Seven months into pregnancy, Mrs Susan Akuekwe was placed on a one-month bed rest by her doctor following several complaints of fatigue.
Two months later, the 35-year-old civil servant delivered of her third child, a baby boy.
Few weeks later, Akuekwe’s colleague and 26-year-old Mrs Funke Alabi, had to go on bed rest based also on her doctor’s recommendation.
Observers are worried that bed rest was becoming common for pregnant women, as treatment for pregnancy-related issues.
But Dr Joseph Olamijulo, a consultant obstetrician and gynaecologist at the Lagos University Teaching Hospital, said that bed rest was not needed by all pregnant women except those that faced challenges.
“Pregnancy is not an ailment; therefore, bed rest is not recommended just because a woman is pregnant.
“Under normal conditions, pregnant women are required to be active during pregnancy.
However, they are not to be exposed to very strenuous activities that will become a risk to themselves and the foetus.
“Before a doctor can recommend bed rest for a woman, he would have established that the woman and the foetus are at risk and need to be off strain and pressure,’’ he said.
Olamijulo explained that a normal pregnancy lasts for about 40 weeks, and grouped into three trimesters.
“By the end of 37 weeks, a baby is considered full term; and its organs ready to function on their own.
“The first trimester is usually characterised by extreme tiredness, tender and swollen breasts, with some people experiencing morning sickness or vomiting.
“During this period, crave for certain foods also start. The woman have mood swings, constipation, frequent passing of urine, headaches and other physical body changes.
“Fortunately, most of these discomforts will go away as the pregnancy progresses,’’ he said.
Olamijulo said that the second trimester is between week 13 and week 28, adding that it was the period most pregnant women find easier than the first.
“Most women find this trimester easier than the first. The symptoms that one experiences during the first trimester begin to ease off.
“However, other bodily changes begin to manifest, including aches, stretch marks on the abdomen, breasts, thighs or buttocks, and darkening of the skin around the nipples, as well as itching on the abdomen, palm and soles,’’ he said.
Olamijulo said that the third trimester, between week 29 and week 40, “features some discomfort’’.
According to him, breathing becomes more difficult for most women because their babies get bigger and put more pressure on the organs.
“As the due date draws closer, the cervix becomes thinner and softer. This is a natural process that helps the birth canal, the vagina, to open during birthing process.
“These symptoms, however, may differ from woman to woman and from pregnancy to pregnancy. Depending on complications, if any, a doctor may recommend bed rest,’’ Olamijulo explained.
Another obstetrician and gynaecologist, Dr Peter Akanwa, said that bed rest should be recommended only when the pregnancy was threatened.
“Most times, pregnant women are advised to take bed rest if they have an increased possibility of delivering too early or have placenta complications.
“Other reasons that call for bed rest include vaginal bleeding, a history of pregnancy loss, and stillbirth and premature birth, and poor foetal development.
“Medical conditions such as high blood pressure, weak cervix, premature rupturing of the membrane, gestational diabetes and some heart diseases can also cause doctors to recommend a time off from one’s regular routine and bed rest,’’ he said.
He stressed that bed rest was not a proven remedy for preventing numerous complications that may develop before and during birth.
According to him, there are divergent views in the medical field on the need for and effectiveness of bed rest for pregnant women.
“For example, researchers at the American Congress of Obstetricians and Gynecologists have discovered that lying down helps to reduce strains resulting from work, activity, exercise and others.
“It helps to reduce stress on the mother’s vital organs such as the cervix, heart and kidneys, and reduces pressure of the baby on the cervix, which in turn decreases the risk of having premature contractions,’’ Akanwa said.
According to him, the study shows that rest also increases blood flow to the placenta, thereby allowing the baby to get more required oxygen and nutrients.
Conversely, doctors at the University of North Carolina School Of Medicine, led by Dr Christina McCall, suggest that lengthy bed rest should not be recommended for pregnant women.
According to them, it does not decrease incidences of having preterm babies or miscarriages, but can even cause harm.
Dr Maymunah Kadiri, a consultant psychiatrist and founder, Pinnacle Medical Services, Ikoyi, Lagos, said many factors make recommendation of bed rest necessary.
“The typical modern woman works hard to keep family and career together. The challenges she faces everyday cannot be compared to those of the times past or those of people in rural areas.
“She wakes up very early and rushes to work; she is faced with gridlocks, unwanted noise and environmental pollution.
“When she gets to work, she is also under pressure to meet certain targets, under rigorous conditions.
“All these, including hormonal changes, anxiety, trauma, emotional stress and more, have detrimental effects on the psychological and physiological health of the pregnant woman and subsequently on the baby,’’ Kadiri said.
For a clinical dietician, Dr Jane Eleodi, poor diet contributes to pregnancy-related complications that can lead to recommendation of bed rest.
“Poor nutrition can result in pregnancy-induced hypertension, gestational diabetes, constipation and others. These can pose risks to the mother and baby.
“ Good nutrition is very essential; before, during and after pregnancy. It goes a long way to determine the physical and mental state of both mother and baby.
“There are no restrictions on what a pregnant woman should eat, except if she reacts to something.
“But it is mandatory that her meal contains all the classes of food – protein, carbohydrates, fats and oil as well as sufficient micro nutrients such as Folic Acid, Vitamin A and B Complex,’’ she said.
Eleodi advised pregnant women to engage in mild exercises and avoid sitting at a place for too long to avoid muscle cramps.
Though bed rest has its own advantages, doctors want pregnant women who are at risk to limit their rate of physical activities instead of resorting to bed rest. (NANFeatures)
**If used, please credit the writer as well as News Agency of Nigeria (NAN)
