BED REST CHECKLIST: WHAT IS BED REST

BED REST CHECKLIST: WHAT IS BED REST?

The term bed rest is a familiar one to mothers experiencing high-risk pregnancies, but they are often confused about the exact parameters of their limitations. Variabilities depend on each mother, the extent of her complications, and even on the physician. This chart has been developed in an attempt to help mothers and their doctors mutually define needs in specific situations. Since variables change during each individual pregnancy, you may wish to make several copies of this chart, to be completed at various stages of your pregnancy.

	Date		Date
WHAT CAN I DO RIGHT NOW?
Activity Level Maintain a normal activity level Slightly decrease activity level Greatly decrease activity level		Driving May drive a car May be a passenger in a car (frequency) May not ride in a car, except to doctor Why:
Working Outside the Home Maintain my full-time job Work part-time (how many hours?) Work in my home (how many hours?) Stop work completely Why:		Bathroom Privileges May use bathroom normally Should actively avoid constipation May not use bathroom (use bedpan) Why:
Working Inside the Home Continue doing all housework Decrease housework including: Heavy lifting (laundry, moving furniture, etc.) Preparing meals (standing on feet for a prolonged period of time) Vigorous scrubbing Other: Why:		Sexual Relations May continue normal sexual relations Should limit relations (maximum times a month?) Should avoid sexual intercourse Should avoid all types of relations which stimulate female orgasm Should abstain from sexual relations Why:
Child Care Care for other children as usual No lifting children Having another caretaker watch an active toddler Have permanent caretaker for children Why:		Maintenance of Pregnancy Should monitor fetal activity ____ hours each day by hand, counting movements Should drink wine each day (When? How much?) Should stop smoking cigarettes Should abstain from alcohol Should limit cigarette smoking (no. per day?) Should monitor fetus by uterine home monitoring Should take (drug) times daily, dosage: Reason: Should take (drug) times daily, dosage: Reason: Should follow these dietary rules: Plenty of: Protein, vegetables, fruits, calcium, other: Avoid: Excess salt, excess fats, junk food, spicy foods other: Approximate number of calories a day:
Mobility Continue normal mobility Limit mobility (sit down frequently) Lie down each day (how many hours?) Recline all day (propped up) Lie down flat all day (on side) May walk stairs (how many times a day?) Stairs forbidden Take a shower/wash hair Eat lying down? Sitting up? Sitting at table? Why:

WHAT MIGHT I EXPECT IN THE FUTURE?
Decrease in Activity Level Limitation at Work Stop working completely Decrease Housework Need for children helper Need to recline in bed Need to stay in bed (total bed rest) Limit driving Stop driving Limit sexual relations Abstain from sexual relations Need to self-monitor fetal activity Need to use uterine home monitoring Need to take labor-inhibiting drugs Need to have a cervical stitch put in Need to stay in hospital for some period of time Need to have amniocentesis Need to have sonograms/ultrasounds Need to visit OB/GYN more frequently than normal Need to visit a High-Risk specialist Need to have alpha-fetal protein levels done Need to have blood sugar screening Need to have a nonstress test Need to have a stress test		4. Personal Hygiene Can I take a shower? Can I take a bath? Do I have to take a bed sponge bath? Can I get out of bed to wash my hair? 5. Mobility Can I walk the halls? Can I walk in my room? Can I sit in the chair in my room? Can I take a wheelchair to the lobby? Can I take a wheelchair to the nursery? Can I take a wheelchair to hospital support group meetings? (If applicable) 6. Visitors When can my husband visit? (If you do not have a husband:) Can I have another friend or relative visit at the times husbands are normally permitted to visit? Who can visit? When? How many people can visit at a time? If I am admitted to the labor room, who can visit? Who can be present in the delivery room?
IF PROBLEMS ARISE AND I GO INTO PREMATURE LABOR . . .		7. Consults
When should I contact my OB/GYN? Where will I be hospitalized? Where might I be transferred? Name of OB/GYN at other hospital? Where would my baby be hospitalized? Could my husband be present at delivery? 7. Is there a possibility of a cesarean?		If appropriate, may I see: a physical therapist an occupational therapist a neonatologist (about fetal development and/or a typical preemie) a social worker an ophthalmologist a dermatologist 8. Other Directions
HOSPITAL BED REST
1. What position do I have to be in? Trendelenburg (head lowered) On side (left or right?) 2. Do I have to use a bedpan? 3. Can I reach for things, or should I use a reacher?		This chart was developed by a former parent support group, Intensive Caring Unlimited for Philadelphia/Southern New Jersey area. Copies may be made without permission.

This page last updated 11/05/04.