The discourse of family responsibility for caregiving work in the home limits supports offered to these women, despite orders from their physician to limit child care and household responsibilities. There is a potential for increased guilt and shame for women unable to comply with these medical directives. This burden may be disproportionately placed upon women with limited family support and fi nancial resources. Offering assistance for women in need, even on a temporary basis, would seem to be the most responsible action until more is known about the effects of activity restrictions and self-regulated activity on perinatal and women’s health. It is unlikely that our preterm birth prevention efforts will be successful until we begin to address some of these inequities.