Activity Level Checklist

Your Baby
Weeks 18 to 22

At the end of 5 months, your baby is 9 inches long and weighs one pound. Her skin is very wrinkled because she has stored very little fat to fill out her body and smooth out her skin. Her eyelids and eyebrows are well developed, but her eyes are still closed. A cheesy coating, called vernix, will begin forming to protect her skin from the amniotic fluid. When she is born, some of the vernix may still be on her skin.

Until now your baby has been protected by the amniotic fluid which completely surrounded her like her own private swimming pool. She is now big enough that the fluid no longer surrounds her and she begins bumping into the walls of your uterus when she moves. From now on you will be aware that your baby is inside of you because you can feel her when she kicks, moves, or has the hiccups.

Pregnancy bed rest

The purpose of bed rest is to keep your baby from putting pressure on your cervix which can lead to the cervix dilating. Bed rest often starts out as limitations on activity. As pregnancy progresses, contractions and preterm labor can become more and more of a problem. Therefore, your doctor may limit your activities in stages. Following your doctor’s advice about your activity level is important in preventing contractions that can lead to preterm birth. Lying on your left side is important to help the blood flow to your baby. Do not lay on your back. When your doctor puts you on bed rest, it means lying down, not sitting, in order to take pressure off your cervix.

To follow your doctor’s advice about limiting your activities, you must understand exactly how your doctor defines those limits. To help you understand these limits based on your pregnancy, complete the following checklist from your doctor’s instructions to you. If you have questions, write them down and ask them at your next prenatal care visit.

Note: Your doctor may change your activity level several times during your pregnancy. Print copies of this list and keep a record of changes.


What can I do right now?


Overall level of activity

___Keep a normal activity level?
___Slightly decrease activity level?
___Greatly decrease activity level?


Working outside the home

___Can I keep my full-time job? Date __________
___Should I work part-time? (how many hours) ______ Date __________
___Can I work in my home? (how many hours) ______ Date __________
___Should I stop working completely? Date __________
Why? ________________________________


Working inside the home

___Can I keep doing housework? Date __________
___Cut down on housework? Date __________
___Heavy lifting (laundry, moving furniture)?
___Preparing meals (standing up for long periods)?
___Heavy cleaning, scrubbing, vacuuming?
Other? ___________ Date __________
Why? ________________________________

Driving/Riding (Wear Your Seatbelt!)

___May I drive? Date __________
___May I be a passenger? Date __________
___May not ride in a car except to and from doctor? Date __________
Why? ________________________________

Child Care

___Care for my children as usual? Date __________
___No lifting of my children? Date __________
___Have someone else watch after small children? Date __________
___Have permanent childcare for all children? Date __________
Why? ________________________________


Sexual Activity

___Continue normal sexual activity? Date __________
___Limit sexual activity? (How many times a week?) ______ Date __________
___Avoid intercourse? Date __________
___Avoid activity that stimulates female orgasm? Date __________
___Avoid all sexual activity? Date __________
___Avoid nipple stimulation? Date __________
___Use a condom? Date __________
Why? ________________________________


Getting up and about

___Continue normal activity Date __________
___Limit standing and walking (sit down frequently) Date __________
___Lie down each day Date __________
(for how long? which position?)___________________
___May I go up and down stairs? Date __________
(how many times each day?)_________
___Can I take a shower (tub bath)/wash my hair? Date __________
___Can I eat sitting at the table? Lying down? Date __________
Why? ________________________________


Bathroom Privileges

___Can I use the bathroom normally? Date __________
___Use a bedpan? Date __________
___Avoid constipation (straining)? Date __________
Why? ________________________________

Maintaining my pregnancy

___Should I do kick counts? (how many times each day?) Date __________
___Should I monitor uterine contractions? Date __________
(how many times each day?)___________
___How much water should I drink? ________________ Date __________
___How much weight should I gain? ___________ Date __________
___Should I avoid certain foods? Date __________
________________________________________
___Should I eat certain foods? Date __________
________________________________________
___Should I limit cigarettes or stop smoking? Date __________
___Should I avoid alcohol? Date __________
___Should I avoid certain medicines?(which ones?) Date __________
________________________________________
___Can I take certain medicines?(which ones?) Date __________
________________________________________


What can I expect in the future?

___Decrease in activity level?
___Limitations on work or stop working completely? _____________________
___Decrease housework?
___Need for childcare help?
___Need to lie down in bed?
___Need to stay in bed (total bed rest)?
___Limit driving or stop driving? ____________
___Limit sexual activities or stop all sexual activities? ____________________
___Need to do kick counts?
___Need to use a fetal monitor at home?
___Need to use a uterine monitor at home?
___Have a stitch in my cervix (cerclage)?
___Stay in the hospital for a time?
___Nursing care at home?


What tests can I expect?

___Amniocentesis?* Blood sugar screening?*
___Sonogram/ultrasound?* Frequent blood pressure checks?
___Nonstress test for my baby?* More frequent visits to doctor?
___Stress test for my baby?* Frequent vaginal exams?
* Ask your doctor for information about these tests and how to prepare for them.


Bed Rest in the Hospital

If you are on bed rest in the hospital, ask your doctor:
___What position should I lie in? ________________
___Do I have to use a bedpan?
___Can I get out of bed to wash my hair or take a shower?
___Can I take a bath?
___Can I walk the halls?
___Can I walk in my room?
___Can I sit in the chair in my room?
___Can I take (or be pushed in) a wheelchair to the lobby, nursery, or support groups in the ___hospital?
___How many visitors can I have? Who? When?
___Can my children visit?
___How often can my partner (friend, relative) visit?


Are there other health care professionals I might see:

___a physical therapist?
___a neonatologist (about my baby’s development or how my baby is doing)
___a pediatrician?
___a social worker?
___an occupational therapist?
___a specialist (cardiologist)?
___a nutritionist?

To Learn More about Preventing Preterm Birth

To Learn More about Caring for Your Newborn