Does Bed Rest Prevent Prematurity in Twin Pregnancy?

  • By: Sandra
  • Date: March 18, 2022
  • Time to read: 6 min.

My twin pregnancy more than 17 years ago was pretty much uneventful. Every doctor’s appointment was met with good news. Blood pressure? Normal. Weight gain? Steady and plentiful. Still, as a precaution, my doctor encouraged me to take my maternity leave a bit early (around Week 30) and “get off my feet.”

I wasn’t put on bed rest per se but she did advocate for my lying down on my left side for 30 minutes several times a day. I followed her advice religiously and spent several hours each day for the next two months horizontal. Although I was convinced that my fraternal twins would arrive early as most often do, my doctor had to induce me at Week 39 with my boys tipping the scales at more than six pounds each. So, were my big bouncy babies due in part to my taking it easy those last few weeks? I’ve always thought so.

Does Bed Rest Prevent Prematurity in Twin Pregnancy

But recent research indicates probably not. In fact, a new study suggests that bed rest not only doesn’t prevent premature birth but may actually increase its likelihood.

But how could that be?

According to the study published in the journal Obstetrics & Gynecology, researchers looked at a group of women at risk for preterm birth—those with a short cervix, a complication that raises a woman’s chance of premature cervical effacement and dilation (or “thinning”) which could lead to preterm labor.

How Common is Bed Rest With Twins?

Of the 646 women in the study, nearly 40 percent were placed on some form of bed rest around Week 24 yet of those women, nearly 39 percent still gave birth prematurely compared with only 17 percent of women who didn’t curtail their activity at all! (Remember, all the women in the study were at risk of preterm labor.)

Although researchers believe that the study indicates that bed rest doesn’t prevent preterm labor, it isn’t definitive and more studies are called for where participants are randomly assigned to bed rest or not.

Is Bed Rest Bad for Twin Moms?

Bed rest has always been very controversial. (In fact, while writing this post, I found several past studies and articles here and here that also raise concern for the practice.) Critics believe that bed rest is simply not effective. Furthermore, it can cause dangerous side effects including raising a woman’s risk for a blood clot.

With inactivity, she can lose important bone and muscle mass as well. If a mother-to-be needs to leave her job earlier than expected, it can also cause financial and emotional stress. So why do doctors recommend it so often especially to moms expecting multiples? Well, there’s really nothing else out there to help women who are at risk of preterm labor.

It’s common for doctors to recommend some form of bed rest ranging from lying down round-the-clock to something less extreme like my part-time respite to moms expecting twins, triplets, quads (or more). In my conversations with other twin moms, almost every single one of them had experienced some form of issue with her twin pregnancy, regardless of whether they were identical twins or fraternal twins.

According to the American College of Obstetricians and Gynecologists, there is insufficient data to suggest that bed rest can prevent preterm birth or preeclampsia in pregnant women. It’s actually not suggested for normal pregnancies because the lack of activity can actually induce blood clots and bone loss, as well as other complications.

Why Does Twin Pregnancy Bed Rest Happen?

Nearly one in five pregnant moms go on bed rest, and you can bet that the bulk of these women are pregnant with multiples. It’s no secret that being pregnant with twins increases the likelihood of having health difficulties compared to being pregnant with a singleton.

However, as previously said, there are a large number of pregnant women who have a simple twin pregnancy experience. For moms-to-be expecting twins and the like, proponents argue, the benefits are plentiful.

  • Lying down takes the weight and stress of carrying two or more babies off the cervix. Some women are born with a short cervix, and the cervix can dilate prematurely as a result of this. In either case, twin pregnancies tend to put a significant amount of additional strain on this area. It is possible to correct this problem with a technique known as cervical cerclage, however this may be accompanied by extended periods of bed rest.
  • Reduced physical activity may reduce the risk of preterm contractions. (Less movement = less contractions.) There is a considerable chance of premature birth with twins in the third trimester, and bed rest can aid to prolong the pregnancy and boost fetal growth.
  • Resting on your left side increases blood flow and nutrients to the babies.
  • When you’re inactive, you burn fewer calories, fuel that is now channeled directly to your babies ultimately helping them grow bigger.
  • High blood pressure or hypertension: Many pregnant women suffer from high blood pressure or hypertension, which can be an indication of a condition known as preeclampsia. Bed rest helps to reduce blood pressure, which is beneficial for both mom and baby.
  • Placenta previa is a condition in which the placenta interferes with the passage of the cervix.

Makes sense, doesn’t it? But with no scientific evidence to back it up, what should a mom-to-be expecting multiples do? Let common sense prevail. Yes, studies indicate that full-on bed rest may not be the answer to preventing preterm labor and delivery but you can still reap the benefits of taking it easy during your twin pregnancy.

Sit or better yet, prop your feet up whenever you can. In other words, don’t stand if you don’t have to! If your doctor does recommend that you go on bed rest, ask questions.

Discuss your concerns. Reach a compromise. And worry if you don’t follow her advice to the letter—remember you have science on your side!

What to do If you Have Been Told To Have Bed Rest

If your doctor has told you that you have to go on bed rest, there are a few things you can do which will make it much better for you.

Have a Physical Therapist Visit

A physical therapist will help keep you active, with safe activities you can do in bed. Doing something safe, rather than just lying in bed will be better for you both physically and mentally.

Get Comfortable!

If you are going to have to stay in bed for a considerable period of time, make sure it is super comfy and you have everything you need. Consider some of the following items:

  • A fan – vital especially in the summer months
  • Mattress topper
  • Extra pillows
  • Have a beautician or hairdresser visit you
  • A room with a view!
  • Plenty of healthy snacks and drinks to hand

Keep your Brain Occupied

You might get bored out of your mind, and along with worry for your unborn babies, its best to have a lot of things to do. Books, puzzles, the internet are just a few items that can keep you going. Now might also be the perfect time to finish all those knitting projects! If you don’t knit, how about learning!

You can also give yourself a little schedule so you don’t just end up binge watching the latest netflix series all day, every day. Even just doing little things like making lists, paying bills, researching can keep you going.

Take Away

Your medical advisors will only advise bed rest if you need it, so take their advice and put your feet up if needed. If you are given strict bed rest, make sure you are comfortable, have a list of exercise you can do for both your mind and body!