- The Washington Times - Saturday, September 4, 2004

Debra Morlier, 31, an avid hiker and former police officer who craves activity and variety in her daily life, barely left her bed, much less her Thurmont, Md., house, in the past six months.

She was assigned bed rest while pregnant with twin girls.

“I’m a really independent person, so it’s hard not to be able to do anything on your own, to be so dependent on people around you,” says Mrs. Morlier. “It’s hard physically, too. You’re sore, and you can’t get comfortable.”

These concerns are common among women on bed rest, and in order to deal with their feelings of inadequacy and isolation as well as the physical limitations and pain, it’s important to involve friends, family and other support groups as much as possible, says Tracy Hoogenboom, co-director of Sidelines. The national nonprofit group supports families with high-risk pregnancies.

“These women need encouragement, and they need to know that they’re not alone,” Mrs. Hoogenboom says. “There’s so much stress and anxiety when you’re on bed rest.”

Though bed rest is used to encourage full-term — 40-week — pregnancies for up to 1 million women a year with high-risk pregnancies, there is no scientific evidence that it actually works, says Dr. Helain Landy, director of the Department of Obstetrics and Gynecology at Georgetown University Hospital.

Bed rest is used for high-risk pregnancies, including such conditions as preeclampsia, hypertension, placenta previa, incompetent cervix and bleeding as well as twin pregnancies.

Dr. Landy echoes the official position of the D.C.-based American College of Obstetricians and Gynecologists, which states that there is no clear consensus or evidence that bed rest has any benefits.

Judi Maloni, associate professor of nursing at Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, takes it one step further. She says bed rest can actually be harmful.

“The side effects for the mother are deconditioning of the heart, muscles and possibly bones,” Ms.Maloni says. She has just completed a six-year research project, funded by the National Institutes of Health, involving 181 women on bed rest.

This “deconditioning” occurs from the many weeks of disuse of muscles, says Ms. Maloni, who holds a doctorate in nursing.

The women are also more likely to suffer postpartum depression, according to her study.

Dr. Landy still prescribes bed rest in certain cases, particularly for women who are expecting twins or higher-order multiples.

“It seems to make sense that less physical activity should put less ‘stress’ on an already stressed situation,” she says. “The more active the woman, the more uterine contractions that can be seen and the higher the blood pressure.”

Another reason bed rest is prescribed is that less physical activity keeps the blood flowing maximally to the uterus and baby, Dr. Landy says. If the mother is physically active, the muscles’ demand on blood increases, and less of it goes to organs.

Both Dr. Landy and Ms. Maloni acknowledge that more research needs to be done to learn if, when and in what cases bed rest can be beneficial.

Shellie Bressler of Capitol Hill spent about four months on bed rest when she was expecting twin boys four years ago. She spent five weeks on strict bed rest in the hospital.

“It was really tough, and I will never know if the bed rest had anything to do with it, but if I were faced with it again, I would make the same decision,” Mrs. Bressler says of her successful outcome.

Her twin boys, who were delivered just short of 36 weeks, got to leave the hospital with their mother. They are 3 years old.

A family matter

Most nights while Mrs. Morlier was pregnant with her twin girls and on bed rest, her husband, Louis, would get just five hours of sleep.

Between working full time for the Department of Homeland Security, taking care of the couple’s 2-year-old daughter, Lynn, doing the grocery shopping, cooking and cleaning, Mr. Morlier had very little time for his own needs, including sleep.

“I never realized how much Deb normally does,” he says.

Mr. Morlier, however, says it’s not enough for him just to be a worker bee around his wife. He has to treat her as a friend, woman and wife, too.

“I have to be attentive to how she feels, what she wants to talk about,” he says. “It’s easy for me to just take care of her and the house and never stop to take time to really listen to what she wants.”

Many fathers get overwhelmed by all the responsibilities, Mrs. Hoogenboom says. The financial burden can be intense because many women have to quit or take a break from their jobs.

The emotional load can be heavy because the woman can be depressed or anxious. It’s important for her husband to carve out some time for himself to get a break, she says.

Mr. Morlier did that.

“I joined a gym week number 16. I go three times a week and spend two or three hours there each time,” he says. “It’s my own little world where no one needs me. It gives me tremendous energy.”

The Morliers also decided they needed to get extra help and asked family members, including Mr. Morlier’s father and Mrs. Morlier’s sister, to pitch in.

“This time I wasn’t afraid to ask,” says Mrs. Morlier, who also was on bed rest when she was pregnant with her daughter. “Last time, with Lynn, I felt as if I should be able to do everything on my own.”

When Mary Erler of Capitol Hill was on bed rest for a heart condition two years ago while pregnant with her son Graham, she was particularly grateful for the help friends and neighbors offered.

“They took Shannen to the park or on play dates, and it was great,” Ms. Erler says. Her older daughter, Shannen, was 5 years old at the time.

Ms. Erler recommends that women on bed rest make lists of things with which they need help.

“When people offer to help, they don’t know what you need. Give them concrete ideas. If you have a list of things, they can pick whatever suits them the best,” she says.

Mrs. Hoogenboom says Sidelines, which is based in Laguna Beach, Calif., offers volunteers — “buddies” — with whom the woman on bed rest can air her concerns via phone calls and e-mails.

Staying busy

Women can be put on bed rest at any time in their pregnancies.

Passing the time — more than six months in Mrs. Morlier’s case — while barely allowed out of bed can be challenging.

“Having short-term goals is important,” Dr. Landy says.

“It’s a vast amount of time, and sometimes you do it a day at a time and sometimes an hour at a time, but knowing that your baby will spend less time in the NICU makes it worth it,” she says, referring to the Neonatal Intensive Care Unit.

Mrs. Morlier says her faith helped her get through the weeks and months of bed rest, when she was able to enjoy her beloved outdoors — the sky, trees and birds — only through her window.

“A cardinal made its nest in a tree outside my window, had a baby cardinal, and now the baby cardinal likes to peck on our windows — a sign that everything will be OK, a miracle, and God’s work,” she said while still on bed rest.

Mrs. Morlier also tried to stay as busy as she could. As she lay in her bed, connected to a uterine monitor that recorded her contractions, she says she finished creating an online course in marriage and family sociology that she’ll be teaching at Harford Community College in Bel Air, Md.

She also studied for and passed an exam to become a licensed clinical professional counselor, she ordered baby items online, she read about 35 books, wrote baby announcements and watched her favorite TV show, “M*A*S*H.”

To do all of these things, she had to have a laptop with Internet access. She also had a 9-inch television set close to her bed, which was moved to the laundry room so she could be close to the bathroom and kitchen.

Mrs. Hoogenboom says this is the best way to organize the room.

“You basically want to set up your bedroom like a living room,” she says.

Mrs. Hoogenboom also recommends having healthy snacks nearby and maybe an ice chest to cool water and other drinks because it’s very important to stay hydrated while on bed rest.

Another way to make the bed rest bearable is to allow for some personal care and grooming.

“If you can, shower and get dressed every day,” Mrs. Hoogenboom says. “Don’t lie around in the same clothes day after day. You’re not sick. You’re doing this for the baby.”

Ms. Erler says personal care was important for her while she was on home bed rest.

“I put on makeup in the morning. It made me feel better,” she says.

Mrs. Bressler, who wasn’t allowed even to shower at the end of her bed rest, remembers one pampering friend in particular.

“She came and painted my toenails while I was in the hospital. I think that was the nicest thing anyone did for me while I was on bed rest,” she says. “Looking down to see my red nails made me happy.”

Doctors and physical therapists also recommend limited and easy exercises for women on bed rest.

Mrs. Morlier, however, was only allowed to move her toes until she was about 35 weeks along, when doctors finally allowed her to get up and walk around a bit.

“Just getting up to walk out and get the paper was great,” she says.

Mrs. Morlier’s long wait finally came to an end Aug. 19, when her twin daughters, Ana Marie and Ava Marie, were born.

“I feel very blessed that the twins were happy and healthy,” Mrs. Morlier says. “In the end, these two miracles are well worth six months of bed rest.”

MORE INFO:

BOOKS —

• “THE PREGNANCY BED REST BOOK: A SURVIVAL GUIDE FOR EXPECTANT MOTHERS AND THEIR FAMILIES,” BY AMY E. TRACY, BERKELEY TRADE, 2001. THIS BOOK DISCUSSES TOPICS SUCH AS ADJUSTING TO HORIZONTAL LIVING, COPING WITH SHORT-TERM AND EXTENDED HOSPITALIZATION, MAKING BED REST A FAMILY AFFAIR, LIMITING THE SIDE EFFECTS OF IMMOBILITY AND COMING TO TERMS WITH YOUR FEELINGS.

• “EVERY PREGNANT WOMAN’S GUIDE TO PREVENTING PREMATURE BIRTH,” BY BARBARA LUKE, IUNIVERSE INC., 2002. THIS BOOK OFFERS PRACTICAL AND SCIENTIFIC INFORMATION ON THE 60 PROVEN RISK FACTORS ASSOCIATED WITH PREMATURITY. IT ALSO OFFERS A STEP-BY-STEP GUIDE ON HOW TO MAKE SMALL CHANGES IN YOUR LIFESTYLE THAT CAN HAVE HEALTH BENEFITS FOR YOUR CHILD.

• “DAYS IN WAITING: A GUIDE TO SURVIVING PREGNANCY BEDREST,” BY MARY ANN MCCANN, DERUYTER-NELSON PUBLICATIONS, 1999. THIS BOOK GIVES PRACTICAL SUGGESTIONS FOR COPING WITH AN AT-HOME OR HOSPITAL BED REST. IT ALSO GIVES TIPS FOR FAMILIES ON HOW TO DEAL WITH A BED-REST PREGNANCY AND HAS A CHAPTER ON BED-REST EXERCISES.

ASSOCIATIONS —

• AMERICAN COLLEGE OF OBSTETRICS AND GYNECOLOGY, 409 12TH ST. SW, WASHINGTON, DC 20024. PHONE: 202/638-5577. WEB SITE: WWW.ACOG.ORG. THIS NATIONAL NONPROFIT MEDICAL ORGANIZATION REPRESENTS MORE THAN 47,000 MEMBERS WHO PROVIDE HEALTH CARE FOR WOMEN. IT HAS ONLINE ARTICLES AND PAMPHLETS ABOUT VARIOUS WOMEN’S HEALTH ISSUES INCLUDING HIGH-RISK PREGNANCIES AND BED REST.

• SIDELINES NATIONAL SUPPORT NETWORK, P.O. BOX 1808 LAGUNA BEACH, CA 92652. PHONE: 888/447-4754. WEB SITE: WWW.SIDELINES.ORG. THIS NATIONAL GROUP SUPPORTS WOMEN ON BED REST THROUGH VOLUNTEERS, ONLINE DISCUSSION GROUPS AND A FACT-FILLED WEB SITE THAT INCLUDES TOPICS ON HIGH-RISK PREGNANCIES AND BED REST.

ONLINE —

• THE WEB SITE HTTP://FPB.CWRU.EDU/BEDREST PROVIDES INFORMATION ON BED REST BY JUDY MALONI, NURSING PROFESSOR AT THE BOLTON SCHOOL OF NURSING AT CASE WESTERN RESERVE UNIVERSITY IN CLEVELAND.

• THE WEB SITE WWW.MIRACLEBABIES.ORG IS AN E-MAIL SUPPORT GROUP OF PARENTS WITH ISSUES SUCH AS HIGH-RISK PREGNANCIES, BED REST AND PREMATURE BIRTHS.

• THE WEB SITE WWW.MOMSONBEDREST.COM, FOUNDED BY A WOMAN WITH PERSONAL EXPERIENCE OF BED REST, PROVIDES SURVIVAL TIPS, RESOURCE LISTS AND LINKS TO ONLINE DISCUSSIONS.

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