Tuesday, October 19, 2010
Why do doctors advise bed rest after an IVF pregnancy ?
When an infertile patient gets pregnant after IVF , they are on top of the world. All that hard work and effort has finally paid off - and you can now look forward to cradling your baby in your arms soon !
However, there are still 8 months to go before your baby is born - and the pregnancy can be packed with anxiety and suspense. Will everything go well ? Will the baby be normal ? Every ache and twinge causes worry because you are scared you may miscarry. This is a "precious pregnancy" - and you do your best to take things easy and be as careful as you can, so you can nurture your baby.
This is one of the reasons why many doctors advise bed rest during an IVF pregnancy. In fact, some patients will voluntarily place themselves under house arrest, because they do not want to take the slightest risk !
The truth is that there is no sensible biological basis for providing this advise. In fact, bed rest can be demoralising and is very unhelpful, because your mind starts playing games when you sleep in bed all day long !
However, it's often patients ( and their relatives) who force the doctor to provide this kind of advise.
When I tell my patients they do not need bed rest, many of them look at me in disbelief, as if I am an idiot and do not know what I am talking about !
Isn't it "common sense" that pregnant women need bed rest to prevent a miscarriage - after all, this is what doctors ( and midwives) have been advising for generations, so it must be true ! Won't walking around cause the baby to fall out ? Isn't this an "artificial" pregnancy which needs to be treated with much more caution and attention ?
If a doctor agrees with this advise , then patients are happy, and feel he is a good doctor because he is providing advise which is sensible by their preconceived notions
However, if he does not agree, then they start wondering if they can trust anything he says ! If he does not even understand the medical importance of bed rest, then his medical competence is suspect !
Most doctors are too busy to argue with patients. It's also good for them to advise bed rest. They can charge extra for home visits ! And if something goes wrong, then the doctor cannot be faulted, because he provided the right advise !
However, if he does not advise bed rest, and the patient miscarries, then no one will ever forgive this doctor. They will actually blame him for the miscarriage ! ( Didn't he know how precious this pregnancy was ? How could he be so callous and careless ? I wish we had gone to a better doctor !" ) His entire reputation will be tattered and torn to bits - and in a few years, he will be left with no patients !
For most doctors, it's much easier to toe the line and tell patients what they want to hear, rather than to spend time educating them and correcting these old wives' tales. This is why all these myths and misconceptions continue to flourish !