Understanding Bed Rest During Pregnancy: Risks and Medical Necessity

Question
You have answered a couple of questions for me before and you are a very helpful person.  I really appreciate you.  Anyway, I am 24 years old and this is my first child.  The date of my last period was January 9th, 2004.  My question has to do with my feeling like I should go on bed rest.  I have asked my doctor to put me on bed rest and she said she couldn't without having a medical reason because she could get into trouble with the licensing board?  I don't see how that could even be an issue so I wanted to check and see if you knew anything about that, but mostly, I wanted to get your advice as to whether I have a medical reason to be on bed rest or not.  I am in my 31st week.  I was just recently put on prescription iron pills to add to my prenatal vitamins because I am anemic.  I am also hypoglacemic and have had a difficult time keeping my sugar up here lately.  But those are not my major concerns.  My concern is that I have been having a lot of swelling in my hands, feet, ankles, and some around my mouth.  I have also been having a lot of headaches and today I have started getting a touch of blurred vision.  It is more like everything looks hazy or cloudy.  However, everytime I go to the doctor and they check my blood pressure it is fine.  It is a little higher than my usual blood pressure, but it is still within normal limits.  So should I be worried about the other symptoms?  Also, my job is very very high stress and I am having a hard time getting through 8 hours a day without completely loosing my stamina.  I literally cannot move when I get home I am so sore and tired.  Last but not least, I have been having a lot of Braxton Hicks contractions and pelvic pain.  I keep thinking I am going into labor because it seems to be increasing in intensity.  I asked them at my doctor's office if there was any way I could tell the difference so that I didn't run back and forth to the hospital all the time and she said no that I needed to come in and be strapped to the monitor to be sure especially since I have been putting out a mucousy discharge going on 4 weeks now.  So my work is getting pretty upset with my having to not only go to the doctor every 2 weeks, but to also have to go running to the hospital everytime I get the pains.  I am afraid I am going to end up loosing my job unless my doctor puts me out on bed rest with a doctor's note until after I deliver.  I have a person already set up to cover for me while I am out for maternity leave or any additional time that I am out, but she can't come on short notice like that when I have to run.  I don't know what to do.  I am at the end of my rope, I am exhausted, and I feel like my body is wearing out.  I feel like I am stretched too far.  Can you please tell me what you think the best thing for me at this point would be?  I would appreciate any advice you could offer.  Thank you so much in advance.  

Answer
If you are having edema of your hands and feet, and headaches, but your blood pressure is within normal limits, you do not appear to have any evidence of pre-ecclampsia (which would be a reason to put you on bed rest). However, sometimes, blood pressure does not always occur. I would suggest that you get some blood tests (Uric Acid, platelet count, and liver function tests). You can always go on bedrest if you wish, but your doctor cannot recommend it officially without any objective evidence of PIH (pregnancy induced hypertension). If the blood tests are abnormal and you continue to have headaches and edema, then the doctor can put your on bedrest. Until you have any objective evidence of pre-ecclampsia, there is nothing else to do, as long as the Non Stress tests are reactive and there is no problems with the baby's heartbeat.