Ninety percent of the time, women have perfectly normal labors when delivering their children. For one reason or another, some women do experience difficulty and must therefore remain in bed through their entire labor in order to ensure adequate oxygen for their baby, to control their blood pressure, or other medical reasons. For women who use an epidural or a similar type of pain medication, they also must spend their labor in bed. Continuous use of the electronic fetal monitor (EFM) and hospital custom are the other reasons why a woman might be restricted to bed during labor.
Many women, especially those who are trying not to use pain medications, may feel overly restless and uncomfortable being restricted to bed. Being upright is what comes naturally to most women, since the use of gravity assists in birthing. When she is forced to lie down, the urge to get up can become overwhelming to some women.
In addition, being restricted to bed can cause labor to slow down, increase the pain of contractions, effect the baby’s heart rate, and inhibit the natural urge to push. So what can you do if you find yourself being told to lie down and you don’t want to? First, ask why. If there is no medical reason for you to lie down, you may be able to persuade your caregiver into letting you get up. Remember that as a patient, you have the right to informed consent, as well as to informed refusal.
The second thing you should ask, if your told there is a medical reason to stay in bed, is how strict the bed rest is. You may need to stay lying on your left side, or you may be allowed periodic breaks to get up to use the bathroom. For some, the restriction may be as loose as allowing them to sit up in bed, change positions in bed, or even sit or stand near the bed.
You can also ask if there is alternative option. For instance, if you are told you need to stay in bed so that your baby’s heart rate can be monitored, ask if you can use the telemetry unit (an EFM on a wheeled IV pole). That way, you can walk to the bathroom or even around the halls. Even if you are connected to many machines and wires, you may be able to stand, or sit in a rocking chair beside the bed.
Once you know why you must labor in bed, and how strict the orders are, you will be able to handle this challenge better if you focus on what you are allowed to do, and not on what you can’t do. Depending on the strictness of the orders, here are some options that you still have for coping with pain or restlessness: relaxation and attention-focusing, visualization, patterned breathing, spontaneous rituals (like counting breaths, timing contractions, speaking mantras, or using particular massage techniques), counter pressure, massage, acupressure, use of heat and cold packs or wash cloths, and Transcutaneous Electrical Nerve Stimulation (TENS unit).
There are also multiple positions you can use while restricted to bed, but these will vary depending on your situation. Some common positions are: side-lying, semi-sitting, sitting cross-legged, on all-fours, kneeling and leaning forward onto the back of the bed, onto an exercise ball or some pillows, standing and leaning onto the bed, sitting on an exercise ball beside the bed, using the bed’s squatting bar, the open knee-chest position, or sitting in a rocking chair beside the bed. If you are uncomfortable with one position, ask your partner or nurse to help you find a better one.
Having a doula can be especially helpful if you are restricted to bed, because she can help to focus you on relaxing, and can help you to change positions. For more information, read “The Birth Partner” by Penny Simpkin.
Remaining in bed throughout labor can be stressful for both you and your partner, but you will be able to cope better if you know that your sacrifice will be beneficial to the health of your baby and yourself, when you know what pain-coping techniques are still available, and by making sure that you have good labor support.
Resources:
“The Birth Partner” by Penny Simpkin
