bed rest

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Check Out ‘The Checkup’: Our New Health Podcast On Slate

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Beginning today, we’re launching a new podcast called The Checkup, a partnership between WBUR and Slate. (We wanted to call it Goldberg and Zimmerman, but they told us it sounded like an accounting firm.) We’re thrilled to announce that for the next six weeks, Slate will be posting it weekly among its extremely popular “Gabfests” and other ear fodder. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download and to get it through iTunes click here. )

The Checkup

Regular CommonHealth readers will be familiar with our blend of solidly reported, somewhat opinionated health-related news you can use (at least we think you can use it, since we can and have). Each segment will focus on a different topic — from sex problems and students’ mental health as they head back to school, to fitness snake oil and vaccine controversies.

Our first episode is “Three Myths of Pregnancy and Childbirth,” a subject near to our motherly hearts. It features interesting, relevant new research on bed rest during pregnancy, labor pain and cutting the baby’s umbilical cord, including information you may not read much about in the best-selling pregnancy bible “What To Expect When You’re Expecting.”

So download the podcast, produced by WBUR’s wizardly sound engineer George Hicks, give it a listen and let us know what you think.

Is It ‘Unethical’ To Prescribe Bed Rest For Pregnant Women?

(cscott2006/flickr)

(cscott2006/flickr)

It seems so intuitively right. You’re facing the risk of delivering your baby early and the doctor prescribes bed rest. What could be more cozy and safe? Why wouldn’t you endure a little extra annoyance (you’re pregnant, after all) if it would help keep your tiny, oh-so-vulnerable fetus floating inside the fortress of your womb as long as possible? Even the words “bed” and “rest” feel so inherently soothing and therapeutic.

Think again.

Bed rest, a growing body of research suggests, may be bad for you.  And for physicians to blithely prescribe it is, in a word, “unethical,” argue a trio of doctors from the University of North Carolina School of Medicine.

In a paper called “‘Therapeutic’ Bed Rest in Pregnancy: Unethical and Unsupported by Data” recently published in the journal Obstetrics and Gynecology, Dr. Christina A. McCall and her colleagues make a powerful case against the practice many perceive as cuddly and innocuous.

They cite the medical paradox in which bed rest remains widely used despite no evidence of benefits and, on the contrary, “known harms.” They further suggest that in its current form, strict bed rest should either be discontinued or else viewed as a “risky and unproven intervention” requiring rigorous testing through formal clinical trials.

“If we have anything to learn from the history of medicine it is that instincts and good intentions are a highly fallible compass without the check of scientific controls.”

In an email exchange, Dr. McCall clarifies that she is talking about strict bed rest here and adds:

“If a woman feels that increasing her daily rest lessens anxiety or improves symptoms (whatever they may be), then we are not suggesting this should be discontinued. We are merely suggesting that every woman receive INFORMED CONSENT regarding the literature on bed rest and the autonomy to make her own decision.”

Research suggests that the potential harms for women on bed rest (a broad term that can include everything from total inactivity to limits on strenuous endeavors like household chores, exercise and sex) can be significant. They range from potentially dangerous blood clots and bone demineralization to muscle and weight loss, financial harship due to restrictions on working and a range of psychological suffering, notably depression. Continue reading