*NOTE: Be sure to check with your OB or midwife before starting any exercise program post partum!

It’s a call (or e-mail) that I’ve come to know well. A former mama on bed rest has delivered and immediately throws herself full throttle into caring for her home and baby. Some mamas have even gone back to work full time within the six week window of post partum recuperation. They ignore (or are unaware of the fact) that their bodies have undergone a major transformation; not only have they developed and given birth to new human being, they have also been deconditioned in the process by being on bed rest.

What many women don’t know and what most obstetricians don’t tell women who have been on bed rest is that their bodies have undergone fundamental changes-changes in addition to their pregnancies. According to Judith Maloni, PhD,

Bed rest for as little as 14 days results in:

• Muscle loss
• Bone loss
• Wt loss (and this can become problematic if the baby doesn’t gain weight as expected)
• Fatigue
• Headaches
• Backaches
• Depression
• Shortness of breath
• Lower Extremity Swelling/circulatory changes

Women, unaware of these physiologic changes who try to resume their pre-pregnancy levels of activity are at increased risk of injury. Many women in the early post partum have sustained back strains, perineal tears, hemorrhoids or hernias.

So what is the safest way to ease back into life after bed rest?

Begin Slowly. As previously stated, significant bone and muscle loss can result in as little as 14 days in addition to circulation and respiratory changes. If you have been on very strict bed rest for more than 60 days, chances are you are quite deconditioned and are at increased risk of injury if you push yourself. If at all possible, do very little in those initial post partum days. Simply walking around your hospital room or home will be sufficient. Your task now is to nurse and bond with your baby and gradually increase your strength.

Get Help. The United States is one of a very few countries that provides no support for new mamas and families. In Asian culture for example, the first 40 days post partum are considered sacred and called “The Golden Month”. Women from the community come and care for mama and her family so that mama does nothing but recuperate for an entire month after pregnancy, labor and delivery. Many countries provide nursing visits to new mamas and families to ensure that mama is recovering well, that breastfeeding is becoming well established and that the family is transitioning well. The fact that the US also has no universal paid family leave is another reason that many mamas rush back to work. But taking on too much too soon often does more harm than good, so if at all possible, get help.

Sleep. This may seem like a no-brainer, but many new mamas become sleep deprived early in post partum trying to recuperate, establish breastfeeding and resume tending to their family’s needs. Again, in the early post partum, it is imperative that mama get enough rest to allow her body to heal from pregnancy, labor and delivery and then establish healthy milk production and breastfeeding, then re-establish her health and strength to regain her baseline level of health. Get help with home chores and activities so that you can rest and regain your strength.

Nutrition. Many mamas tell me that they barely have time to eat during the day and find themselves grabbing meals on the go. This can lead to “mal” nutrition, i.e. eating lots of fast and/or processed foods which we know are often laden with fats, sugar and empty calories. Preparing meals can be difficult during this time. Again, get help. See  if a family member, neighbor or friend can help with grocery shopping and food preparation, preparing individual portions and readily (quickly) heated foods will help mama eat well and nourish her body back to health.

Exercise. One of the most common requests I get from mamas is “How do I get back into exercise?“  Mamas feel that since they’ve been “lying around” they need to get back to physical activity as soon as possible. Additionally, many mamas wish to regain their pre-pregnancy weight quickly. First and foremost, I remind mamas that it took 9 months for their bodies to grow and develop their babies, so they should allow at least 9 months to regain their pre-pregnancy bodies. Also, just as you wouldn’t start an obese person on marathon training, as a new mama coming off of bed rest, you too must start slowly. Walking Gets Mama into Shape After Bed Rest and 5 Tips to Enhance your Post Bedrest Post Partum Workout provide great information to get you started.

These 5 tips will surely get you started, but for more detailed or customized help, take advantage of our coaching programs. You can also ask questions at info@mamasonbedrest.com.

At the top of the list is Norway, which has one of the highest rates of contraceptive use in the world and one of the most generous maternity-leave policies among developed nations. Women in Norway are highly educated and well represented in government. The country also boasts the highest female-to-male income ratio and is tied for the second-lowest under-5 mortality rate among developed countries.

• Infant/Child Mortality. Many countries have staggering infant and child mortality rates. In Niger for example,virtually every mother will lose a child before the age of 5. This is primarily due to malnutrition and lack of health care resources. Unfortunately, children in the poorest countries will die from some of the most easily treatable diseases because they are malnourished and lack access to health care when they do in fact become ill.

• Maternal Mortality. Many mothers worldwide are dying in childbirth or as a result of complications from childbirth. In the United States, One in 2,100 births result in the death of the mother which is a shocking statistic given the resources in this country. However, despite our vast resources, many women and children live in poverty in the United States and poverty is a strong indicator of mortality in both mothers and babies worldwide. In the US, the big gap in health care that’s available for well-off women vs. very poor women is the driving force behind the maternal (and infant) mortality numbers.

• Economic Empowerment. It’s a known fact, when women can earn a living wage, they fare better and so do their children. In countries where women are able to earn a substantial income-nearly equal to that of a man, her health goes up and her mortality (risk of early death) goes down.

• Education of Women and Girls. It stands to reason that if women aren’t educated, they cannot attain high paying jobs, cannot earn a living wage and cannot support themselves and their children. It’s a vicious cycle. In countries like Norway where women are highly educated, we see women economically secure and thriving. In countries like Mali, Afghanistan and Niger, where education of women and girls is scanty at best, we see a high rate of maternal and infant mortality and and those women and children that are “surviving” are living in abject poverty. Ms. Miles added,

“The longer you keep girls in school, the longer they delay having their first child. And that child will be much healthier. A girl who has a baby at 14 is a much higher risk pregnancy, and her baby is at much higher risk of death, than a girl who gets pregnant at 17 or 18.  If she stays in school, it’s much more likely she’ll she’s going to wait until she’s older. That’s why education of girls is so important.”

• Political Involvement. In countries where women are allowed to be involved in the setting of political and social policies, women are doing much better. No surprise. When you have no representation, you have no voice and no way of making your needs known.

• Access to HealthCare. When women have readily accessible access to health care, their health and the health of their children is markedly improved. According to Ms. Miles, one of the reasons that Afghanistan was able to move from 165th to 164th is because of a surge in community health clinics.  “And a lot of these health centers are in the places where moms and babies do die, kind of at the end of the health system, if you will, at the end of the road, really remote areas where these moms are oftentimes giving birth at home. So, having a health clinic close at hand really saves lives.”

• Maternity Leave. We also know that when women are allowed time off to give birth, recuperate from that birth and spend time with their babies bonding and breast feeding, both mothers and babies do well. One of the reasons that the United States ranked 25th in the Save the Children report is because of it’s poor maternity leave policy.”The report also notes that the U.S. has one of the least generous maternity leave policies of any wealthy nation. It is the only developed country — and one of only a handful of countries worldwide — that does not guarantee paid leave for working moms. Instead, by law, new mothers get 12 weeks of unpaid leave.”

We now know what it takes to make mamas and babies healthy. Now its time to implement these practices globally. It’s being done very successfully in many countries and very poorly in many more. Let’s hope that this new knowledge will bring forth improved standards of living and care for women and babies.

Share your thoughts in the comments section below!

As it happens, after interviewing Carla she mentioned another great resource called Workoptions.com. (Click here to visit WorkOptions) Founded by Pat Katepoo, work options advisor and work-life consultant, Pat has crafted 4 proposal packages that show folks step by step how to create the work situations they desire. The 4 proposal packages are:

1. Telecommuting
2. Part Time
3. Compressed Work Week
4. Job Sharing.

If you are interested in any of these work situations, you simply purchase the proposal templates and fill them in with your information. Pat also offers coaching and help with preparation of the proposals.

The WorkOptions website has a plethora of information on how to propose an alternative work schedule or environment and even coaching around getting up the nerve to approach your boss. It really is a comprehensive website! But what is probably most relevant to Mamas on Bedrest is Pat’s article entitled “Five Ways to Return to Work After Maternity Leave”. In this article Pat shares the 5 most common ways mamas choose to work once they have children and she then offers information and materials to get started on each path. Pat also has a website specifically for new mamas called Maternity Leave Mentor. Sheer genius!!

Mamas, I highly recommend that you take a look at the WorkOptions available to you and seek out Pat’s expert advice if you have questions regarding your situation. In today’s economy, most of us have to work, but as the saying goes, work smarter not harder. Pat Katepoo and her WorkOptions show you how! Click here to visit WorkOptions.

Before bed rest, my husband and I were almost always “on.” Between networking events and political fundraisers and 14 kinds of tweetups every night, we were rarely home. Social media is my profession and my passion, and it’s pretty impossible to turn yourself off when you love what you’re doing. I knew we’d have to slow down for the baby, but never expected to have to come to a screeching halt. I thought I’d learn to appreciate the forced slow down and make the most of the time to reflect on my priorities, consider new strategies at work, and maybe even learn to knit. I had high hopes that I would handle bed rest with dignity and grace. Not exactly.

My husband prepared a day’s worth of healthy meals in a cooler and left it by the sofa for me every day. One day he forgot to pack a fork for me, and I tiraded for an hour. I would scream obscenities at the FedEx delivery driver who insisted on ringing the doorbell multiple times before dropping the package on the porch. I threw things at the TV when I’d see pregnant women in cute maternity workout clothes. I cried every single day.

But I did it. I stayed flat all the time, sitting up only to eat and walking only to the bathroom. And I checked in with other bed rest mamas online, cheering them on, letting their support carry me when I needed a boost. I reminded myself how lucky I was to have a job that restructured my duties so I could still work full time, to have a husband who learned to make incredible salads so I could keep eating healthy, and to stay pregnant week after week.

At 23 weeks, I went on bed rest. At 26 weeks my cervix hovered around 1.9 and stayed there until 32 weeks, when I was allowed to get up. I was weak, my belly was huge, but I was walking again and my baby was incredibly active and healthy. At 37 weeks, my water broke and Eli arrived at 7 pounds, 8 ounces, and happy, healthy, and strong. Now he’s almost 6 months old and I can’t believe how lucky we are to have such an easy going baby, and such a fun, amazing person in our lives.

Most people associate physical feats of the human body with activity, but bed rest is amazing, too. It’s an incredible sacrifice to make for someone you haven’t even met, and it is ridiculously difficult. But it’s survivable, and ultimately the most rewarding thing I’ve ever done.

Sometimes mamas on bed rest feel a bit apprehensive about celebrating Mother’s Day. What if something happens and the outcome isn’t good? I had a friend for whom this was an issue. She had 2 miscarriages prior to becoming pregnant with her now oldest child. Her family refrained from throwing her a baby shower until she was ready to deliver to “make sure this was going to really happen this time.” I was appalled at their lack of sensitivity. A mama is a mama and even for those little souls that didn’t make it, my friend was and is their mama.

But enough negativity. You are a mama! It doesn’t matter if you are on bed rest. It doesn’t matter if this is your first or 5th pregnancy. If you have a baby in your belly you are a mama!

In your honor, I am happy to highlight some of the fabulous mama made products here on Mamas on Bedrest & Beyond’s website, some mama friendly websites and mama friendly services. If you know and love a mama on bed rest, consider pampering her with one of these fantastic mama friendly items or services. You’ll not only make your mama’s day, but you’ll also be supporting other mamas as well!

Gifts

Hot Mama Gowns

Hot Mama Gowns are the “baby” of “Hot Mama” Deidrea. After the birth of her daughter in 2006, she was less than thrilled with the standard hospital garb. Determined to create gowns that would not only make mamas feel “hot”, but would also be extremely comfortable and sensible, Deidrea created “Hot Mama Gowns”. Created out of 100% cotton, all the gowns come in beautiful colors and prints, allow easy access for breastfeeding and most of all are really lovely! Click here if  you’d like to purchase a “Hot Mama Gown” for the Hot Mama in your life!

The Shower Hug

This is the one item that I wish I had had when I was pregnant and nursing my babies!! We mamas all know what it’s like when our breasts feel too heavy for our chests and we know how  a warm soothing shower can start our milk flowing. The Shower Hug is a soft Terry Cotton wrap that mamas can wear over their breasts for added support and comfort. If you are just lounging, the Shower Hug provides support and comfort. In the shower, if you do happen to have milk letdown, the shower hug provides added comfort. They come in a wide variety of sized. Click here to purchase and learn more.

Maternity Boutiques

Maternitque

This mama owned website provides natural pregnancy, maternity and baby products. They have everything from belly balms to belly supports, nursing tops and baby items and accessories. Tara, the owner has done a wonderful job assembling fine products, so if you are looking for something for a mama or mama to be, please consider purchasing from a mama!

Bedrest Butler

This is a new online boutique owned and operated by Mom and daughter duo Pamela Marie and Kelly. After Kelly spent 63 days on hospital bed rest with twins, she knew first hand how invaluable the love, support and gifts from family and friends were. To that end, Kelly and her mama Pamela Marie have created a wonderful online shop with a variety of wonderful gifts for mamas on bed rest.

Services

Massages

Massages are an invaluable gift for any mama or mama to be-on bed rest or not! But for mamas on bed rest in particular, because they are not up and about, it’s important to maintain their circulation, lymph drainage and muscle stimulation. A full body massage from an experienced prenatal massage therapist can stimulate circulation and lymph drainage reducing venous stasis and edema (pooling of blood in the feet and lower legs and swelling in common lingo!), stimulate muscles, reduce aches and pains of pregnancy and ease tension and stress. Check your local listings for massage therapists in your areas. Many are portable and willing to do home visits!

Mani/Pedi

When I was setting up this business, one thing that I wanted to be able to provide to Mamas here in Austin is in home Mani/pedis. However, I learned that because of issues of hygiene and sanitation, at least here in Texas, cosmetologists are not able to provide in home Mani/pedis. But those rules don’t hold true for friends! If you have a friend of family member who is on bed rest, offer to do her nails for her! Go to her house, soak her hands and feet, gently rub them with fragrant lotions and paint her nails for her. I guarantee that you’ll both have a wonderful time and you will have provided your friend with an invaluable experience of loving kindness.

As I pondered how I would like to go about increasing support to mamas on bed rest, I had the awesome opportunity to attend the second annual spring reception for one of my favorite non-profit organizations, Hand to Hold. The mission of Hand to Hold is,

To provide comprehensive navigation resources and support programs to parents of preemies, babies born with special health care needs and those who have experienced a loss due to these or other complications.

I am a HUGE fan of this organization, as it steps in and provides the support and resources necessary for parents of preemies. I first became involved when I interviewed the founder and executive director Kelli Kelley for an article that I was writing back in 2005. She shared with me then,

I don’t want another mother to go through the pain, isolation, frustration and desperation that I felt when I had my son. (born at 24 weeks and who spent 4 months in the NICU).

Since that day some 7 years ago, Kelli has been on a mission, garnering support and forging ahead with programs and services for parents of preemies.

We have often talked about collaborating to bring much needed services to mamas on bed rest. The time has come. As I looked in awe and admiration at what Kelli has created, I realized that similar programs and services need to be in place for mamas on bed rest. So here we go ladies!

But I want to hear from you. I need your stories and experiences so that I can craft the most perfect and most suitable programs and services for Mamas on Bedrest. When you were on bed rest, what did you most desire? What did you wish you had known? What would you have liked from your health care providers? What did you need when your bed rest journey was over? Share it all and leave no little detail undisclosed. The only way that we can craft the perfect program for mamas on bed rest is to have the crucial input from Mamas on Bedrest. So please share your stories with me. Help me to help other mamas not suffer the isolation, fear and depression that is so prevalent with the bed rest experience. Kelli Kelley has made a HUGE impact in how parents of preemies experience the birth and subsequent lives of their children and we can do the same for Mamas on Bedrest. But it’s going to take your input. Share your experiences in the comments section below and thanks so much for helping me to realize my vision of easing the burden of bed rest.

I have really mixed feelings about cesarean sections. Having had 2 cesarean deliveries and knowing that at least in the case of my first one, it pretty much saved my life and the life of my daughter, I can’t be entirely “anti-cesarean section”. But in the United States thousands of women have cesarean sections for bogus reasons and that is what this movement and month of awareness is really all about.

So what are the facts about cesarean sections?

• Cesarean deliveries are one of the most commonly performed surgeries in all of medicine. The other most commonly performed surgery is a hysterectomy.
• Cesarean deliveries currently account for some 32% of all deliveries in the United States annually.
• Originally, Cesarean deliveries were intended to birth a fetus when the mother was dead or dying. It has since evolved to be indicated for “large babies”, uterine/placental/vaginal issues, fetal distress or shoulder dystocia
• According to MedScape, The leading indications for cesarean delivery are previous cesarean delivery, breech presentation, dystocia, and fetal distress. These indications are responsible for 85% of all cesarean deliveries.

I think that most of us would agree that in a healthy mother and baby, a vaginal birth is the way to go. However, in an effort to “control the situation and avoid complications” or to “avoid the pain” or “avoid going into labor at an inconvenient time”, mothers and doctors often schedule a cesarean section “to be on the safe side”. This is the impetus behind the International Cesarean Awareness Network (ICAN) and its supporters.  ICAN and other organizations hope to raise awareness amongst women that cesarean sections are to be the exception to vaginal birth when it is unsafe for mother and baby to undergo vaginal delivery. And while most of us agree with that statement, thousands upon thousands of women often mistakenly believe that delivering vaginally will be unsafe or them and their babies and opt for the cesarean delivery.

Probably the most common reason for cesarean birth is repeat cesarean delivery. There used to be a saying, “Once a cesarean always a cesarean.” Thankfully this is no longer the case. Because of the risks associated with cesarean sections, more and more practitioners are beginning to look at VBAC (vaginal birth after cesarean section) as an option. One has to understand, a cesarean delivery involves cutting the abdominal and uterine walls, creating defects or weaknesses at the sites of the cuts and places for scar tissue to develop. The greatest concern is that in a VBAC, these areas won’t hold and the uterus will rupture causing hemorrhage and risking the lives of both mother and fetus. However, data is showing that this risk of uterine rupture is not as great as previously thought and that women who have repeat cesarean sectioins are at even greater risks. Additionally, in very healthy women having uncomplicated pregnancies and birthing with a skilled practitioner, VBAC’s are quite safe.

Another common reason for cesarean delivery is “large baby”. This is probably the most disputed reason for cesarean delivery and the most controversial. Who hasn’t heard stories of the 5 foot woman delivering an 11lb baby vaginally, or the 5ft 10 inch woman who had difficulty delivering a 5lb baby and required a cesarean section? Size of the baby is rarely the issue, but more aptly the position of the baby in the pelvis, the shape of a mama’s pelvis and how well mama and baby are faring during the delivery process.

Cesarean sections are also more common during labor inductions.  When labor is allowed to start and proceed spontaneously, babies have time to adapt and progress along the birth canal. Normal birth proponents continually state that when a baby is not ready to be born and labor is induced, the baby is rarely in the correct position in the birth canal, the baby often becomes distressed as a result of the uterine contractions, the labor fails to progress and then a cesarean section is performed.

So how does a mama decide whether or not a cesarean delivery is best for her?

• Do your research. Know the indications for cesarean delivery
• Talk with your health care provider. Know (as much as possible) the position of your baby in the uterus, consider the gestational age of the baby
• Consider your obstetrical history. If you have certain complications, you may be more likely to require a cesarean delivery. Talk with your health care provider to assess your risks.

It’s a really tough decision. Even today, some six years after my last cesarean section, I often wonder if I should have tried to deliver my son. (my second child). But I had a list of obstetrical complications that would have made a VBAC quite risky. For women without my dicey history who are considering a VBAC vs. a cesarean delivery, I say, do your research, “be aware”. Only once you’ve fully informed yourself and spoken with your health care provider can you make an informed decision about whether or not to have a cesarean delivery.

Resources

The International Cesarean Awareness Network (ICAN)

MedScape

NIH Consensus Development Conference on Vaginal Birth after Cesarean: New Insights

The American Pregnancy Association

American Congress of Obstetricians and Gynecologists

About.com

Giving Birth With Confidence

Unnecesarean

My daughter at birth