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Hard Labor of Bed Rest : * Relationships: Mothers are forming a network to support pregnant women who have been ordered to stay off their feet.


What doctors call bed rest is hard labor for women ordered to stay off their feet for weeks--or months--to prolong high-risk pregnancies.

Being forced to stay in bed when you don't feel sick might sound like the ultimate vacation to some, but it can be a nightmare for pregnant women facing the threat of losing their babies--or seeing them go from the womb to an intensive care unit.

In addition to the fear of making a move that will induce labor dangerously early, women on bed rest struggle with a number of other unsettling emotions--guilt, loneliness, boredom--as well as the physical discomfort caused by inactivity and side effects of drugs that help delay labor.

For some women, especially those with young children, the temptation to rationalize potentially disastrous departures from doctor's orders becomes overwhelming.

Candace Hurley, a 37-year-old Laguna Beach resident, knows how powerful the impulse to cheat can be, because she's been through two complicated pregnancies that involved extended periods of bed rest.

She considers the time she was confined to her bed during her first pregnancy "the most difficult 14 weeks of my life." But she emerged from that pregnancy--and another that required eight weeks in bed--with the satisfaction that she had done everything in her power to improve the odds of delivering healthy babies.

"Every day you're in bed makes a big difference for your baby," says Hurley, who has two healthy sons, ages 3 and 4.

But expectant mothers need someone to remind them of how critical it is to stay down when they feel the urge to get up--someone who understands the emotional and physical trauma of a high-risk pregnancy, Hurley says.

She has initiated a project designed to meet that need--a national, nonprofit network of support groups that will train volunteers who have been through complicated pregnancies themselves to serve as telephone coaches for expectant moms on bed rest. Some also will provide grief counseling for women who lose their babies.

The 24 mothers from around the country who gathered in Orange County last weekend for a training session are preparing to launch support groups in their own communities in February, Hurley says.

The local groups--including one in Orange County--will operate under the umbrella of the Sidelines National Support Network, which Hurley is organizing with a start-up grant from Tokos Medical Corp. of Santa Ana, a maker of in-home uterine monitors.

As executive director of Sidelines, named for the most-recommended bed-rest position, Hurley will oversee the local support groups and produce a national newsletter as well as educational materials to help motivate and inform volunteers and expectant mothers.

She also plans to make instructional videos available for those who can't get to the hospital for pre-childbirth classes, she says.

Hurley says bed rest is prescribed for an estimated 300,000 pregnant women in the United States each year, and she plans to reach as many as possible through referrals from physicians and home uterine monitoring services.

Dr. Peter Anzaldo, a maternal fetal specialist at St. Joseph Hospital in Orange, says the support Sidelines will provide is of "utmost importance," because many patients on bed rest take chances they shouldn't.

"They don't do it knowingly. They just don't understand the consequences of getting up," he says. "Sometimes just getting up to go to the bathroom can tilt the scale and begin labor that can't be stopped."

Anzaldo says even the most careful high-risk patients are likely to deliver early, but bed rest--combined with medication and home uterine monitoring--can often prolong the pregnancy long enough to protect the baby from critical health problems related to prematurity.

Because bed rest is so crucial, Anzaldo has long used an informal support network in his own practice to motivate patients to follow his instructions. For example, when he put Hurley on bed rest during her first pregnancy, he asked a former patient named Kathleen to give her a call. Kathleen, who had a healthy boy after 16 weeks of bed rest, ended up talking with Hurley several times a week, answering her questions and keeping her spirits up.

The relief that connection gave Hurley is largely what inspired her to begin making contacts with the mothers across the country who have now signed up to be Sidelines support group coordinators.

Hurley's research led her to six groups that were already supporting high-risk moms, and she says they all are expanding their services as part of the Sidelines network.

Among those groups is Moms on Bed Rest, which has 20 Orange County volunteers who call expectant mothers regularly and, in some cases, even make personal visits. Linda Scott, the group's coordinator, says she hopes to quickly attract more volunteers now that she's working with Sidelines. (Moms offering--or needing--help, should call (714) 979-7059.)

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