Is bed rest necessary for Incompetent Cervix? My doc says no.

[wannabeamom]

My question: Is bed rest necessary for a shortened cervix??

I have a background of early miscarriages. This is my 7th pregnancy and I still have not had a child. I am now at 18 weeks for the first time ever and last week my doctor said my cervix is shortened to 2.3 cm. Again, I have never gotten this far along, so we have no idea what my cervix will do. I am going in for a cerclage this week and the nurse and doctor didn't say I would have to be put on bed rest. The nurse even said they don't prescribe bed rest unless I have funneling or dialation.

I am really concerned about this, because it is WAY TOO EARLY to deliver. I just got laid off last week also, so I am capable of being on bed rest if I have to. Everything I am reading online says I should probably be on bed rest.

Has anyone had success without bed rest? What have you heard about if and when you need bed rest for a shortened cervix? If you were put on bed rest for a shortened cervix was it strict bed rest or modified? I just want to do what's best for the baby.

Thank you!

P.S. Please only post relevant comments. Please only post if you have something to contribute. Thanks again. 

[sara]

Hi XX – I am so sorry for all that you have gone through and I am so glad you are getting a cerclage which should help.  I have not heard of anyone with a cerclage who was not put on bed rest for some period of time. From my personal experience, I had an emergency cerclage at 23 weeks and I will be on bed rest until I deliver, although it has been modified since I started. I am now 32 weeks. I am still not allowed to drive or go up and down stairs more than twice a day but at 28 weeks my doctor said I could go out to dinner once a week and now at 32 weeks I will start to work from home a couple of hours a day.

My doctors made it very clear that during those first couple of weeks you don’t want to put pressure on your cervix so laying down is best, only sitting up for meals, going to the bathroom and taking showers, etc. For me, it was uncomfortable to sit up more than an hour or so since I would get a lot of cramping. That has subsided which is why I am going to begin working from home.

I think every woman is different, but with my cerclage I couldn’t get a straight answer out of any of my doctors about bed rest or whether or not I’d be able to work until after the cerclage was put in and I was recovering in the hospital. My high risk doctor made it very clear that it was crucial to get to 28 weeks to increase the chance of the baby’s survival, so I took him seriously and am obeying all his restrictions. 

Every woman is different but it seems surprising that your doctor would say no to bed rest, especially with your history. Doesn’t seem to make sense. I would get a second opinion.

[wannabeamom]

Thank you so much Sara! This really helps!

[Lanespoli]

Hi Wannabeamom,

Congratulations on coming so far this time!  I always had a shortened cervix, it usually measured between 2.5 and 2.2.  The doctors did not seem concerned and did not recommend a cerciage or bedrest.  At 25 weeks I went in for my usual exam (I was going every 2 weeks for cervical checks) and my cervix shortened to 1.6.  They immediately put me on strict bedrest and said I would probably be there until the baby was born.  Strict meaning I could get up to pee, shower and make something quick to eat.  Also, laying horizontal as much as possible, and only driving to doctors appts.  It was also too late at that point to do a cerciage.  They also started me on progesterone weekly injections.  This is my 4th week of bedrest (feels like FOREVER) and when I went to my appointment this past week, my cervix was up to 2.6 which I was elated about!!  They said it could fluctuate, but if it stayed around 2.6 for the next 4 weeks, they would put me on "modified" bedrest at 32 weeks.  I am keeping my fingers crossed, but am not going to get my hopes up.  I can tell you that for me, it seems that the bedrest has definately helped.  I knew the weekend before they put me on that I was doing way too much.  I am a Beverage Supervisor at a casino and I am constantly running around on my feet.  I maybe sit for a total of 2 hours during my 9 hour shift.  I am convinced after seeing the results of my cervix gaining length being on bedrest that I was working too hard and wasn't taking it easy.

I am 41 years old with no children or prior pregnancies and was told last June that I could not conceive children.  They also said I probably wouldn't be able to carry a child to term as well b/c of 2 procedures I had years and years ago on my cervix for pre-canccer.  My cervix was short to begin with.  I like you, long to be a Mom and I am willing to do anything the doctors tell me to make that happen!  I agree with Sara, I would get a second opinion or take it upon myself to do my own bedrest.  I was not funnelling or dilating when they put me on bedrest at 25 weeks.  And even this week with it being up to 2.6, I begged my doctor to let me go out to dinner one night with my family and she said no, wait until 32 weeks as long as it stays at 2.6 or better.  Bedrest totally sucks, I will be honest with you.  I cry every week out of frustration that I can't do things for myself and I miss doing things like shopping, cleaning etc...., but after seeing the results, I will get through it as best I can.  My advice to you is if you have the time, I would definately do bedrest!! 

Good luck, keep us posted!

Lori

[wannabeamom]

Thank you Lori! I just went to the perinatologist today (1 week after my cerclage). My cervix has apparently improved, and has thickened to 3cm. The stitch looks great, and everything else is going really well! The doctor said I can resume all normal activities including exercise and sex. Just to be on the safe side, I will take it easy and look into non cervical weight bearing, gentle exercise.
From many of the forums I am reading, it looks like many women go on and off bed rest depending on their current cervical status. I have read cases of the cervix improving, and thinning out again. Back and forth...
 I would assume that if my cervix thins out again or goes below 2cm, I will have to change my activity level. I will keep you updated!

[wannabeamom]

I'd like to add a note. I spoke with my United Health Care nurse yesterday and she recommended a modified bed rest or decreased activity until the pregnancy is viable at 24 weeks. However, speaking to my friend who is a NICU nurse, she said that 24 weeks is too soon (statistics show 40% success rate and less than 2 pound birth weight.) The baby is much safer if I can limit my activities until 27 weeks, when the baby has an 80% chance of survival and higher birth weight. Then.. As the nurse suggested, I can see where my cervix is and possibly gradually introduce more activity such as grocery shopping.

Other women in my situation with modified bed rest have mentioned some of the following:
- No more than 15-30 minutes of standing at one time
- Limited stair climbing
- NO exercise
- Limited or no sex
- Limited chores. (For example.. 15 minutes of doing the dishes, then rest. No vacuuming or active chores)
- Keep feet elevated at least 2 hours in the day
- Showering and bathing is ok, just remember the standing rule. Rest after if you took a long shower. Put makeup on while sitting, and same with hair and teeth brushing if you can manage.
- Walking into stores only if you are parked close or hubby drops you off. Then sit down ASAP. Limited shopping.
- No pushing or pulling
- Lift weight up tp 5-10 pounds. No more.
- Swimming is controversial, but many doctors say it is ok. Private pools are best as they are cleaner.

I'm going to follow this regime until at least 27 weeks to be safe. There are a couple fitness DVD's online for working out in bed. One is called BedRest Fitness and one is called Yoga in bed. I'll see how these are, and sell my other prenatal workout DVD's.

[Lanespoli]

I would DEFINATELY do the modified bedrest plan as long as you possibly can.  Everytime I found myself wanting to do more, I just looked at all the youtube.com videos of preemie babies that were born at 27 weeks, then 28 weeks etc....and it definately gave me the strength every week to stay put and follow the rules.  The video's are soooo sad of the poor babies fighting to survive.  And even though they are viable and will survive, it is sad to see them hooked up to all the wires and be so fragile.  I would really like to be able to take my baby home with me instead of having to leave her in NICU.  I am 31 weeks this week, and I still watch the video's of the babies born the same week that I am at the present, and even the 31 week preemie's made me cry this week when I watched them .  I guess it's a good scare tactic for me to abide by my bedrest rules as long as I can for my baby.

I have United Health care as well, and have a nurse call me every 2 weeks to check on me, but so far most of my valuable information learned has been from this site and from other internet sites (and of course seeing the video's of actual preemies on youtube).

Good luck, I know you've had a long, difficult time with past pregnancies so do everything you possible can and extend your new goal by a week, each week you clear!!  Here's to making it to at least 30!!

[wannabeamom]

Good news! It's been 5 weeks since the cerclage and my cervix has gone from a length of 2.3 cm to 3.8! I'm still taking it easy, but since the improvement I have been walking more. I'm even able to walk the dog on a short stroll! my husband has to constantly remind me to take it easy, but with the low activity it seems to be helping!

[Angela]

wannabeamom: That is so wonderful to hear! A cerclage can be an amazing thing. That's great you're able to get some exercise to maintain your strength and muscle tone. Just remember to listen to your body, and never hesitate to call your OB if anything seems different or if you have any of these preterm labor symptoms: http://www.keepemcookin.com/symptoms.aspx

Thanks so much for the update! This is something to celebrate!!!
Angela

[wannabeamom]

So, here's an update. I am 34 weeks, and have been off of modified bed rest for about 6 weeks. My cerclage is still in. I started cramping (menstrual like cramps) at 30 weeks, and round ligament pain at 31 weeks, and now at 34 weeks my cervix is funneling to the stitch.

I'm scheduled to have my cerclage taken out June 28th (at 37 weeks), and we are hoping everything "holds" until then. I was not ordered back on bed rest even with the funneling cervix.

I'll let you know what happens!

[babyrom]

Your an inspiration!  To know that you had a short cervix and cerclage put in at 18 weeks and are now 34 weeks! Congrats!  I had a cerclage put in at 19 weeks and am now at 24 weeks on bedrest.  You give me hope that I can make it   All the best to you!

[lindyloo]

Thanks for all these great posts, I'm learning so much.  It is so incredibly hard to stay lying down so much and not 'just' get up to do this and that.  i'm hating all my muscle tone wasting away and the aches of lying on the left side so much.  I do find I start to get contractions when I've been up too much so will go and look on youtube to scare me into being more bed rest compliant!   (thanks lanespoli) Wannabemum it does sound like you should still be on bedrest to ensure you go as long as possible.  So awesome you've made it to 34 weeks though, v inspiring!  Well done

[BedrestPractitioner]

Hello Moms,

I invite you to read my article posted on KEC.  You may find it supportive during this time of bedrest and beyond. 

Thanks,

Nicole

The Feel-Good Energy of Aromatherapy in Pregnancy
http://wp.me/p1pmvo-H

[Alicia]

This is my reply from another post:
But first - bed rest has alot of implications - blood clots, loss of muscle and fintess (important when you are expectecd to bounce out of bed and alook after a new born). The arches of my feet collapsed last time and I had to hobble for months, making excersize to regain health very hard. That said, I have a very healthy baby from it (now 19 months) and a am ACTUALLY waiting for the next baby to arrive (37weeks now, stitch out).
So you can ALWAYS do rest at home yourself and ask family for help. You are doing amazingly well already! 18 weeks! yah!
Ask family and friends with help for a few meals and cleaning. Or sit down preparing meals.
Do online shopping.
Set up a comfy station at home with phones, TV, DVD's, laptop, craft, books, mags to KEEP in you in bed.
Get carried away with a project - a photobook of your wedding>
Do what you can, and in my opinion - the less the better!
 Good luck. It was hard being told to lay down to save baby, but I can imagine even harder when you haven't been!

OLD REPLY
I've been off bedrest for 3 days! yah.
After 15 weeks of strict bed rest in bed (22 weeks to 37 weeks).
Would have been in hospital but the hospitial here was too small.
I thought I would be off at 34 weeks, but the doctor said to keep doing it as it was working!
My cervix was 3.7cm at 18 weeks then 1.7cm at 21 weeks! and funnelled
Stitch in at 15 weeks and the cervic opened to stitch for the rest of the pregnancy and had flatten as well.
I guess this was the basis of the decision to keep bed rest (as 34 weeks is still very early).

Last pregnancy was emergency stitch at 20 weeks (cervix 9mm and funnelled) and strict  bedrest is hospital for 8 weeks.
Then modified bed rest at home (rest when I could).
Waters broke at 34+5 weeks.

Before that waters broke at 20 weeks and he didn't live.

Which makes me throughly believe in bed rest.
This is your one and only chnace for garanutee your babies health.