10 Questions About Bed Rest

One in four pregnant women are placed on bed rest annually.  That is approximately 700,000 women.  Its a measure that doctors prescribe when they feel that the baby and/or mother is at risk for complications during the pregnancy.  It can be a sudden and sometimes devastating turn of events in an otherwise healthy pregnancy term.  For BellyButtonBoutique owner Karla Trotman, bed rest meant 2 weeks in the hospital on 24-hour monitoring where should could only leave the bed to use the restroom and to shower.  Some women must spend their entire pregnancy in bed.  Darline Turner-Lee is the founder of Moms On Bedrest & Beyond.  She took the time out of her busy schedule to give us an in depth look at the emotional and physical side of a pregnancy prescribed to bed rest.

1.  Why would a pregnant woman have to be on bed rest?

Pregnant women are prescribed Bedrest when they are at risk for going into preterm labor (defined as labor before 37 weeks of pregnancy). Common causes of preterm labor that would require a woman to be placed on bed rest include incompetent cervix (cervix dilating and shrinking in preparation for delivery before it’s time for delivery), placenta previa (placenta presenting first at the opening of the birth canal) Uncontrolled Gestational Diabetes, uncontrolled hypertension/pre-Eclampsia/Eclampsia, poor fetal growth, A multiple pregnancy (twins, triplets, etc..), vaginal bleeding, premature rupture of membranes (early water breaking) history of pregnancy loss.

2.  Are there different types of bed rest?

The bed rest prescription varies depending on the situation. Sometimes a woman will be asked to stay close to home, not drive and not do any heavy lifting or strenuous activities, yet she can work on a computer and putter around her home. Some women will be on “house arrest” where they have to stay at home, either in bed or on the sofa, keeping their feet up and not doing any vigorous activity, getting up only to go to the bathroom and are only allowed to shower once daily. Then there is strict bed rest when a woman has to remain in bed and get up only to go to the bathroom (No Showering!), and very strict bed rest where she has to remain in bed on her left side and use a bedside commode.

3.  What are the emotional effects of bed rest on a woman?

Bed rest is very emotionally draining. Remember, a woman is placed on bed rest to protect both her health and the health of her baby. So many people chide a woman on bed rest with, “Girl, I wish I could lie around all day! Relax and enjoy it! Take advantage!”

Bed Rest View

But it’s pretty hard to relax when you know that you may be losing your baby. So many women on bed rest have had a difficult time getting pregnant and have often lost other pregnancies. In another example, a woman with very high blood pressure that is being refractory to treatment is often very worried that she may have a stroke or other life threatening complication where she could die or be very much impaired. There is a lot of anxiety and guilt because women often feel it’s their fault that the complications are happening. Often it’s no one’s fault, just something that happens. This is often not a fun time but one that is very stressful-the opposite of what is desired.

4.  What are some things that women on bed rest can do enhance their mood?

I always advise women on bed rest to stay cheerful. Listen to music, read good books, watch favorite movies. This is a great time to journal or to start a scrapbook for your little one. Gather lots of family info and photos and put it together for the baby.

Mostly, get as much interaction as possible. There are lots of great online forums women can join and chat with other women on bed rest. This seems to be one of the best ways women pass time, share hopes and fears and support one another.

5.  On your website you mention how exercise is very important while one is on bed rest.  Can you elaborate?

Pregnancy is a state of volume overload, meaning that there is more blood in a woman’s circulation and more fluid in her body. The added strain on the circulatory system puts pregnant women at risk for developing blood clots, mostly in the legs as they are the furthest from the heart. These clots can cause inflammation in the blood vessels where they develop and infection. If these blood clots dislodge (embolize) they can travel to the heart, lungs or brain and be fatal. These dangers are compounded in women on bed rest because not only do they have the additional fluid volume of pregnancy, they are immobile. (Ever notice that your feet swell on a long ride?? Same thing! Women on bed rest are at increased risk of developing blood clots in their legs and at increased risk of embolism that could result in a heart attack, pulmonary embolism or stroke.

While it seems crazy, women on bed rest must exercise. Since they cannot walk around, they have to move their limbs and contract their muscles to keep the blood circulating to avoid the aforementioned complications. Also, keeping their muscles active and toned will enable them to regain their physical function once they are able to be up and about.

6.  How can family members support loved ones on bed rest?

Take care of the household duties so that she is not worrying about them; help with children, pets, community obligations. Stop by and clean her house or bring a meal. Offer to run errands or to take her children out for a day of fun (remember, they have lost the mommy that they know as well!) Mostly, visit. Being at home alone on bed rest can be very isolating. We have all experienced times when left to our own devices we think up all kinds of crazy scenarios. Unfortunately, some of the scenarios a woman on bed rest may be imagining may not be too far fetched. Visit her, sit with her, listen to her, and don’t dismiss her worries and fears. If you don’t know what to say, just listen and acknowledge her feelings. Throw her a party or a shower. Anything that will lift her spirits and keep her calm is good.

7.  What are the top 3 items a woman should have by her side during this time?

I actually came up with 4 things:

1. A telephone
2. The TV Remote
3. A laptop computer
4. A cooler or small fridge with snacks and drinks.

8.  On your website you offer services to help moms on bed rest in the Austin, Texas area.  Have you thought about partnering or franchising in other cities?

I would love to have a Mama on Bedrest & Beyond in every major city in the country! We really don’t do enough to support women and families and when a woman is not able to fulfill her regular obligations, it really impacts the family. The mission of Mamas on Bedrest & Beyond is to support high risk pregnant women and their families during a very difficult time by maintaining as much “normalcy” as possible.

9.  Why did you start your business?

I had 2 high risk pregnancies and had no local support. I am originally from the Northeast and my husband is from the east as well. We are the only ones here in Texas. When I had problems with my pregnancies, both my mom and mother in law were trying to figure out how they could come and support me. With my first pregnancy, they were both still working and could not spare what could have been weeks away to care for me. Home health Agencies in the area cater only to the elderly or those with injuries or severe debilitation. When I called, I was told that pregnancy, even a high risk pregnancy, would not be covered. Luckily for me I did not end up on bed rest (my daughter was born early and I worked with my OB to avoid bed rest with my son because I had no local support), but I knew that I could not be the only person who lived far from family and had high risk pregnancies. So I decided to fill the gap.

10.  What is the one thing that readers should take away regarding bed rest?

Bed rest is anything but restful and is often very stressful. When a woman is placed on bed rest, she worries about her own health, the health of the baby and how she will meet her obligations. Anything that friends and family members can do to minimize her stress, to keep her spirits up and to keep her life on an even keel will be greatly appreciated.

Darline Turner-Lee is the founder of Mamas On Bedrest & Beyond, a subsidiary of Next Step Fitness, Inc*. She brings nearly 17 years of experience as a physician assistant, ACSM Certified Clinical Exercise Specialist and perinatal fitness instructor to the business along with extensive personal experience. Turner-Lee was pregnant every year between 2001 and 2006 with the exception of 2003. She has has 4 conceptions, 2 miscarriages, 2 high risk pregnancies and 2cesarean births.She has the unique perspective as a clinician and as a high risk and older mom (who gave birth at 37 and 40 respectively) which enables her to meet the unique needs-both physical and emotional-of high risk pregnant women. Turner-Lee’s vision for Mamas on Bedrest & Beyond is to change the way that clinicians, friends and loved ones care for high risk pregnant women.

Chrissy Fink – Health Coach and Certified Fitness Instructor

Chrissy Fink is a wife and mother of two children.  Six (6) years ago, in the midst of having children, she started to look and feel “not well”.  She discovered that she was not only 40 lbs overweight, but also had high cholesterol.  This lead her to study and research health and nutrition with a vengeance.  She was able to change her lifestyle in ways that she could live with.  Chrissy also got her entire family into a healthier way of living and has forever kissed high cholesterol and those 40 lbs goodbye!  She is now an AFAA Certified Fitness Instructor and teaches group fitness at AFC in Jenkintown, Pennsylvania.  Her passion is helping people reach their goals and change their lifestyles for a happier self.  On a side note, her picture here does zero justice.  Chrissy has an amazing body and an amazing personality!  She was more than happy to share some of her most effective tips with fellow mommies.

1.  Low fat, low carb, South Beach, Jenny Craig, its all so confusing.  What are the first steps for clean eating?  What advice to you have for new moms just starting out?

1st. Cook at home when ever possible… this way you know what’s in your food! Buy the best quality food/ ingredients  you can afford!  You want your food to be healthy and taste really good… Don’t be afraid of healthy fats.. you will see me repeat this! It is very important for so many reasons! Your plates should look like this…Pile of cooked or raw veggies, Lean protein (size of fist), and some healthy complex carbs I.E. Whole Grain Pasta, Quinoa, Millet, whole grain Couscous.   (Please don’t be afraid of good carbs as well.. You need Energy to burn Energy!!)

2.  Its important to keep your calories up when you are nursing, yet you want to lose weight.  What are the best foods in order to balance that?

Your body does need some extra calories during this very special time.  You will need energy to make your milk.. If you are eating a similar meal like I described in the first question and sticking to healthy snacks that I go over in question 3  w/ good fats, your body will use that energy without gaining.  Sleep in also a must  when we talk about weight loss… So moms, new and old, you need to make sure that you are getting your rest in order for those growth hormones to kick in!

Also, get that baby in the stroller and GET MOVING!

3.  Moms are always on the run.  What are some great snacks that are good for storing in your purse or at your desk at work?

I love this question!! Purse, car or  small bag cooler… Seeds & nuts, apples (any fruit), Greek yogurt (or any low sugar yogurt w/good bacteria),  chopped veggies ( w/ some dressing or hummus)…We can’t absorb some of the nutrients from some veggies without some fat.   Healthy fat will help you feel satisfied!! Just be sure to portion out handfuls of nuts and seeds so you don’t overdo.. great to pair with fruit!

4.  What are the worst foods that one can eat?

Hydrogenated oils and High Fructose Corn Syrup!!

5.  Vitamins and supplements, what are the basics that one should know when just starting out?

Vitamin D~3 at least 1000 mg, Calcium and Magnesium w/ at least 1000 mg of Calcium.  Get one that has both, take 2 times a day for that total amount.  The body can only absorb 500 mg of calcium at at time… If it’s good multi[vitamin] and has these numbers in them that’s great!  [Vitamin] Bs are very important also a good B~Complex will work!

6.  What is your typical eating pattern and daily meal look like?

Breakfast (within a hour of waking):

Oatmeal or Greek yogurt w/a heaping teaspoon on almond or cashew butter. (Vitamins and herbs) Glass of water. Sometimes a smoothie

** Workout**

Snack/ lunch: I try having this as my biggest meal of the day!

Hummus and veggies, Big salad : seeds, chopped veggies, mixed greens and spinach and dried berries , chicken that’s grilled little feta with fresh squeezed lemon and a drizzle of cold press olive oil with sea salt and pepper … Our very favorite dressing!!! I add lemon to every salad!!! Yummy

Snack: If  I didn’t have a big lunch… Pesto, Hummus or gazpacho w/pita, rye crisps or veggies , fruit in season

Dinner:

Could be a home made soup w/a grain bread or garlic bread or I make traditional meals.. Pasta dishes, Pot roast. We love my lunch salad with some warm yummy seasoned steak or fish on top and I add any chilled grain in there to keep us full!

7.  Should you not eat after a certain time of the day?

3 Hours before bedtime, But if you can have your dinner and not eat again until the AM even better.. you have to make sure you had enough dinner to get you through, you can work up to this… Your body has time to digest and them burn fat and cleanse itself.

8.  Which foods do you suggest for maximum impact for weight loss?

Whole grains, organic veggies (when possible), fruit, lean protein’s ( local, wild, free range, organic when possible).  You will not gain weight on whole foods!!  It’s the processed foods that get us!!

9.  How can one kill their sugar craving?

We naturally crave sweet flavors.. Usually at 3 pm! My tips would be make sure your meals are satisfying and vary in flavors (ex. sweet veggies) as well and not to get to the point of starving!  Craving means the body needs some energy.  Your don’t want highs and lows during the day.. you need to stay even. Once you start to balance your meals and still need to have something sweet: Fruit, good piece of dark chocolate (70% or more) helps without the sugary processed food which cause us to gain!

10.  What is the one major piece of advice do you have for women struggling with weight loss?

Adding veggies to your  home cooked food!!!  Cook your own food!! Season with lots of herbs to bring out flavors and always add love!

If you would like a personal consultation with Chrissy, you can check out her website: http://www.healthyfitgirl.com/ for a free consultation.  She would love to help you!

Bellybuttonboutique.com Q & A with Julie Tupler, RN, CCE

Julie is a Registered Nurse, certified childbirth educator and fitness instructor. She developed the Maternal Fitness Program in 1990 and has been working with pregnant women and new moms ever since. She is on the advisory board of Fit Pregnancy and the Women’s Sports Foundation. She is the author of two books, Maternal Fitness and Lose Your Mummy Tummy. She is the producer of the Maternal Fitness and Lose Your Mummy Tummy DVD Lose Your Mummy Tummy DVD s and has developed the Diastasis Rehab ™ splint . She speaks frequently at conferences throughout the U.S on the Tupler Technique for Treating Diastasis Recti. Her program is the only research based program on exercise and diastasis recti.

1. What is Diastasis?
The word diastasis means separation. A diastasis recti is the condition where the outer most abdominal muscles (rectus abdominis) separate. When they separate the connective tissue joining them stretches sideways. The function of these outermost muscles is to support the back and the organs. When they separate it weakens the support system for the back causing back problems and the organs causing the “mummy tummy.” The mummy tummy is actually your organs being supported by a thin piece of saran wrap-like connective tissue instead of the muscles.

2. Can a woman have diastasis and not realize it?
Yes, many women have a diastasis and do not know it. Since a diastasis is not common knowledge they usually do not know unless diasgnosed by their doctor or midwife. What makes a diastasis more noticeable…..like looking 5 months pregnant…is when the connective tissue is very weak.

3. Why do exercises like crunches or the pilates hundred exacerbate the condition?
When talking about working the “core” we are talking about working the inner most abdominal muscle…the transverse muscle. Working the core correctly means being able to bring your belly button to your spine and hold it there. If you cannot do that then the muscles are going forward forcefully making a diastasis larger. It is physically impossible to hold the belly button at the spine in a backling position with the shoulders off the floor. That is why crunches and the pilates 100 make the diastasis larger.

4. Why do doctors not diagnose this condition at your postpartum visit?
Sometimes doctors or midwives will diagnose this condition if asked by their client.

5. If you do not close your diastasis what affect can it have on your body?
If you do not close a diastasis, you are at risk for what is called a ventral hernia if you have any abdominal trauma and the connective tissue is torn away from the muscle. Also, back problems are much more prevalent as when the muscles are separated it weakens the support system for the back.

6. How does the Tupler Technique differ from other diastasis programs?
It is a 4 step program
1. Three Tupler Technique exercises
2. Wearing and holding a splint to pull the two halves of the muscles together
3. Engaging the transverse muscle on the work of all activities of daily living as well as while exercising.
4. Getting up and down correctly from a backlying position

This program is the only program that has research to support that it makes the diastasis smaller. It also is the only program that heals the connective tissue.

7. Can a woman who had a baby 20 years ago use your technique to close her diastasis?
Yes, a diastasis can me closed no matter when or how it was created by doing the Tuper Technique program.

8. Can a pregnant woman close her diastasis while pregnant?
Yes, Many women doing the Tupler Technique during their pregnancy if they started early in their pregnancy were able to close it.

9. Has the medical community been receptive to learning about the Tupler Technique?
Yes, the medical community has been very receptive to learning about the Tupler Technqiue.

10. Why not just get a tummy tuck?
A Tummy tuck is major surgery. To repair a diastasis the doctor can do this one of three ways. They can sew the connective tissue, sew the muscles or put a piece of mesh in to support the connective tissue. All three surgeries involve stitching. And stitching can be undo by doing improper abdominal exercises. So if a woman chooses to have this surgery it is important for her to do the Tupler Technique BEFORE the surgery so she can maintain the integrity of the stitching after the surgery when the muscles are numb.

Click Here to Ask Julie A Question

Maternal Fitness & Diastasis

Truth be told, vanity aside, women want their stomachs back.  They hitting the gyms, buying DVDs and ab machines in hopes of flattening out their postpartum mid-sections.  The problem is is that millions of women have a diastasis and are going undiagnosed.  I know this problem intimately and well.

What is diastasis?  It is a separation in your abdominal wall.  You can find out if you have it by laying on your back with your feet flat on the floor.  Take 3 fingers (fore, middle and ring) and place them 3 inches above your belly button,  pointing your fingers downwards, towards your legs.  Relax.  Press your fingers about an inch into your belly, then slowly lift your head.  You will feel the sides of your abdominals close in around your fingers.  If you can feel this, you have a diastasis.

I just got back from a Diastasis training course in NYC taught by Julie Tupler, RN.  She is the Mummy Tummy guru and a vendor of my online store http://www.bellybuttonboutique.com.  I sell her Diastasis Rehab products on my website and they continue to be best sellers.  When I met Julie last year I had given up on my body and just decided that I was going to have a tummy tuck or abdominalplasty.  She explained to me what diastasis was and talked about her program.  That night I researched Julie and her products.  I found that Julie was Elle MacPherson’s prenatal fitness trainer and figured, if her guidance is good enough for a supermodel that I surely could trust her with my body.  But like most things that involve discipline and exercise, I didn’t do anything with the information.  I sit on it for almost a year before I decided to give it a try…all I can say is that it works.  I am in the midst of repairing my diastasis, but I can tell you that it is really working.

I hope to post before and after pictures and measurements as I go through this program on my site.  I want to stop looking 3 months pregnant…especially since I gave birth 18 months ago.