When is absolute rest indicated in pregnancy?

By (embryologist), (gynecologist), (gynecologist) and (embryologist).
Last Update: 04/21/2022

Many pregnant women can lead a relatively normal life throughout their pregnancy. However, there are pregnant women who are advised to rest in the event of certain risk situations that may endanger their health or that of the baby.

Rest may be relative or absolute, the latter being stricter. In general, pregnant women on bed rest should only get out of bed to go to the bathroom

Relative rest and absolute rest

Rest implies no exertion. However, when the specialist recommends the pregnant woman to rest, it can be a relative or absolute rest:

Relative rest
involves limiting the usual physical activity and resting, but the pregnant woman can do certain light tasks, without making any effort.
Absolute rest
the woman should remain in bed, getting up only when it is very necessary, such as to go to the bathroom.

Therefore, it is always advisable for the pregnant woman to ask her doctor and to specify beforehand, as far as possible, which activities she should restrict, as well as if there is a more appropriate posture to adopt during the rest.

Finally, it is important to mention that rest may have a variable duration and should be maintained until the woman receives a new indication from the specialist.

Indications for absolute rest in pregnancy

There are several reasons why the gynecologist may prescribe absolute rest to the pregnant woman. Among them are:

Threatened abortion with bleeding
bleeding during the first trimester of pregnancy may lead the specialist to instruct the pregnant woman to maintain absolute rest. However, rest may be relative if the bleeding subsides, until gradually recovering normal life.
Placenta previa
when placenta previa is detected in a follow-up ultrasound of the pregnancy, the pregnant woman is usually advised to maintain relative rest. However, if bleeding has occurred, rest will be absolute.
Intrauterine hematoma
some intrauterine hematomas are a reason for the gynecologist to order absolute rest for the woman.
Medical intervention
after certain medical procedures, such as amniocentesis or cerclage, the patient usually has to rest absolutely for a few days.
Early rupture of the amniotic sac
if it occurs before 34 weeks, the patient will be put on bed rest until it is more certain that delivery will occur.
Premature uterine contractions
rest is usually recommended to try to reduce the risk of premature delivery. Rest will be absolute or relative depending on the intensity of the contractions and the particular situation of the pregnant woman.
Intrauterine growth retardation
if it is due to placental insufficiency, the pregnant woman is often advised to rest.
Preeclampsia
sometimes requires hospitalization, but in certain milder cases the specialist may recommend rest for the woman.

On the other hand, the increased risk of complications such as premature delivery that exists in a twin or multiple pregnancy, also makes it very common for the pregnant woman to have to rest.

Risks of absolute rest in pregnant women

Some of the negative effects that rest during pregnancy could have on the pregnant woman are:

  • Muscle atrophy and loss of bone mass, which can hinder postpartum recovery.
  • Blood clots (venous thrombosis).
  • Constipation.
  • Stress, anxiety and depression.

In addition, the beneficial effect of rest on the prevention of preterm labor is currently a matter of controversy. However, it is true that many doctors still recommend restricting activity for pregnant women with any problems.

Useful tips for rest during pregnancy

To avoid muscle wasting caused by rest, it is advisable to make postural changes and gently move the legs and feet. It is possible that the doctor may recommend certain light movements that the pregnant woman can do, so it is advisable to ask about this.

On the other hand, it will be imperative that the pregnant woman on bed rest carefully monitors her diet. This will be critical to monitor caloric intake, as activity restriction can lead to excessive weight gain during pregnancy. However, it will also be important to incorporate fiber and adequate water intake to avoid constipation.

In addition, this period of rest can be especially hard psychologically for the pregnant woman. Women are limited in their activity, but they can also feel a great responsibility. Therefore, it is best to keep busy reading, watching TV, doing those things you previously never had time for (as long as they don't require effort), planning for the baby's arrival and keeping in touch with family and friends.

FAQs from users

What may be the reasons for complete bed rest in pregnancy?

By Marta Zermiani M.D., Ph.D. (gynecologist).

In most pregnancies it is possible to lead a normal life and even do moderate physical activity, but on some occasions it is necessary to recommend that the pregnant woman rest.

Among the reasons for which rest may be recommended during pregnancy are vaginal bleeding, the threat of premature delivery, intrauterine growth retardation, medical procedures, loss of amniotic fluid, preeclampsia and maternal illnesses.
Read more

What is considered relative rest in pregnancy?

By Marita Espejo Catena M.D., M.Sc., Ph.D. (gynecologist).

Pregnancy is a natural state in which a new being is generated, grows and matures inside a woman. Although physiological, gestation implies an overload for all the structures of a pregnant woman and, although the organism has an amazing capacity to adapt to this new situation, there are pathologies that may appear and with which the obstetrician may recommend some kind of physical rest.

Absolute rest is total rest, the absence of physical activity and implies bed rest.

Relative rest is not such a drastic measure, but it does imply a notable reduction in movement and effort. Although it is not an indication of absolute immobility, the pregnant woman should assume that everything that involves exertion should be avoided.

The duration in both cases can be variable and only under medical prescription can a normal daily life be resumed.

Are there better positions than others for absolute rest in pregnancy?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

In general, the specialist will recommend that the pregnant woman remain lying on her side for absolute rest. However, it is important to vary this position relatively frequently to avoid skin damage and irritation.

However, the pregnant woman can ask her specialist about this, as well as about some light exercises and movements she can do in bed to prevent muscle loss and the appearance of blood clots.

Can I do voluntary bed rest during pregnancy?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Some pregnant women may be tempted to voluntarily take complete rest during pregnancy because they are afraid that any activity they do may affect their pregnancy.

However, it is not necessary for the pregnant woman to restrict her activities in this way. Absolute rest has certain disadvantages and risks such as the appearance of blood clots and muscle atrophy, so it should not be done voluntarily.

In case of any doubt or concern, it is best for the pregnant woman to always consult a specialist.

Suggested for you

As we have mentioned, rest during pregnancy may be recommended by the specialist in the event of certain complications. You can learn more about some pregnancy complications in the following article: What are the most common pregnancy complications?

On the other hand, we have also mentioned that rest may be common in multiple pregnancies. For more information about the risks of this type of gestation, you can visit the following link: Risks of multiple pregnancy for mother and babies.

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References

Bitar G, Sciscione A. The Compliance of Prescribed Activity Restriction in Women at High Risk for Preterm Birth. Am J Perinatol. 2022 Jan;39(1):54-60. (See)

Care A, Nevitt SJ, Medley N, Donegan S, Good L, Hampson L, Tudur Smith C, Alfirevic Z. Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta-analysis. BMJ. 2022 Feb 15;376:e064547. (See)

Crowther CA, Han S. Hospitalisation and bed rest for multiple pregnancy. Cochrane Database Syst Rev. 2010 Jul 7;2010(7):CD000110. (See)

da Silva Lopes K, Takemoto Y, Ota E, Tanigaki S, Mori R. Bed rest with and without hospitalisation in multiple pregnancy for improving perinatal outcomes. Cochrane Database Syst Rev. 2017 Mar 6;3(3):CD012031. (See)

Lawrence ME, Carr L, Hart K, Whitaker KM. Perceived stress and support preferences during bed rest in twin pregnancies: A cross-sectional online survey. Midwifery. 2022 Jan;104:103189. (See)

Matenchuk B, Khurana R, Cai C, Boulé NG, Slater L, Davenport MH. Prenatal bed rest in developed and developing regions: a systematic review and meta-analysis. CMAJ Open. 2019 Jul 9;7(3):E435-E445. (See)

McCall CA, Grimes DA, Lyerly AD. "Therapeutic" bed rest in pregnancy: unethical and unsupported by data. Obstet Gynecol. 2013 Jun;121(6):1305-1308. (See)

Sosa CG, Althabe F, Belizán JM, Bergel E. Bed rest in singleton pregnancies for preventing preterm birth. Cochrane Database Syst Rev. 2015 Mar 30;2015(3):CD003581. (See)

Walsh CA. Maternal activity restriction to reduce preterm birth: Time to put this fallacy to bed. Aust N Z J Obstet Gynaecol. 2020 Oct;60(5):813-815. (See)

FAQs from users: 'What may be the reasons for complete bed rest in pregnancy?', 'What is considered relative rest in pregnancy?', 'Are there better positions than others for absolute rest in pregnancy?' and 'Can I do voluntary bed rest during pregnancy?'.

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Authors and contributors

 Laura Garrido
Laura Garrido
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Pablo de Olavide University (UPO) of Seville, Spain. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). Experience at IVF, andrology, and general analysis laboratories. Embryologist specialized in Assisted Reproduction. More information about Laura Garrido
 Marita Espejo Catena
Marita Espejo Catena
M.D., M.Sc., Ph.D.
Gynecologist
Graduated in Medicine and Surgery from the University of Valencia in 1992. Specialist in Gynaecology and Obstetrics. Doctor in Medicine from the University of Valencia in 2000. Master in Assisted Human Reproduction by the Rey Juan Carlos University and IVI in 2008. Currently, she is the director of Instituto FIVIR. More information about Marita Espejo Catena
License: 464616497
 Marta Zermiani
Marta Zermiani
M.D., Ph.D.
Gynecologist
Graduated in Medicine and Surgery from the Università degli Studi di Padova in Italy, specializing in Gynecology and Obstetrics at the Hospital Universitario de Bellvitge in Barcelona. Specialist in Assisted Reproduction with 4 years experience and currently a gynecologist at Clinica Tambre in Madrid. More information about Marta Zermiani
Licence number: 280847526
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV

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