Pelvic rest is a temporary, protective step your medical team may recommend to safeguard your health and the health of the intended parents’ baby.
Following these clinical instructions provides the best
possible environment for the intended parents’ baby to thrive while giving you
peace of mind.
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surrogacy process? Fill out
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What Does it Mean to Be on Pelvic Rest During Your Surrogate Pregnancy?
The term pelvic rest is a
clinical directive from your doctor, usually a Reproductive
Endocrinologist (RE) or your Obstetrician (OB), that restricts activities
that cause stimulation or increased blood flow to the pelvic area.
Unlike full
bed rest, which requires you to limit most physical activity, pelvic rest
is specific. It focuses on limiting anything that could stimulate the cervix or
uterus. This restriction is almost always temporary and is considered a
proactive measure.
Surrogates typically encounter these restrictions during the
embryo transfer phase or if responsive medical needs arise later in the
pregnancy. Common restrictions include:
- Sexual intercourse or vaginal penetration
- Inserting anything into the vagina (including
tampons, douches, or menstrual cups)
- Orgasms, which cause uterine contractions
- Sometimes, specific types of exercise or heavy
lifting
This medical guidance is always given with the goal of
protecting the pregnancy. Your medical team will provide clear, specific
instructions tailored to your unique situation.
Proactive vs. Responsive Pelvic Rest
If your doctor advises you to be on pelvic rest, it is not a
sign of failure or that you have done anything wrong. It is simply a precaution
used to reduce the risk of complications.
The reasons a surrogate would be placed on pelvic rest
generally fall into two categories: proactive precautions related to the
medical process and responsive measures due to a potential complication during
the pregnancy.
- Proactive
Pelvic Rest: This is a standard part of the surrogacy medication timeline.
REs prescribe rest 2–3 weeks before and immediately following an embryo
transfer to ensure optimal
implantation conditions.
- Responsive
Pelvic Rest: This occurs later in the pregnancy if an OB identifies
specific conditions. Common triggers include vaginal spotting, placenta previa
(where the placenta covers the cervix), or signs of a shortened cervix that
could lead to preterm labor.
Who Decides Pelvic Rest – and Who Supports You?
When you are a surrogate, many individuals are involved in
your medical and contractual well-being, but the lines of authority for medical
decisions are clear.
The Role of the Medical Clinic
Your Reproductive Endocrinologist (RE) and, later, your
OB/GYN are the only parties who will advise or mandate pelvic rest. You should
always follow your clinic’s recommendations above all else. They are the
medical professionals guiding the pregnancy. Here’s how they support you:
- The RE manages the protocol leading up to and
immediately after the embryo transfer.
- The OB takes over once the pregnancy is
confirmed and manages your health for the remainder of the pregnancy.
The Role of the Surrogacy Contract
While the medical decision is always the doctor’s, your
surrogacy contract is the document that legally binds you to following that
medical guidance.
American Surrogacy works with reputable attorneys to draft
contracts that protect all parties. The contract will not typically require
pelvic rest during the entire pregnancy but will include wording about
following the clinic’s guidance, which is legally enforceable.
The Role of Your Surrogacy Specialist
Your specialist at American Surrogacy serves as your medical
advocate and emotional support system.
If you receive a pelvic rest order, your specialist can help
you clarify the doctor’s instructions, communicate the news to the intended
parents, and ensure everyone is aligned. This means we will:
- Act as the primary communicator between you and
the intended parents (IPs), ensuring the IPs receive timely, sensitive updates
without overwhelming you.
- Clarify medical terminology and logistics,
helping you understand exactlywhat restrictions are in place so you
can follow them confidently.
- Confirm contractual obligations are being met,
especially concerning expense reimbursement if the rest order impacts your work
or childcare needs.
- Provide emotional support to help manage any
anxiety or frustration that comes with physical limitations.
What’s Not Allowed on Pelvic Rest During Pregnancy – and Why It Matters
Pelvic rest is a focused restriction meant to keep the
uterus and cervix calm. The restrictions are in place to reduce the risk of
irritation, infection, or uterine contractions. The restrictions typically
include:
- No
Sexual Intercourse: The primary goal is to prevent penetration
and the associated risk of infection or cervical irritation.
- No
Orgasms: Orgasms cause involuntary contractions of the uterus,
which can irritate the cervix or, in a high-risk situation, potentially trigger
premature labor.
- No
Vaginal Insertion: This includes tampons, or any medical exam
that is not strictly necessary and approved by your doctor.
How Pelvic Rest differs from Full Bed Rest
Full
bed rest is a much more intensive and less common restriction that limits
most activities, requiring you to remain in your bed for most of the day.
Pelvic rest is often a partial restriction, meaning you can typically continue light activities, work (if not physically demanding), and carry out daily tasks.
Unless your doctor specifically restricts it, you may still be able to:
- Walk and perform light chores
- Engage in non-strenuous, non-pelvic exercises
(like arm stretches)
- Go to work or school
- Drive and run errands
Generally, high-impact activities, heavy weightlifting, or
exercises that significantly jar the pelvis are restricted. Always confirm with
your medical provider what activities are safe.
When Can You Have Sex While Being a Surrogate? Intimacy During Surrogacy
Concerns about intimacy are completely natural for a
surrogate and her partner. These questions often center around three stages:
before embryo transfer, immediately after transfer, and during the confirmed
pregnancy.
Guidelines around intimacy will be driven by the RE’s
specific protocol, and this protocol will be incorporated into your surrogacy
contract.
When Should My Partner and I Stop Having Sex Before the Embryo Transfer?
The general recommendation is to abstain from sexual
activity in the weeks leading up to the embryo transfer. The main reason is to
eliminate any risk of infection or potential uterine irritation during the
preparation phase.
The specific date you stop having sex before the embryo
transfer will depend on your clinic and the contract, but it is typically
advised to stop sexual activity approximately 2–3 weeks before the scheduled
transfer or from the start of the preparation medications.
The RE is priming your body for the best chance of
pregnancy, and following this advice ensures that your uterus is in the optimal
condition.
When Can You Have Sex After the Embryo Transfer?
This is a time of high anticipation, and the rule is simple:
be on pelvic rest until otherwise advised by the clinic. You will likely be
instructed to remain on pelvic rest until the clinic confirms a positive
pregnancy test, or sometimes until they release you to your OB/GYN (around 8–10
weeks).
Waiting until confirmation ensures that any potential
irritation or contractions that sexual activity can cause do not interfere with
the embryo’s ability to successfully implant and grow.
Sex During Confirmed Pregnancy
Once the RE releases you to your OB, the guidelines typically
follow those of any healthy, low-risk pregnancy. If the pregnancy is
uncomplicated, most doctors lift the pelvic rest restriction after the first
few weeks, allowing you to return to normal intimacy.
However, if your OB identifies any of the responsive reasons
mentioned above (like spotting or placenta
previa), they will re-issue the pelvic rest order. The golden rule is
always to communicate with and follow
your OB’s advice throughout the medical process.
How Pelvic Rest Can Affect a Surrogate’s Emotional Wellbeing
Physical restrictions can impact your emotional health, and
it is completely normal to feel frustrated, isolated, or anxious if you are
placed on pelvic rest.
- Normalize
Emotional Responses: Whether you are restricted for a few days
after the transfer or a few weeks later in the pregnancy, it is natural to feel
limitations. You may feel bored, miss your regular routine, or feel pressure to
be perfectly still.
- Stay
Engaged: Although your body is resting, your mind does not have
to be. Use this time to read, catch up on movies, listen to podcasts, or engage
in non-physical hobbies. Staying mentally active helps manage feelings of
confinement.
- Focus
on the Purpose: Remind yourself that this limitation is a
direct sign of your commitment and care for the intended parents and their
baby. It is a temporary sacrifice for an eternal gift.
- Our
Support: Your specialist understands the emotional complexity
of these limitations. We are here to check in, listen, and connect you with
resources if you feel your emotional health is struggling.
Navigating Pelvic Rest With a Partner or Spouse
When a surrogate is placed on pelvic rest, it impacts the
entire household, especially
the spouse or partner.
Physical restrictions on intimacy are a temporary sacrifice
to help a family grow. Maintaining a strong connection with your spouse or
partner during this time requires clear communication and a reframing of
intimacy.
Partners can support the journey by taking over strenuous
household tasks or childcare duties involving lifting.
To maintain closeness without physical stimulation, many
surrogates focus on “non-pelvic” intimacy, such as shared hobbies,
movies, or focused conversation.
If physical limitations cause friction at home, your agency
specialist can provide resources to help you and your partner navigate this
stage as a team.
How Pelvic Rest Fits into the Bigger Picture of a Healthy Surrogacy
Pelvic rest is not a contractual red flag or a sign that the
entire surrogacy is at risk. It is a standard medical precaution that
reinforces the protective nature of your journey.
Legal and Contractual Clarity
Your surrogacy contract will detail how lost
wages or unexpected costs are handled. If a doctor’s order for pelvic rest
causes you to miss work, the contract ensures you are appropriately reimbursed
for your time, just as you would be for any other medical inconvenience.
The contract, the medical guidance, and the agency support
all work toward the single shared goal: a safe, healthy pregnancy and a
successful delivery. When you are on pelvic rest, everyone involved is doing
their part to support that goal.
Get Support from Surrogacy Specialists
Choosing to be a surrogate is an incredible act of
compassion, and it deserves an agency partner that prioritizes your health,
support, and clarity at every turn.
When medical instructions like pelvic rest come up, you
deserve to have an expert who can advocate for you, communicate with the
intended parents, and ensure your contract protections are honored.
If you have questions
about the surrogacy journey, how our specialists handle medical protocols, or
what support is available to you, fill out
our contact form to get free information.
