Beyond the Myths: Real Science in Women's Health - Bed Rest Prevents Preterm Birth? A Comfortable Illusion.
Study after study shows no benefit to bedrest in pregnancy to prevent prematurity. Women on bed rest did not deliver later, and their babies did not have better outcomes.
Bed Rest Prevents Preterm Birth? A Comfortable Illusion.
When I was a trainee, a woman with preterm contractions was almost automatically admitted to the hospital and prescribed “strict bed rest.” Nurses would carefully document the hours she stayed flat in bed. Families rearranged their lives to support it. The underlying idea seemed simple: if the uterus is quiet while lying down, resting must stop labor.
It felt intuitive. It felt caring.
But it was wrong.
What Is “Bed Rest”?
“Bed rest” in pregnancy usually means restricting activity—sometimes partial, sometimes complete, and in the strictest form, lying in bed around the clock. For decades it was prescribed for preterm labor, high blood pressure, bleeding, growth restriction, twins, and just about any complication doctors worried about.
It was one of the most common “treatments” in obstetrics. Yet it was never rigorously tested before becoming routine.
The Evidence Arrives
Starting in the 1990s, researchers asked: does bed rest really reduce preterm birth? The results were striking. Study after study showed no benefit. Women on bed rest did not deliver later, and their babies did not have better outcomes.
Worse, bed rest carried real risks:
Blood clots (deep vein thrombosis and pulmonary embolism).
Muscle and bone loss, especially worrisome after weeks of inactivity.
Depression and anxiety, intensified by isolation and lack of control.
Financial strain, since many patients were unable to work or care for other children.
Instead of preventing complications, bed rest often added new ones.
Why Did the Myth Persist?
Part of the answer lies in psychology. Doing something feels better than doing nothing, especially in the face of preterm labor. Rest also carries cultural weight—friends and family often say, “Take it easy, stay in bed, don’t move.” It became the ultimate symbol of maternal sacrifice, of doing “everything possible” for the baby.
Doctors, too, found reassurance in prescribing rest. If a complication worsened, at least they had ordered the “standard” approach. It was medicine by tradition, not by proof.
What We Recommend Today
Professional guidelines now advise against routine bed rest for preterm labor, twins, high blood pressure, or most other complications. Instead, we encourage normal activity as tolerated, sometimes with modifications depending on the condition. For example, avoiding heavy lifting or long standing may be reasonable, but prolonged immobilization is not.
There are exceptions, of course. If a woman is hospitalized for a serious complication—like severe preeclampsia—she may spend more time in bed because of her illness, not because “bed rest” is the treatment. The key is that we no longer prescribe immobility as therapy in itself.
Lessons Learned
The story of bed rest carries bigger lessons:
Intuition is not evidence. Just because something feels right doesn’t mean it helps.
Doing nothing can be better than doing harm. Withholding an ineffective treatment is not neglect—it’s good medicine.
Maternal well-being matters. A prescription that increases depression, blood clots, or financial hardship without helping the baby is no longer acceptable.
Reflection
For decades, bed rest was one of the most common “treatments” in obstetrics. Today we know it is a myth that cost women their health, independence, and peace of mind. The harder question is: what other comforting illusions still hide in our practice—things we prescribe more out of habit and hope than out of evidence?