美国国家公共电台 NPR Rethinking Bed Rest For Pregnancy

 

RACHEL MARTIN, HOST:

Doctors send thousands of pregnant women to bed each year, some for just a few days, some for months. The idea is that laying still may help women with complicated pregnancies¹ carry their babies to term. But the practice is questionable² at best. In fact the American College of Obstetricians and Gynecologists generally advises against putting women on bed rest. NPR's Alison Kodjak recently spent time with a woman whose life was upended when she was sent to bed.

ALISON KODJAK, BYLINE³: The scene in Margaret Siebers' house at the end of the workday is pretty chaotic⁴.

(SOUNDBITE OF BABY CRYING)

KODJAK: Her husband, Alex, is tending to a wound on his finger that he got at work that day.

ALEX SIEBERS: I was using miter saw, and it crushed my finger.

KODJAK: Margaret stands in the kitchen popping corn.

(SOUNDBITE OF CORN POPPING)

A SIEBERS: It's a special treat because tonight is their daughter Frances' first birthday.

MARGARET SIEBERS AND ALEX SIEBERS: (Singing) Happy birthday to you.

KODJAK: Frances toddles⁵ through the kitchen. And her older sister, Violet, twirls around in red sparkles.

VIOLET SIEBERS: I want to be in the...

KODJAK: It's a typical scene for a busy family, not one that lends itself to rest. But rest is what Margaret was ordered to do last year by the doctors and midwife who were caring for her during her pregnancy⁶.

MARGARET SIEBERS: So I could come downstairs and sit on the couch and hang out on the couch.

KODJAK: This couch right here?

M SIEBERS: Yeah. This is where I spent several months.

KODJAK: Margaret was 22 weeks pregnant and getting a routine ultrasound. The baby was fine, but there was a potential problem - her cervix was shortened, a sign that she might go into labor⁷ too soon.

M SIEBERS: That was really scary for us. It was, like - we were at this appointment. And the doctor's looking at the baby and saying, they've got a beautiful heart. And I'm thinking, oh, great. They've got a beautiful heart. And they might die.

KODJAK: A year earlier, Margaret had a miscarriage⁸ when she was about 14 weeks pregnant.

M SIEBERS: So it was, you know, just - it was really scary to think that we might lose another baby.

KODJAK: Her midwife and doctor recommended the procedure called a cerclage, where they stitch up her cervix in hopes of keeping it closed. And they told her to go to bed and stay there. It was hard financially.

M SIEBERS: My husband immediately quit his full-time⁹ job. And he took care of me. He brought me - like, I wouldn't even get my own glasses of water.

KODJAK: And it was hard emotionally.

M SIEBERS: I like to say that I was on bed rest, and he was on house arrest because he really couldn't leave, either.

A SIEBERS: Her mobility¹⁰ was extremely limited. And the fact that we live in this house where the bathroom's upstairs, you know, wasn't helpful.

KODJAK: The whole experience was isolating¹¹.

A SIEBERS: We felt kind of, like, knocked out of society for a while, you know, out of, like, our daily routine in our lives and connections with people we lost touch with because we were, you know, trapped in here, just trying to make it.

KODJAK: Margaret worked from home part time for her family's company. But the loss of Alex's paycheck was tough.

M SIEBERS: So we qualified¹² for Medicaid, which we were on. We qualified for food share, which we were on. We qualified for WIC.

KODJAK: Friends from church brought them food. Their landlord gave them a break on the rent. Margaret received a small inheritance, about a thousand dollars. And they got an $800 tax return.

M SIEBERS: All of those things together helped us to get through - but barely.

KODJAK: And all of that upheaval¹³ may have been unnecessary, says Anne Drapkin Lyerly, an OB-GYN and professor of bioethics at the University of North Carolina.

ANNE DRAPKIN LYERLY: The bottom line is that there's never been any proven benefit of bed rest.

KODJAK: In 2013, Lyerly and her colleagues did a review of the scientific research. They found that bed rest didn't reduce premature¹⁴ births, miscarriages¹⁵ or low-birth-weight babies. It didn't help women who had high blood pressure. It didn't help women pregnant with twins carry them longer. And it didn't cut the risk of placenta previa, a condition where the placenta covers the cervix. In fact, Lyerly says, bed rest can cause harm.

LYERLY: The thought has been how could it be bad to have a woman stay in bed for a bit? It doesn't seem like a dangerous intervention¹⁶ in the same way we think about surgeries or medications. But, in fact, it is and can be very dangerous.

KODJAK: Lying in bed can cause blood clots¹⁷, which are potentially fatal. It can also weaken a woman's muscles and bones or reduce their lung capacity. Some become depressed¹⁸. And the economic hardship can be dramatic. Kelly Jones is an economics professor at American University and a senior researcher at the Institute for Women's Policy Research.

KELLY JONES: If you're telling a woman to undertake an activity that you're not certain is going to be benefiting her and yet it's keeping her away from her job, what you're saying to her is your participation¹⁹ in the economy is not important.

KODJAK: Margaret's midwife, Deb Studey, who cared for her during her previous pregnancy that ended in miscarriage, says the temporary hardship pales in comparison to what could've happened had something gone wrong.

DEB STUDEY: And I know that being on bed rest was hard for Margaret. But I also know, on the flip²⁰ of that, having a 24-week baby in ICU wasn't going to be an easy outcome either. So in my mind, bed rest let her get to term.

KODJAK: Studey is well aware of the research showing that bed rest doesn't improve outcomes. But, she says...

STUDEY: I pay attention to how things are working for women. And that doesn't always fit a study. I think we're all different.

KODJAK: Lyerly, the bioethicist, says one of the problems in prescribing bed rest is that women can end up blaming themselves when something goes wrong.

LYERLY: The implication is that it is useful and that the immobilization is what is going to prevent whatever dreaded²¹ outcome. So I think this false sense of agency that is imposed around bed rest is highly dangerous.

KODJAK: Margaret Siebers actually read the research on bed rest while she was stuck on her couch. Still, she stayed there just to be safe. When she was 37 weeks pregnant, her doctor removed the cerclage. She was allowed to get up and returned to normal activity. It was a full three weeks before she went into labor and gave birth to Frances.

M SIEBERS: So maybe it worked really well. Or - maybe it worked really well. Maybe it wasn't necessary. It was a strange time.

KODJAK: Alison Kodjak, NPR News, Milwaukee.

1 pregnancies   

怀孕，妊娠( pregnancy的名词复数 )

参考例句：

• Since the wartime population needed replenishment, pregnancies were a good sign. 最后一桩倒不失为好现象，战时人口正该补充。
• She's had three pregnancies in four years. 她在四年中怀孕叁次。

2 questionable   

adj.可疑的，有问题的

参考例句：

• There are still a few questionable points in the case.这个案件还有几个疑点。
• Your argument is based on a set of questionable assumptions.你的论证建立在一套有问题的假设上。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 chaotic   

adj.混沌的，一片混乱的，一团糟的

参考例句：

• Things have been getting chaotic in the office recently.最近办公室的情况越来越乱了。
• The traffic in the city was chaotic.这城市的交通糟透了。

5 toddles   

v.（幼儿等）东倒西歪地走( toddle的第三人称单数 )；蹒跚行走；溜达；散步

参考例句：

• She toddles down to the park most afternoons. 多数下午她都溜达着去公园。

6 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

7 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

8 miscarriage   

n.失败，未达到预期的结果；流产

参考例句：

• The miscarriage of our plans was a great blow.计划的失败给我们以巨大的打击。
• Women who smoke are more to have a miscarriage.女性吸烟者更容易流产。

9 full-time   

adj.满工作日的或工作周的，全时间的

参考例句：

• A full-time job may be too much for her.全天工作她恐怕吃不消。
• I don't know how she copes with looking after her family and doing a full-time job.既要照顾家庭又要全天工作，我不知道她是如何对付的。

10 mobility   

n.可动性，变动性，情感不定

参考例句：

• The difference in regional house prices acts as an obstacle to mobility of labour.不同地区房价的差异阻碍了劳动力的流动。
• Mobility is very important in guerrilla warfare.机动性在游击战中至关重要。

11 isolating   

adj.孤立的，绝缘的v.使隔离( isolate的现在分词 )；将…剔出（以便看清和单独处理）；使（某物质、细胞等）分离；使离析

参考例句：

• Colour filters are not very effective in isolating narrow spectral bands. 一些滤色片不能很有效地分离狭窄的光谱带。 来自辞典例句
• This became known as the streak method for isolating bacteria. 这个方法以后就称为分离细菌的划线法。 来自辞典例句

12 qualified   

adj.合格的，有资格的，胜任的，有限制的

参考例句：

• He is qualified as a complete man of letters.他有资格当真正的文学家。
• We must note that we still lack qualified specialists.我们必须看到我们还缺乏有资质的专家。

13 upheaval   

n.胀起，(地壳)的隆起；剧变，动乱

参考例句：

• It was faced with the greatest social upheaval since World War Ⅱ.它面临第二次世界大战以来最大的社会动乱。
• The country has been thrown into an upheaval.这个国家已经陷入动乱之中。

14 premature   

adj.比预期时间早的；不成熟的，仓促的

参考例句：

• It is yet premature to predict the possible outcome of the dialogue.预言这次对话可能有什么结果为时尚早。
• The premature baby is doing well.那个早产的婴儿很健康。

15 miscarriages   

流产( miscarriage的名词复数 )

参考例句：

• Miscarriages are usually caused by abnormal chromosome patterns in the fetus. 流产通常是因为胎儿的染色体异常造成的。
• Criminals go unpunishedareconvicted and are miscarriages of justice. 罪犯会逍遥法外，法律会伤及无辜，审判不公时有发生。

16 intervention   

n.介入，干涉，干预

参考例句：

• The government's intervention in this dispute will not help.政府对这场争论的干预不会起作用。
• Many people felt he would be hostile to the idea of foreign intervention.许多人觉得他会反对外来干预。

17 clots   

n.凝块( clot的名词复数 )；血块；蠢人；傻瓜v.凝固( clot的第三人称单数 )

参考例句：

• When you cut yourself, blood clots and forms a scab. 你割破了，血会凝固、结痂。 来自《简明英汉词典》
• Milk clots when it turns sour. 奶变酸就凝块。 来自《现代英汉综合大词典》

18 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

19 participation   

n.参与，参加，分享

参考例句：

• Some of the magic tricks called for audience participation.有些魔术要求有观众的参与。
• The scheme aims to encourage increased participation in sporting activities.这个方案旨在鼓励大众更多地参与体育活动。

20 flip   

vt.快速翻动；轻抛；轻拍；n.轻抛；adj.轻浮的

参考例句：

• I had a quick flip through the book and it looked very interesting.我很快翻阅了一下那本书，看来似乎很有趣。
• Let's flip a coin to see who pays the bill.咱们来抛硬币决定谁付钱。

21 dreaded   

adj.令人畏惧的；害怕的v.害怕，恐惧，担心( dread的过去式和过去分词)

参考例句：

• The dreaded moment had finally arrived. 可怕的时刻终于来到了。
• He dreaded having to spend Christmas in hospital. 他害怕非得在医院过圣诞节不可。 来自《用法词典》