During a surrogacy journey, healthcare providers may recommend pelvic rest as a precautionary measure to support a healthy pregnancy. This medical guideline restricts certain activities to reduce pressure on the cervix and minimize the risk of complications. For surrogates, following these recommendations helps protect the pregnancy, while intended parents benefit from knowing how these temporary limitations support their growing family. Effective communication among surrogates, intended parents, and medical professionals ensures everyone navigates this aspect of the surrogacy journey with confidence and clarity.
What Pelvic Rest Involves
Pelvic rest represents a specific set of medical recommendations aimed at protecting pregnancies with certain risk factors. This precautionary measure differs significantly from bed rest, as it targets particular activities rather than limiting all physical movement. By reducing pressure on the cervical and pelvic region, pelvic rest helps maintain the integrity of the pregnancy in situations where complications have developed or risk factors have been identified.
The restrictions associated with pelvic rest typically center around activities that could physically impact the cervix or stimulate the uterus. Healthcare providers usually advise against sexual intercourse, particularly penetrative activity, as this can directly affect the cervix. Other intimate activities that might lead to orgasm may also be restricted, as orgasms can trigger uterine contractions. Additional recommendations often include avoiding the use of tampons, douching, or any other objects introduced into the vaginal canal.
Physical activity guidelines during pelvic rest vary based on the specific medical concern and its severity. In some cases, surrogates may need to limit heavy lifting, strenuous exercise, or activities that place significant pressure on the pelvic floor. In other situations, normal daily activities remain perfectly acceptable as long as direct cervical stimulation is avoided. The prenatal care team provides personalized guidance based on each surrogate’s unique medical circumstances, ensuring that restrictions support the pregnancy while minimizing unnecessary limitations.1
“Pelvic rest is a relatively common precautionary measure to prevent complications, and it is not necessarily a sign that something is seriously wrong. When a surrogate is placed on pelvic rest, it is important to follow medical advice to ensure the best outcome for both the surrogate and the baby. As Journey Coordinators, we support our surrogates by staying in close contact and being sensitive and empathic to their experience, knowing it can feel restrictive at times. The close-knit Journey Coordinator team at CFC brings a variety of personal and professional experiences which elevates our ability to support our surrogates. I was previously a birth/postpartum doula and childbirth educator, and I am always happy to share my knowledge and experience with my team and our amazing surrogates when we encounter situations like pelvic rest.” -Juli Textor, CFC Journey Coordinator
Medical Reasons for Pelvic Rest in Surrogacy
Healthcare providers recommend pelvic rest for several specific medical concerns that may arise during a surrogate pregnancy. These recommendations aim to reduce pressure on the cervix, prevent uterine contractions, and minimize the risk of complications. Regular prenatal monitoring helps identify these conditions early, allowing for timely intervention and appropriate management. Common medical reasons for pelvic rest during surrogacy include:
- Placenta previa: This condition occurs when the placenta partially or completely covers the cervix. It creates a risk of significant bleeding if the cervix begins to dilate or experiences pressure. Pelvic rest helps prevent bleeding episodes while healthcare providers monitor the placenta’s position throughout pregnancy. Delivery typically occurs via planned C-section if the placenta remains over the cervix.
- Cervical insufficiency: This involves premature cervical softening, shortening, or dilation without contractions. Surrogates with a history of this condition or those who show cervical changes during pregnancy may receive recommendations for pelvic rest. In some cases, pelvic rest accompanies a cervical cerclage procedure, where the cervix is surgically reinforced to provide additional support.
- Vaginal bleeding: Bleeding during pregnancy often leads to pelvic rest recommendations while healthcare providers determine the underlying cause. Even minor bleeding warrants evaluation, with temporary pelvic rest serving as a standard precautionary measure. For surrogates, prompt reporting of any bleeding allows for timely assessment and appropriate care planning.
- Preterm labor concerns: Particularly in surrogates with a history of previous preterm births, pelvic rest may be necessary to reduce potential triggers for uterine activity. This precaution helps extend the pregnancy to full term or as close to term as possible.
- Multiple gestations: Carrying twins, triplets, or more places additional strain on the cervix and increases the risk of preterm labor. Pelvic rest often forms part of the management strategy for these higher-risk pregnancies.
The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine provide guidelines for managing these conditions, with pelvic rest frequently included in their recommended approaches. Throughout the surrogate pregnancy, the healthcare team assesses these situations and determines whether pelvic rest recommendations should be initiated, continued, or modified as the pregnancy progresses.2
Timeframes and Monitoring
Pelvic rest recommendations vary widely in duration, depending on the specific medical concern and how the pregnancy progresses. Some situations require only brief periods of restriction, particularly when addressing temporary concerns like mild spotting that resolves quickly. Other conditions, such as placenta previa or significant cervical insufficiency, might necessitate pelvic rest for the remainder of the pregnancy until delivery. In some cases, certain conditions could lead to an earlier delivery or physician-recommended induction date.
Healthcare providers establish regular monitoring schedules to evaluate the continued need for pelvic rest restrictions. These appointments typically include ultrasounds to assess placental position, cervical length measurements, and other relevant examinations based on the specific medical concern. For surrogates, these check-ups provide important reassurance while helping the medical team determine whether restrictions can be modified or must continue.
As the pregnancy advances, healthcare teams may adjust pelvic rest recommendations based on how the specific condition evolves. For example, in some cases of placenta previa, the placenta migrates upward as the uterus grows, potentially allowing for the easing of restrictions in later pregnancy. In other situations, such as progressive cervical shortening, pelvic rest might become more stringent as the pregnancy continues. These assessments ensure that restrictions remain appropriate to the current medical situation rather than unnecessarily limiting a surrogate’s activities.
Practical Considerations for Surrogacy
Surrogacy agreements typically include provisions addressing medical recommendations like pelvic rest should they become necessary during pregnancy. These provisions might outline additional support for the surrogate if restrictions significantly impact her daily responsibilities. In most cases, pelvic rest represents a relatively minor adjustment within the broader surrogacy journey, managed through routine communication among the surrogate, her healthcare providers, and the surrogacy agency. Creative Family Connections ensures these situations are handled with compassionate support while maintaining focus on the goal of a healthy pregnancy.
