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In addition, pregnant women who suffer from diagnosed complications may be eligible for short-term disability insurance. Health care reform has brought improvements to programs for some pregnant women offering the potential to reduce the number of women who need to be on bed rest in the first place. The truth is that for lower income women in low-wage jobs, there are essentially no options. For some, it makes more sense to simply quit a job that offers no reason to stay. Without workplace flexibility or paid leave, low-income workers are forced to choose between caring for their families and their economic security.

The United States is one of only four developed countries that do not offer paid leave to all new mothers. FMLA is available to employees of businesses with more than fifty employees, with other restrictions in place as well. Short-term disability insurance is helpful — if your employer or state offers it or you think to purchase it on your own. However short-term disability usually covers only six weeks of leave — and at approximately 60 percent of your salary. I think this would help employers and insurance companies acknowledge that bed rest is a treatment, just like a medication or a surgical procedure.

It is a method of keeping pressure off of the cervix, of keeping blood pressure down, of increasing blood flow to the baby, and of encouraging healthy growth. Bed rest is a medical treatment, not a vacation. Aviva worked for a small business.

Types of bed rest

Short-term disability insurance was not available to her. But immediately that went out the window. At thirty weeks my water broke so I needed to go to the hospital, where I stayed until my baby was born at 32 weeks. I had three weeks of accrued vacation time and a week of sick leave. I had to get loans from my family. When Babs became pregnant in she and her husband Joe were thrilled. But a month after finding out she was pregnant with twins Jack and Kate, devastation rained down.

When she was 22 weeks pregnant, Jack died in-utero and Babs wound up on bed rest, in the hospital. Kate was born just weeks later, at 25 weeks, and months in the NICU neo-natal intensive care unit followed. To cover expenses while dealing with the loss of one baby, her own fragile health and the health of her daughter before birth and then in NICU afterwards, Garrett Haller used a combination of accrued sick and vacation time as well as a brief period paid for by short-term disability insurance.

Still, after four weeks of bed rest, and two more months afterwards dealing with intensive care for her daughter, her employment was terminated. Her husband was employed but not able to cover all expenses plus the immense burden of the new medical expenses they were now carrying. They were out of money — and time. When my daughter finally came home from NICU, she was mine to hold, feed, have at home, free of wires and tubes but I had to choose between returning to work keeping my job or spending time with my new baby getting fired.

Becoming pregnant and birthing a baby, should not throw families into poverty, frantically trying to find a way to piece together a puzzle only to find key pieces missing. Yet it does. And, a full quarter of families with children under six live in poverty. They offer support for and resources to women and their families, but they are also banding together to support paid family leave efforts in Congress. Mikulski was instrumental in the passage, in , of the Federal Employees Paid Parental Leave Act which gives federal employees four paid weeks of leave, of the twelve weeks total leave allowable.

To that end, the organization is pushing an expanded federal FMLA to include businesses with at least 15 employees, to cover more family members and to provide paid leave. For mothers who have been on bed rest, there is no shortage of creative suggestions for how this country can best assist pregnant women on bed rest: from supplemental coverage for all mothers who end up on bed rest for at least thirty days to extended leave options for mothers and fathers who have premature infants to emergency grants for families who find themselves in financial crises from an unexpected bed rest stint.

Unpaid leave is simply of no use to many working families who live paycheck to paycheck and cannot afford even one day without paid work. If we stand up together and say this is absurd, then something will get done.

[Essay] | The Bed-Rest Hoax, by Alexandra Kleeman | Harper's Magazine

We have to stand up and demand what we deserve. Both assumptions are largely unsubstantiated. The reason that bed rest is almost universally recommended for women who go into preterm labor is that physical activity is directly related to uterine activity. Guidelines released in by the American College of Obstetricians and Gynecologists acknowledge that it does not improve rates of preterm birth in these women and caution against its routine use in the treatment of preterm labor.

And so can abnormalities in the placement or attachment of the placenta. Some obstetricians make the case that women have very little to lose and potentially a baby to save by going on bed rest. Others, however, argue that significant restrictions in activity can take a physical, financial and emotional toll on women and their families.

Downside of bed rest often gets overlooked

Inactivity weakens muscles -- women on bed rest tend to lose strength and stamina. This atrophy occurs not just in skeletal muscles but those throughout the body, including the heart muscle.

Bones, which are strengthened through regular use, deteriorate as well. For some women, leaving a job can be financially devastating.

The Bed-Rest Hoax

For others, the inability to help at home is most challenging. I felt helpless.


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There are not a lot of useful therapies for the prevention and treatment of preterm labor. Medications called tocolytics are perhaps the most effective way to stop preterm labor once it has started, and they have been found to prolong pregnancy by only two to seven days.


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Some new tools are being used to help identify women at greatest risk of giving birth to their babies preterm and who thus are most likely to benefit from intervention. One involves a test for fetal fibronectin, a protein that attaches the fetal sac to the lining of the uterus. A negative test means that the likelihood of delivering in the following two weeks is very low.