What is "light activity", exactly?
June 29, 2007 9:02 PM   Subscribe

My OB has put me on "light activity" due to IUGR (Intrauterine Growth Restriction) and a shortened ("funneling") cervix. He specifically said: No strenuous activity. No heavy lifting. I can go places as long as I drive and do not walk. I should stay off my feet as much as possible, and sit with my feet up. I should not take walks. He says this is "almost bedrest, but not quite". This all seemed self-explanatory when I was at the office, but now I'm not exactly sure what I need to be doing.

Background, just in case it is relevant: I'm 23 weeks pregnant, type 2 diabetic for 10 years, have been on insulin for a few weeks and it is controlling the blood sugars very well. Also have been taking metformin for many years. Also have asthma, which flared up recently, for which I am taking albuterol. Was taking Avandia prior to the pregnancy for 90 days, but stopped when I became pregnant, as my doctor said no one really knows how it can affect pregnancy. Also taking: vegetarian source DHA supplement (I am not vegetarian, but allergic to fish), 100 mcg thyroid pill, prenatal vitamin, folic acid. I have had two previous full-term pregnancies: #1 was 8 lb 10 oz, went into labor naturally at 38 weeks, he's now 17. #2 was 6 lbs 6 oz, induced at 38 weeks because they thought he was going to be huge, now 3. The ultrasounds have revealed that the placenta seems fine, the baby seems to have no birth defects, but she is measuring in the 15th percentile, and the amniotic fluid is "high normal". I have not gained a lot of weight, in fact I'm at the same weight as my first visit. I'm not trying to keep my weight down-- I eat whenever I am hungry and try to eat well. In my previous pregnancies, I was constantly fussed at for gaining too much weight (70 pounds and 38 pounds), but this time they haven't said anything. I have had a gastric bypass, but that was before pregnancy #2, and seemed to cause no problems with it.

The things I specifically want to know are: How long is too long on my feet? 15 minutes? 30 minutes? What activities are too strenuous? Loading the dishwasher? Cooking (if it's a quick dinner, not a huge feast)? How much weight constitutes "heavy lifting"? My 3 year old weighs 32 pounds, is that too much to lift? When I'm sitting down, it is better to have my feet level with my hips, or above? I was thinking that perhaps being tipped back more would cause my uterus to fall on my vena cava. I also feel somewhat uncomfortable in this position. If I go to a store, how long should I walk around? Should I get a wheelchair or motorized cart if I shop? I'm having trouble finding information about this, because most places seem to define "light activity" as "mild to moderate exercise", which is specifically forbidden to me.
posted by Shoeburyness to Health & Fitness (6 answers total)
I know this isn't too helpful, but maybe you could call his office and talk to the nurse. I'm sure she'd know what he considers strenuous, etc. I hope everything goes well for you.
posted by la petite marie at 9:05 PM on June 29, 2007

I can't answer all of your questions - but when my cervix started shortening earlier than ideal I was told to lay down. Sitting puts the same stress on the cervix as standing so there really isn't much difference - you've got to take gravity out of the equation.
At 23 weeks with a tiny baby - I'd just plan on erring on the side of caution. Lay down as much as possible (with a 3 year old I'm guessing that isn't that much) and ask yourself if anything you're about to do that isn't laying down is really all that important. Have your partner (or your 17 year old) take over dinner making and 3 year old carrying. I was allowed to get up to go to the bathroom and to get myself something to eat if no one else was around - other than that - on my side in my bed or on the couch. It was maddening - and mine was only for 2 weeks but now I have a lovely daughter delivered on her due date who just turned one.
If I were you I'd do whatever I could to keep that baby on the inside as long as possible. In my circle of folks there have been a bunch of pre-term - and one super pre-term babies and you really really really want to avoid that.
My daughter was breach and I was told by my MD to do headstands to encourage her to turn herself around - so I wouldn't worry too much about tipping too far back!
Oh and yeah - don't be afraid to call the doctor's office back. it's what they're their for.
posted by Wolfie at 10:18 PM on June 29, 2007

Just short of bed rest means you can get up to go to the bathroom, you can drive to your doctor's appointment, etc. It does not, however, mean that you can do your regular activities. Don't cook. Don't shop. Lie down most of the time, but get up to move around every once in a while to keep the blood moving. It's not an absolute prohibition, but if you don't take it easy, it really will become an absolute prohibition, or worse.

Also, Nth calling your doctor's office for more details.

IANAD but I do have some common sense.
posted by Void_Ptr at 4:48 AM on June 30, 2007

For me "not quite bed rest" meant, according to my doctor, normal light activity-- go to work as long as I stay off my feet, no lifting (couldn't carry groceries, etc.) driving okay, standing for 20 minutes to make dinner okay, stuff like that; however, I was told no stairs ever. Since I lived in a third floor walk up, this was both completely impractical (couldn't quit my job for financial reasons) and essentially a prison sentence. So I ignored it.

And ended up with a horrible, managed labor with 11 hours of hard contractions, 11-stitch episiosotomy, drugs I didn't want, and the hospital wouldn't let me use the birthing center. (Baby, who is now 21, was fine.)

Who knows if the labor was connected with my ignoring the doctor's advice, but I say err on the side of caution.
posted by nax at 6:10 AM on June 30, 2007

As with all things pregnancy & post-partum related--and even more appropriate in your case--I think if you cut your expectations by half you'll be about right on. So if you feel up to making dinner for 30 min. and 15 min. of clean up, you probably should be spending only 15min preparing a meal and 5min cleaning up. I'd probably third anything related to Baby Shoebury (I have a toddler). Used to carrying him for 5 min? Make it one.
posted by cocoagirl at 8:08 AM on June 30, 2007

I would also get onto one of the Bypass patients website/support groups. I'm sure some of them have groups of post-op gravidas who can advise. It is true to say we do not know the long term impcct on the malabsorptive elements of the different types of bariatric surgery but there's a huge amount of expertise in expert patients groups I feel you could hook into, more for reassurance than anything else.
posted by Wilder at 6:57 AM on July 1, 2007

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