Bed rest and activity restriction for women at risk for preterm birth: a survey of Canadian prenatal care providers.

• Author(s) / Creator(s)

  • Newburn-Cook, C.V.
  • O'Brien, B.
  • Sprague, A. E.
  • Nimrod, C.
  • Heaman, M.

• OBJECTIVE: To explore the practices of Canadian obstetricians, family physicians, and midwives in recommending bed rest or activity restriction for women at risk for preterm birth (PTB) and to assess the decisional conflict experienced by care providers when they recommend these therapies. METHODS: A self-administered mail survey of prenatal care providers was carried out using Dillman's Tailored Design Method. Analysis included descriptive statistics and analysis of variance. RESULTS: The survey was distributed to 1441 potential participants; of these, 1172 were eligible participants, and 516 (44.2%) completed the survey. For women at risk of PTB, 60 of 170 obstetricians (35%), 88 of 206 family practitioners (42.7%), and 30 of 140 midwives (21.4%) recommended bed rest in hospital; 110 of 170 obstetricians (64.7%), 144 of 206 family practitioners (69.9%), and 73 of 140 midwives (52.1%) recommended bed rest at home. These recommendations occurred despite the response from about two thirds of each professional group that the effectiveness of bed rest was in the fair-to-poor range in helping to prevent PTB. The mean score on the Provider Decision Process Assessment Instrument, measuring decisional conflict for all care provider groups, was 30 (SD 7.4) (possible score range 12-60). There were no significant differences in decisional conflict scores among provider groups (F [2,347] = 2.24; P = 0.11). CONCLUSION: Care providers have been discouraged from routinely recommending bed rest for women at risk of PTB because of potential adverse side effects. This study demonstrates that most Canadian prenatal care providers have not been persuaded to incorporate these recommendations into practice. Except for women with multiple gestation, there is inconsistent practice in recommending bed rest and activity restriction. Additionally, Canadian prenatal care providers have some decisional conflict about using this therapy. These results provide some of the first Canadian perspectives on the practice of prescribing therapeutic bed rest for PTB.

• Date created

  2008

• Subjects / Keywords

  • Preterm birth
  • Decisional conflict
  • Bed rest

• Type of Item

  Article (Published)

• DOI

  https://doi.org/10.7939/R30G3H01H

• License

  © 2008 Society of Obstetricians and Gynaecologists of Canada. Permission to upload this article in the ERA has been provided courtesy of the Society of Obstetricians and Gynaecologists of Canada (SOGC). This material is under copyright and accessible for educational purposes only and cannot be reproduced in any form without prior written approval from the SOGC