy and more anxiety. I remained in the hospital for seven days and then was discharged. I was sore and extremely fatigued, but while there I could easily go to the NICU and be with my babies. When I was discharged, my babies remained in the NICU.
Trying to get my head and heart around the idea of leaving my babies was very challenging. The day I left, I was wheeled down to the hospital exit, while my husband got the car and the most devastating event occurred. Another mother with her "healthy" baby in her arms was being sent home. I could not stop the tears, or the ache in my heart and arms. I felt defeated and like a failure.
Having a premature or critically ill baby and watching them inch forward one step and then back two as they struggle to become strong and healthy enough to come home, is tough for parents. You get to know the nurses, respiratory techs, perinatologists and ward clerks as a pseudo-family. You get acclimated and even comfortable with all the technology and variety of medical terms ascribed to the many tests and procedures done to your little one. But on the day they are ready to come home you face a myriad of new feelings. The range covers celebration and happiness to overwhelming fear.
I remember all the instructions; follow up care plans, goodbyes and hugs. And then, it was just my husband and I. We drove home in our tiny Honda Civic with the babies in their car seats in the back seat. I was so nervous! I made my husband stop on the side of the freeway so I could check if they were still breathing. It was then that we both recognized the awesome responsibility we were facing.
Becoming full time parents of two tiny babies created a staggering sense of inadequacy. We had just left a hospital where it took a highly trained team of nurses and doctors to manage the care of Michael and Sarah. We felt ill equipped for this immense task. Parents need assistance to prepare for the homecoming on two levels. The physical maintenance of the baby, and, the emotional maintenance of the baby and oneself both need to be addressed.
Health care for high-risk continues to become more technically sophisticated each day. Doctors are saving micro-preemies that ten years ago could not have been saved. Complicated in-utero surgeries occur and mothers' with high-risk medical problems are being managed. Preparing parents as caregivers involves not only education regarding equipment and procedures, but access to care and support services. Coping with the entire experience of having had a high-risk pregnancy and/or birth and the delivery of a sick baby and then bringing your little one home taxes the most competent individual. It is highly recommended that you utilize external resources to help. The use of visiting nurses, respite care, support groups and educational reading material are all vital options.
The emotional maintenance of self and baby revolve around a series of steps. The aftermath of hospitalization and homecoming result in common themes parents learn to address little by little on the emotional roller coaster. Grieving for the 'wished for" baby is important and allows the parents to accept and bond with this unique little infant. Dealing with one's own exhaustion is necessary for healing physically. Often times parents experience information overload. Planning for current care and trying to anticipate and problem solve or "guess" the developmental future of their baby can be difficult. Once home it seems as if there is an invasion of privacy as the couple tries to nest with their baby. Establishing routines and quiet times and working to communicate with your partner, family and friends can all help facilitate a sense of beginning well being.
Strategies to cope fall under three headings: physical, emotional and interpersonal. Self- care in the first area requires proper sleep, good nutrition, time for relaxation, and avoiding the use of drugs or alcohol. Meeting emotional needs can include taking things day by day, setting realistic goals for self and baby, becoming more assertive, focusing on positives, and sharing time with supportive family and friends that can lend a ear and a hand. Interpersonal needs revolve around learning to ask for help, delegate, and recognizing others are under stress too. I remember I felt frustrated with my husband when it seemed he worked so much and I needed him home helping me with the babies. But, I needed to recognize he was dealing with an overwhelming sense of financial responsibility with the addition of two children, the loss of my income while I was on bed rest, and mounting hospital bills.
The first few minutes and for some families up to a year, can be very traumatic with Bringing your Baby Home from the Hospital. But, it is also a time of celebration, great joy and a beginning closeness for a new family. As individuals, when we are faced with a crisis we survive and thrive as we find wonderful graces and opportunities. Tapping in to our own coping skills, along with the availability of resources such as: Sidelines while we were on bed rest, caring health care workers who share their wisdom and hope with us, the regional center, visiting nurses, family and friends, all allow us to confront the crisis and begin the process of successfully traveling a very challenging road.here
By Jenna C. Schmitt
When I was ready to turn sixteen, I remember telling my friends and family that I all wanted for my birthday was a hysterectomy. Okay - part of the reason I said it was for the shock value - but in truth, I never wanted to have any children. I loved being an "only" and actually felt sorry for my friends who had to share their toys and their parents' attention with siblings. I was a loner and a bookworm, and I loved my independence.
The years went by, and sure enough, that "perfect guy" eventually came along when I was in my late twenties. He shot that old theory to hell. Meeting my husband John was the perfect excuse: now that I had found someone I REALLY liked, why not try to replicate ourselves into a little person? So we decided to get pregnant after about a year and half of marriage. We were shocked and thrilled to conceive after about five days (yes, my husband was very pleased with himself) of trying and only a day off the ole birth control pill. Little did we know that my old teenage desires to rid myself of my female parts would actually come true, after an eight-month long battle to bring our first and only child Jay to term.
I recall that couple of days before we actually knew I was pregnant (but I knew, like most women do), I experienced my first tinges of nausea. I was delighted! This, for sure, confirmed my pregnancy and eased my fears of early miscarriage, a common worry of many women becoming pregnant for the first time. The nausea was ever-so-slight and hardly present, but it was there. I could still eat most of what I wanted and had an appetite for everything, which was normal for me.
This slight nausea remained "slight" for about four days, and the next morning I awoke with powerful nausea and ran straight to the bathroom, where I wouldn’t leave until my son was delivered eight months later. This was SERIOUS stuff; I couldn’t watch T.V. because the movement of the screen flickering would be enough to provoke five minutes of uninterrupted gagging and vomiting. I couldn’t read anything either: just the action of moving my eyes from word to word would start the spasms. I was so weak from dehydration and not eating that I could hardly sit up in bed. After about a day of these extreme symptoms, I begged my husband to take me to the emergency room.here
By Laurie Krauth
How often do the one in five pregnant women assigned to bed rest get to brag about the experience? Yet here we lie, accumulating perks unknown to our mobile counterparts. So here’s a reminder to horizontal pregnant women, and a lesson to our vertical sisters, about just 15 of the benefits I’ve accrued in taking pregnancy lying down.
- My husband has learned to cook. And not just in the microwave.
- He can run the house. (He no longer puts the first load of wash in the machine and leaves it to mold. He regularly fills--and empties--the dishwasher, notices when we’re out of milk, creates a shopping list, hits more than one store to get the goods, buys in bulk and looks out for sales.)
- I am amassing a quantity of sleep-time that I won’t see again until my baby is 2.
- I am tearing through novels, mastering (in theory) the football hold for breastfeeding and gossiping with friends with laziness that my baby won’t permit again until preschool.
- I’m losing my type A-ness - is it possible? Before this bed rest thing, I couldn’t talk on the phone or have a friend over without also cooking or filing papers.
- My old definition of a top-flight evening--one spent eviscerating eight items on my to-do list - has been replaced by one spent watching two videos with my husband.
- I can stare aimlessly into space (without mentally adding tasks to said to-do list).
- My athletic virtuosity no longer depends upon at least one sweaty set of tennis, three jogs and a night of swing dancing a week. Tackling the stairs now makes me proud.
- Lying on the couch in the living room (aka Bed Rest Central), I savor sightings of cardinals and chubby snowflakes. Gone is the muttering about barren, skinny trees and steel gray sky. This is a cornucopia of earthly delights compared with the medical building that stared back at me from the hospital bed I occupied the other week (and could occupy again any time).
- I relish my baby’s increasingly zealous kickboxing because I know he’s well and happy, and that matters more than anything.
- Forget any worries that my new husband loves me conditionally - for the sex, or how I take care of business around the house, for my fanatical energy, or for my lithe body. These are a distant memory and still he treats me like his bride.
- No doubts left about how he’ll handle Real Life with me. As our honeymoon giddiness has been replaced by his holding me from 3 to 5 a.m. while I await crisis-level bleeding, as well as preparing my meals and cleaning up after me, we’ve cruised seamlessly through a decade’s worth of marital developmental stages in less than a year.
- Improbably, he still makes me feel like a honeymooner, despite my girth, exhaustion and periodic fear. Curling up together on Bed Rest Central beats a night at a Parisian café with a new lover. I feel this exquisite bittersweet appreciation of each moment we spend together that’s intensified by the knowledge that a hospital bed may beckon at any moment.
- I am finally ready to have my baby. All this lying around finally put a stop to my obsessive worries about handling the transition to motherhood, leaving in its wake the searing desire to get on with toughening up my nipples and changing diapers for the kick-boxer I’m carrying.
- I’m actually looking forward to being liberated by childbirth. While my fellow expectant mothers anticipate losing mobility and independence, I can’t wait to be off bed rest and carry my baby and his hundreds of accoutrements through the house and out into the world. I’ll be free!
Laurie Krauth is a psychotherapist and writer in Ann Arbor, Michigan, whose complete placenta previa required that the last month of pregnancy be spent at Bed Rest Central. She has a healthy, delicious seven-month-old boy.here
by Margie Ostrower
"What color would you like, Margie?"
"I'll take Rendezvous Red, Lisa! After all, the summer is here and it's time to bare the only non-swollen part of my pregnant body, my toes, to the world."
Little did I know that those two coats of polish would be my last contact with the outside world for some time to come. I was receiving the Indestructible Pedicure.
Two days after my nail salon visit, Memorial weekend arrived. I was six months pregnant and couldn't wait to parade around in my new summer maternity wardrobe. I begged my husband, Don, to take a picture of me in my new bright pink bathing suit. He said, "Honey, I'll take it next weekend!" Well, what awaited us beginning the very next day was a life-altering experience that would test our patience and strength, but ultimately bring us the happiest ending we could ever imagine.
"Call the doctor," Don said firmly when I said something just didn't feel right.
"I'm really nervous. What if something is terribly wrong?"
"Well what exactly are you feeling?" he asked.
"I don't know," I explained. "I've never been pregnant before. I just can't explain. And I have a little spotting."
The doctor's response to my call alarmed us. He said to meet him on the eighth floor of the hospital in the labor and delivery ward. We arrived at the hospital and saw the doctor. After an examination and an hour on a uterine activity monitor, we had the diagnosis. Good news and bad news. The diagnosis was preterm labor. That something-isn't-right feeling was contractions. I couldn't believe it. I told the doctor I thought they were just funny little Braxton Hicks contractions.
I had just completed twenty-six weeks of pregnancy, much to early to have a baby. The good news? The doctor said that with medication and 100% bed rest, I had a good chance of reaching term and delivering a healthy baby. The bad news was that if I were to deliver now, our newborn would fight for every breath, every ounce and every day, trying to survive against the odds of severe prematurity.
And so began the toughest fight of our lives.
I was introduced to tocolytic medications and the true definition of bed rest.
Tocolytic medications are a family of three drugs whose primary purpose is to quiet uterine contractions. Two of these drugs can best be described as intravenous coffee. They speed up the heart rate and pulse, and lower blood pressure, so that one feels weak and shaky all the time.
The other drug, magnesium sulfate, makes one feel like a rotisserie chicken. It generates intense body heat from the inside out, causes muscle aches, diarrhea, blurred vision and an overall comatose feeling. Quite a picnic, to say the least. The combination of mega- caffeine and stupor. I went from being reluctant to drink a diet soda while pregnant to gulping powerful medications. What reassured me was discussing these drugs with my doctor, asking tons of questions and learning that hundreds of thousands of pregnant women had healthy, normal birthweight babies as a result of this aggressive intervention.
I understood the medical task of "weighing the risks against the benefits". If my preterm labor was not treated my baby would probably not survive or suffer health problems that could last a lifetime. I was determined to do whatever was necessary to give my baby a chance for a healthy life.
I took all three of these drugs at one time or another throughout my ten weeks in bed, both in the hospital and at home. Home sounds like such a comforting place until you are confined to bed, making friends with a bed-pan and going ten days at a time without a shower. Bed rest meant a refrigerator at my bedside, three meals a day in bed, and really hating my sheets.
The days and weeks dragged on. Every Saturday marked the completion of another week, moving us closer to the thirty- six week mark, the point at which it would be much safer for the baby to be delivered. Don and I celebrated every Saturday night with a "birthday party." We shared a special dessert and even sang "Happy Birthday" to my belly.
I experienced so many feelings every day, every hour during my bed rest. I felt isolated as life in the outside world went on without me. I felt inadequate physically; why did it seem everyone else had normal pregnancies? I felt angry, as in "why did this have to happen to me?" I felt trapped; I would have been overjoyed just to have permission go outside to get the mail.
I was totally bored. I knew the cost of every item on the "Price is Right" down to the penny! I suffered through days of tears and frustration over my situation, worried about the baby and convinced this struggle would never end.
At thirty-six weeks, I was taken off medication. I thought I would feel terrific, but in reality I felt exhausted and uncomfortable as my body adjusted to the awesome task of walking. I left the house for the first time and Don took me baby shopping. I clutched those little stretchies and it began to sink in. We had made it! A gush of water sent us to the hospital. Twelve hours later, Mitchell came into the world weighing 6 pounds, 10 ounces. After a thorough examination, we were assured he was absolutely healthy. I couldn't help flashing back to the day in my twenty- seventh week when I nearly delivered a one and a half pound baby. lnstead I had a healthy, normal birthweight son who would be coming home with me. The fight had been worth everything.
I am sitting here watching Mitchell sleep. He is healthy and full of potential only because of the miracles of medicine and "confinement". I will never forget, never regret, what it took to get him here. All the challenges, sacrifices, emotional upheaval were such a small price to pay.
If you are in the middle of a high-risk pregnancy, your feet may not touch the floor all season. Therefore, I highly recommend the "lndestructible Pedicure". You may be looking at those toes for some time.
Mine has finally begun to chip.here
(with apologies to David Letterman!)
- Paint your toenails and fingernails...as often as you'd like!
- Learn a foreign language with books or cd’s.
- Take a correspondence course through your local college or trade school.
- Volunteer to make phone calls, or stuff envelopes for your place of worship or your kids' school.
- Subscribe to the daily newspaper, and don't forget the puzzle page!
- Teach yourself a new hobby: knitting, cross-stitch, calligraphy, etc.
- Organize scrapbooks, or photo albums, and start new ones for your baby!
- Create a new budget, adding in all the expenses your new baby will add!
- Start designing your baby announcements! Buy the envelopes and address and stamp them all!
- Create a bed rest journal, and make a commitment to writing something every day. Include photos, details about your doctor's appointments, visitors, etc.
Ideas taken from "Days In Waiting: A Guide to Surviving Pregnancy Bedrest" by Mary Ann McCann, a Sidelines e-mail volunteer.here
By Leslie Cutler
As mothers-to-be, most women imagine a picture perfect pregnancy-- mild or no morning sickness in the first weeks, and within the fourth month, the soft kicking of new life within. Along with the growing, telltale tummy of an expectant mother, comes the choosing of a name decorating a nursery, buying baby clothes, and baby showers in honor of the mommy-to-be and the impending "arrival". The dream of an uncomplicated labor and childbirth, then holding a newborn baby, come to mind. After a short hospital stay, excited parents bring home a new family member to be loved and cherished for a lifetime.
Sometimes, this enchanting vision is lost when pregnancy complications arise. Sometimes, not only is the dream shattered; for a time, life is altered beyond what any mother-to-be can imagine. Not only is she placed on bed rest; her pregnancy risk has become great enough that her physician deems it necessary for her to complete that bed rest in the hospital. After overcoming the initial shock, anxiety, and disbelief that something so life altering is happening to her, this woman is faced with days, sometimes weeks, of hospital confinement, in some cases for the rest of the pregnancy! At this point, how the time remaining in such a pregnancy is spent can greatly affect her mood and anxiety. So how does the hospitalized expectant mother deal with the complexities faced with her situation? Here are a few suggestions, which are based on the experiences of several Sidelines volunteers (including the author) and how they managed their hospital bed rest. Just a few pointers.
- If you have children, talk with your partner and family about their care. ". . . maintain their schedules as much as possible. Ask friends to transport them to scheduled activities. Get child care help, particularly for young children." 1 Do you live near parents or family members who are able to assist you with day care? If not, do you have any close friends who would be able to help you with your children, at least until other arrangements could be made?
- If you have children, find out your hospital's policy regarding family visits. If children are permitted, make arrangements for them to visit often. This not only helps them with the adjustment of you being away, it helps lift your spirits too.
- Since you can't be home, bring some of home to where you are! Have someone bring items from your home to spruce up your room-pictures of your family and other children, posters, stuffed animals&. ...well, you get the idea!
- Hospital bed rest is stressful enough for you and your partner without the added strain of financial pressure. "Get household finances in order. If your partner can no longer work and finances are strained, work with creditors before you miss any payments."1
- Establish a routine- schedule yourself a wake up time, a grooming routine, time for writing letters, making telephone calls to friends, reading books, working on your favorite hobbies, and perhaps watching a favorite TV show. It's also a good idea to reserve time in the afternoon for visitors. Try to coordinate your daily activities with the schedule of your nursing unit.
- Try not to let yourself be overrun by television. Be selective of the shows you watch. The moods set by much of what is available for your viewing are less than the positive and upbeat influence needed at this time.
- Write your feelings down in a journal, diary, or notebook. The power of the pen sometimes not only rests in the words that are written; seeing your thoughts on paper may help you clarify your feelings. In addition, write down questions to ask your doctor the next time he/she visits you that you might have otherwise forgotten.
- Perhaps you were one of the lucky few to be admitted to "a room with a view"-- not just a blank wall or the next hospital tower-one with a more panoramic vista! If not, make arrangements with your doctor or nurses to be moved into such a room when space permits. If this is impossible, check with your doctor to see if you might be able to be taken outside for a few minutes on a fair weather day.
- When your family is not present, are you the type of person who would enjoy the companionship of a roommate or would you prefer to be alone? Accommodations may be able to be made according to your preference, so check with your nurse. Upon discussing this issue in daily rounds, your nursing staff may be able to find someone who might be compatible with you, that might also be helped by sharing this experience. On the other hand, you might be able to arrange for a private room, if you would be more comfortable. Both of these are dependent also on the census (number of patients) in your hospital's high-risk pregnancy unit. If the census is high, you might have to make the best of sharing a room!
- Use the time available to work on projects you've been too busy to complete. Read your favorite novels, or have your family bring in books you've wanted to read but haven't had the chance. If you are being administered tocolytic drugs that make reading difficult or impossible, have your partner or family check with the local library for books on tape. Also, needlework, artwork, creative writing, or other forms of self-expression that you have denied yourself in the past may now help prevent boredom and depression.
- Strive for variation in your meals. Most hospital menus repeat in one- or two- week cycles. If your hospital cafeteria allows, ask in advance for different fare. Hamburger not on the daily menu? Write it in! Better yet, if your doctor permits, ask friends and family to bring in your favorite foods from time to time.
- Some hospitals allow "mini-fridges" in rooms and even have them available for use. Check to see if the is the case at your facility. Keep your favorite fresh foods handy for a healthy snack. If this is not an option, your nursing staff may have fresh fruit available for you at your request.
- You may be especially prone to more depression and boredom on the weekends. While many of the people you know are spending their time off of work doing recreational activities with their families, you are in a small room, and if your situation dictates, not even able to leave your bed! Discuss this with your family and friends- maybe they can spend some time with you visiting, playing games, and including you in their schedule.
- Lastly, work with your doctor(s) and nurses. Your job is difficult-compliance to your medical regimen, even though you might be uncomfortable, bored, and depressed! You often feel powerless as the patient. But you are and integral part of a team! In the management of a pregnancy complicated enough to require hospital bed rest, you and your baby are at the center of your care. Ask questions so you can be informed regarding the treatment you are receiving and, when required, make the best decisions regarding yourself and your unborn child. Keep in mind the physician's responsibility is the best outcome for the baby, while keeping the mother healthy also. To quote a maternal-fetal medicine specialist, "In perinatology our goal is to treat the fetus," he says, "but what makes it unique is that we often treat the baby through the mother. The mother becomes incidental to treating the patient."2 Isn't it also your goal, to have the best outcome for your baby regardless of the difficulties you may face?
Hospital bed rest, in any situation, is trying and stressful on you, your husband or partner and children, and your extended family and friends. Instead of letting yourself become dejected at the thought of a long-term hospital stay, try to revel in the privilege of being pregnant for yet another day, getting closer each day to a healthier infant. Even though you are left on the Sidelines, you're the one who matters most to your unborn baby!
Assistance/Contributions from the following Sidelines Volunteers: Gina Caliendo, Jackie Castellano, Annie Douglas, Martha Keiser, Christine Lemely, Lauren Paul, Libby Starnes, and Lesa West.
1. Gibbons Paul, Lauren, "Go Directly to Bed& Do Not Pass Go: Why Bed rest is Prescribed in Some Pregnancies and How Moms-To-Be Cope", The Boston Parents Paper, May 1997, pp. 24-26.
2. Lipshitz, Jeffrey, in an article written by Sharon C. Chayra, "Top Docs: Five Specialists Who Are Truly Special", Las Vegas Life, February 1999, pp. 47-49.
by Jennifer R. Bloome
Relax? I need to relax? But I'm on bed rest, aren't I relaxing all the time? Even though you are resting your body 24/7, your mind is still on high alert. What about the dishes, the laundry, the bills, getting the children to their activities, the physical pain, the worries about the baby, the guilt, the "what ifs", the sadness, the anger&. Your mind and your body are intertwined - what happens to one happens to the other.
When you experience stress, whether it is a short-term event (we don't have any milk and I can't get to the grocery store), a long-term event (how are we going to be able to live on just one paycheck for the next 5 months), whether it is a physical event (contractions) or mental event (generalized worry or fear), your body releases hormones. These hormones affect all the organs in your body. This comes in handy when you need to have a final burst of energy to meet a deadline, but it wrecks havoc on your uterus. Sometimes the level of hormones is enough to irritate your uterus to cause contractions, or send your blood pressure sky high.
Your mind is an incredible organ. However, it doesn't know the difference between an actual event and one that you are "just thinking about." The same areas of your brain are engaged whether you are looking a red ball, or if you close your eyes and think about that same red ball. The same is true for stress. Your mind knows what you tell it.
The physiologic opposite to your body's response to stress has been termed the Relaxation Response. During this response, your breathing, heart rate, blood pressure and metabolism all slow down. Short-term effects of inducing this response include feeling more in control, feeling refreshed. The long-term effects of inducing this response on a regular basis include improvement in concentration, energy level, self-acceptance, and inner peace. The most important long-term effect is that your body becomes less responsive to the stress hormones. The stress hormones no longer have the same effect on the organs of your body.
Scientific studies have proven that women who use the Relaxation Response for 20 minutes a day have longer pregnancies and heavier babies.
What do you need to do to elicit this response? There are many ways, some more conducive to bed rest than others. Yoga, prayer, meditation, relaxation techniques, and imagery are all ways to induce the Relaxation Response. The basis of inducing the response includes repetition of a word, sound, prayer, thought, phrase, or muscular activity and the passive return to that repetition when other thoughts come into your mind. The repetition can include focusing on your breath. Any activity that you do that incorporated these two principles will help you induce the Relaxation Response.
Try these activities:
- Close your eyes and begin to focus your attention inward. Begin to lengthen out your breaths, keeping them as deep and as slow as is comfortable. Just focus on your breath. As you breathe in, say to yourself, "in", and as your breathe out, say to yourself "out." If you find yourself thinking of other things, just let those thoughts slip away and return your attention to your breath. Start by trying to do this activity for 5 minutes, working your way up to 20 minutes.
- Close you eyes and begin to focus your attention inward. Again, begin to lengthen out your breaths, keeping them as deep and as slow as is comfortable. As you breathe in, picture the air that you are breathing in is a cool shade of blue or green. Imagine that you are filling your lungs with this relaxing color. Imagine that as you continue to breathe in this air that the colorful relaxing air is going into your bloodstream, being carried throughout your body. Your bloodstream eventually comes to your baby. Imagine the relaxing air circulating around the outside of your uterus, massaging the muscles and quieting them, and then circulating inside your uterus, around your baby, filling your baby's home with peace and relaxation. Try to keep this image for 5 minutes initially, working your way up to 20 minutes.
These activities will help you induce the Relaxation Response. Notice how you feel before you try the activity and how you feel afterwards. You will find that it gets easier to focus the more you practice. Many relaxation recordings are available to help you focus your thoughts if you have difficulty doing it on your own.
These activities are a gift that you can give yourself and your baby. They are one tool that you can use to complement the care you are receiving from your healthcare team. Schedule a specific time in your day to induce the Relaxation Response. Try to minimize all distractions during that time and concentrate just on yourself and your baby. Using the Relaxation Response can improve your day-to-day quality of life and help to support both your health and the health of your baby during your time of rest.
Decrko JP, Domar AD, Deckro RM. (1999). Clinical Application of the Relaxation Response in Women's Health. AWHONN's Clinical Issues in Perinatal and Women's Health Nursing, 4(2), 311-19.<
Janke J. (1999). The Effect of Relaxation Therapy on Preterm Labor Outcomes. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28 (3), 255-63.
Jennifer R. Bloome is the owner of Anji, Inc., a company specializing in serving women's needs from preconception through birth and beyond. Jennifer is an Occupational Therapist and a Health and Wellness Educator. She works with women to teach the mind/body connection and its positive effects on both Mom and Baby during pregnancy. Jennifer provides both custom recordings and a line of relaxation recordings designed specifically for women with preterm labor as well as enhancing pregnancy. For more information, you may reach her at 888-770-2770, Jennifer@AnjiOnline.com, or by visiting her website www.anjionline.com.
By Chris Swingle, Gannett News Service
Diana Colón of Rochester, N.Y., was confined to her bed for much of her pregnancy. From May until her daughter was born in September, she was allowed to get up only for meals, trips to the bathroom and doctor's appointments. "Basically, it's a complete withdrawal from everything," Colón says. "You're staring at four walls. The highlight of the day is for the mail to come." Each year, nearly 700,000 U.S. women whose pregnancies run into trouble are told to quit work and stay off their feet. That's 18% - nearly one out of five - of pregnancies that last at least 20 weeks. Bed rest is ordered for many reasons, including pre-term labor, problems with the cervix, vaginal spotting, and complications from multiple pregnancies, diabetes or abdominal surgery. Though physicians generally support the practice, studies of bed rest haven't been able to show that it improves newborns' health. And women often say the experience is far from relaxing.
Colón, who lost one twin in August before having a healthy 3-pound, 11-ounce girl, is one of 15 mothers whose worries were eased by a small support group in her community made up of two bed-rest veterans who call and visit those who are bedridden.
Pregnant women say someone who's been through the same isolation can offer a level of understanding and encouragement that most friends or husbands can't.
Palma Jackman of Ogden, N.Y., fretted about not being able to take her daily walk or drive her 9-year-old daughter to religious instruction or Girl Scout meetings. She couldn't even go outside to enjoy the sunshine.
Friends brought meals, cleaned her home and washed her clothes. And volunteer Kim Rovitelli eased her mind, calling every week. "She kept giving me that reassurance. . . . 'It's OK the yard work isn't getting done,'" says Jackman, whose son was born Dec. 29 after about 15 weeks of varying levels of bed rest.
A Pillow of Support, Rovitelli’s fledgling Rochester support group, was conceived after she spent parts of two pregnancies in her second-floor bedroom. "I can remember lying up there and thinking, 'I wonder where they're putting the potato peeler? I'll never find it again.'"
Stress on top of worry
That was the lighter side. Rovitelli also remembers leaving the doctor's office in tears when, six months into her first pregnancy, he ordered complete bed rest except for bathroom trips. It was added stress at a time when she and her husband had just moved and her father-in-law and aunt had died. "Every twinge, every twitch, you wonder what's going on," Rovitelli says. "You're worrying that the baby's not going to make it."
During her second pregnancy, Rovitelli's complete bed rest started earlier and stretched on for three months. Her sister took over her home day-care business, and her husband, Dave, came home from his computer job at lunchtime to help juggle the cooking, cleaning and caring for their year-old son. Recognizing that many other women with high-risk pregnancies are lonely, bored and anxious, the former preschool teacher felt compelled to create local support. She was encouraged in her efforts by representatives of Strong Memorial Hospital, Blue Cross/Blue Shield of the Rochester Area, nurses and others.
The result delighted physician James Woods, who oversees high-risk pregnancies at Strong. Women are bound to be more at ease and healthier if someone offers empathy as well as coping tips. "That is the kind of advice that, sadly enough, most of us don't take the time to offer," he says. A support group can be "a true complement to the medical care that's going to have to evolve as we move more and more care to home."
Doctors say weeks 24 to 28 of pregnancy (full term is 40 weeks) are critical to the developing baby. During that time, each extra day in the womb increases the chance of survival by 3%, Woods says. Women on bed rest need to hear - from medical personnel, friends or volunteers - that they are actively helping themselves and their babies by resting.
Still, since studies of newborns haven't proved that bed rest is effective, there is some controversy. Judith Maloni, associate professor at the Bolton School of Nursing at Cleveland's Case Western Reserve University, has documented a number of negative side effects of extended bed rest for the mothers: depression, anxiety, boredom, muscle atrophy, weight loss and body aches. The problems can continue well after delivery, she says, just as space travel's weightlessness can have long-term effects on astronauts. "Bed rest is a form of sensory deprivation," says Maloni, who has studied bed rest for a dozen years. Patients need people to visit them and offer support: "That's what keeps women going."
It's the little things
Woods concedes that bed rest isn't a proven way to improve newborns' health, and he acknowledges that there is much doctors don't know about the early months of pregnancy. But bed rest is a common prescription because doctors believe it makes sense. In cases of vaginal spotting, for example, reducing activity lowers blood pressure and cuts the risk of bleeding, Woods says. Bed rest traditionally hasn't included frequent checks on the mother-to-be. Woods says that if such support were more common, bed-rest studies might find more benefits.
One of the first women referred to Pillows of Support was Sue Barnes of Rochester, who now volunteers with Rovitelli. Rovitelli found it rewarding to talk Barnes through her first pregnancy's struggles.
"One day she called me and said, 'all I want is a bagel,'" Rovitelli recalls. She encouraged Barnes to call a nearby bagel shop and explain her predicament. The shop didn't usually deliver - but it made an exception. A small thing, but a welcome treat that helped Barnes through yet another day.