You may have heard of doctors recommending bed rest during pregnancy if they are concerned about a health condition that could cause complications or premature labor. Today, “bed rest,” or minimizing physical activity, is no longer recommended for most patients during pregnancy.

“It was previously thought that excessive activity may increase the risk for pregnancy complications such as preterm delivery and preeclampsia, a condition characterized by new onset of high blood pressure in pregnancy,” says maternal-fetal medicine specialist Maggie Kuhlmann, MD. “Better research studies have shown that bed rest increases the risk for preterm delivery, as well as other serious complications, including blood clots, bone demineralization, and deconditioning.”

While certain conditions, such as poorly controlled heart disease, may be worsened by exercise during pregnancy, these are rare. Activity restriction (not bed rest) may be briefly recommended for those with conditions like poorly controlled heart disease, but once your condition is under control, activity levels will likely be increased. If you have a condition that worries you about staying active, speak to your doctor to see what they recommend and for how long.

Physical activity during pregnancy comes with benefits

Remaining active during pregnancy provides protective benefits, including:

• A higher chance of vaginal delivery.
• Less weight gain.
• Decreased risk for gestational diabetes, preeclampsia, and preterm birth.
• Decreased risk of having a baby with low birth weight.

Although bed rest and activity restriction are rarely necessary during pregnancy, many women find it challenging to do the activities they did before pregnancy consistently. This might be due to pregnancy-related fatigue, pain, or balance issues due to the effects of hormones on joints.

Most women can maintain their pre-pregnancy activity levels, although care should be taken to avoid falls or other injuries. “Your body changes throughout pregnancy, and modifications to your daily activities may be necessary,” adds Dr. Kuhlmann. “It’s important to listen to your body to avoid injuries. Simple steps, such as designating certain household tasks to other family members or modifying your exercise routine, can avoid these problems and reduce pregnancy-related stress.”

If bed rest or hospitalization is required, what then?

Although activity restriction is rarely necessary during pregnancy anymore, if you have a medical condition or injury or your pregnancy is considered high-risk, work closely with your care team to ensure that you clearly understand what should be avoided.

“Deconditioning can occur quickly, even in young and healthy women,” says Dr. Kuhlmann. “If prolonged periods in bed or the hospital are required, such as with an illness, surgery, or injury, activity should be resumed carefully. Persistent pain in the legs or arms, or chest pain or shortness of breath, can be signs of a blood clot and should be evaluated immediately.”

When discussing plans for resuming activity following injury or surgery, discuss any particular circumstances with your doctor, such as stairs in your home or the need to care for older children. There may be resources, such as assistive devices, which can help you accomplish your daily tasks.