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Therapeutic Bed Rest in Pregnancy: Unethical and Unsupported by Data

McCall, Christina A. MD; Grimes, David A. MD; Lyerly, Anne Drapkin MD, MA

doi: 10.1097/AOG.0b013e318293f12f
Current Commentary

“Therapeutic” bed rest continues to be used widely, despite evidence of no benefit and known harms. In this commentary, we summarize the Cochrane reviews of bed rest and propose an ethical argument for discontinuing this practice. Cochrane systematic reviews do not support “therapeutic” bed rest for threatened abortion, hypertension, preeclampsia, preterm birth, multiple gestations, or impaired fetal growth. This assessment has been echoed in other comprehensive reviews. Prescribing bed rest is inconsistent with the ethical principles of autonomy, beneficence, and justice. Hence, if bed rest is to be used, it should be only within a formal clinical trial.

“Therapeutic” bed rest in pregnancy continues to be prescribed, despite lack of benefit and established harms; prescribing it for obstetric indications outside of controlled clinical trials is unethical.

Departments of Obstetrics and Gynecology and Social Medicine and the Center of Bioethics, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Corresponding Author: Christina McCall, MD, Department of Obstetrics and Gynecology, CB# 7570, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7570; e-mail: camccall@unch.unc.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 The American College of Obstetricians and Gynecologists