photo credit: Michael Hollander; Flickr Creative Commons
M
any women have asked me if it’s possible to safely run and train for a marathon while pregnant.
It’s a very important question and I’ve thought about dedicating a whole podcast episode to this topic.
Well, lo and behold I was recently invited to speak about this on the Run Run Live podcast. A big thanks to Chris Russell for having me on the show! You can hear me on episode 4-308.
Chris sent over 10 really great questions about pregnancy and running that he wanted me to tackle during the interview.
Here are the answers I gave based on my own experience of running through two pregnancies and the science I’ve read on this topic.
10 Questions About Pregnancy and Marathon Training
Unique Challenges
It’s my understanding that you’ve trained before, during and after your most recent pregnancy, what are the unique challenges are of mixing marathon training and pregnancy?
I had just come off running a marathon when I got pregnant with my 3rd son early in 2010 so I definitely had a fairly high fitness base. I was able to continue running my normal mileage at an easier intensity until around 22 weeks into my pregnancy.
At that point my round ligaments couldn’t take the impact anymore and I had to transition to doing all low impact exercises. During pregnancy the primary goal is doing what you can to have a safe and healthy pregnancy. Maternal cardiac output increases by 30-50% during this time and blood volume doubles.
So even though it may not seem like it, especially during the 1st trimester but your body is working hard and it’s important to respect that. Breathing rate also increases during exercise, especially during the 3rd trimester when you have a larger body mass. So it’s important to listen to your body and be okay with the fact that you’ll have to slow down. I’ve heard it said that pregnancy is a time to “train for two, not for you.”
Safety
I’ve seen the experts voice different opinions on what is safe for pregnant runners. I’m sure you researched all of this being both a runner and a mom, what did you decide on as an approach and why?
Let me just preface this conversation by saying that I’m not a doctor and my advice is not a substitute for that of your doctor. But in general, aerobic exercise like running has been proven to be safe during a normal pregnancy.
However if you have a chronic medical condition or history of miscarriage then you should always act with more caution and follow the advice of your doctor. But, for most women pregnancy doesn’t mean you put your identity as a runner aside. Things have definitely changed from the day when having a baby meant spending a week in bed.
And one of my pet peeves is that some people treat pregnancy like some kind of terminal disease. I’ve received comments like “are you sure you should be doing that?” and “don’t hurt yourself honey” more times than I care to count. I would often wait to announce my pregnancy until later than some people because I wanted to act “normal” for as long as possible.
Another thing to keep in mind is that every pregnancy is unique even if this is not your first child. This is a time to exercise more caution and listen to your body. Now I certainly don’t advocate sitting on the couch for nine months, but it isn’t a time to take on bigger challenges either.
Pregnancy and childbirth are much like a marathon experience and require a lot of patience with the process.
The American College of Obstetricians and Gynecologists (ACOG) which always takes a very conservative approach and states that,
“Continuing to run or do other aerobic activity during pregnancy for 30 min on most days of the week can reduce backaches, constipation, bloating, and swelling; prevent or treat gestational diabetes; increase your energy; improve your mood; improve your posture, muscle tone, strength and endurance; help you sleep better; and improve your ability to cope with labor pain.” They also say, “If you were a runner before you became pregnant, you often can keep running during pregnancy, although you may have to modify your routine.”
So if you’ve been running regularly before pregnancy then it’s fine to continue running at that level with less intensity during pregnancy as long as you listen to your body and adjust accordingly. However, pregnancy is not the time to train for a marathon for the first time or try and set PR’s. Your body needs to be invested in the healthy development of the baby.
The body will also present different challenges during the three trimesters of pregnancy. During the 1st trimester nausea, exhaustion and dizziness can be common. During the 2nd the center of gravity shifts, joints and ligaments get looser and women may start dealing with bladder pressure, urinary frequency and occasionally stress incontinence.
But you will see a wide range of what people can do during pregnancy and this was true for me as well. During my 3rd pregnancy I experienced a lot of fatigue in the 1st trimester (which is very normal) and felt great during the 2nd trimester. I was able to do a half marathon and 15k during this time. However, once I got to around week 22 my center of gravity had shifted enough that it was putting a lot of pressure on the round ligaments. From this point on any high impact activity caused a lot of discomfort. So I began transitioning to the stationary bike, elliptical, yoga and strength training. In fact, I worked out by cycling and some strength training the day my son was born.
Perception by Society
I remember seeing Paula Radcliffe racing quite well and quite pregnant. Is there still any cultural backlash around that? Or have we grown up enough as a society to understand, what I’ve always known, that women are tougher than men?
Yes, I still think it’s pretty shocking for many people to see a woman running during pregnancy. I remember a lot of noise on social media when Alysia Montano competed in track events while quite pregnant and a woman who completed the Chicago Marathon at 39 weeks of pregnancy.
There have been several examples of elite women who have trained throughout pregnancy like Paula Radcliffe, Deena Kastor and Kara Goucher.
When I was pregnant in 2010 Kara Goucher was also pregnant with her son and I remember following her experience since we were due at nearly the same time. She slowed down her pace quite a bit but I still found it amusing that her slow pace was better than my fastest pace. However, I would say that women who continue to train for the duration of their pregnancy are more of the exception rather than the norm. But us runners are a different breed and running is more part of our identity as opposed to just a form of exercise.
Advice
What are you top 3-5 bits of advice for women who find themselves pregnant during their training? What is the advice you got and what did you find to be true and maybe not so true?
I did a lot of reading and in general there’s a lot of good advice out there. Of course everyone has a different experience so it’s important to focus on what works for you. But my advice would be to:
Focus on training for a healthy pregnancy. Having a healthy baby is every mother’s number one goal and personal running goals will take a backseat during this time.
Listen to your body. In your head you may think you should be able to still run a certain pace or distance but it’s important to slow down. Don’t feel pressured to keep running through your pregnancy if you don’t want to and don’t feel pressured to stop if you feel good.
Don’t neglect core strength. Keeping your back, abdominal and hip and pelvic floor muscles strong will give you a more comfortable pregnancy and easier post-partum recovery. Just make sure not to do exercises that diminish blood flow to the uterus like those that require lying on your back or doing things like crunches from the 2nd trimester on. You also don’t want to hold your breath during exercises.
Make sure to wear comfortable exercise clothes. You may need a larger size of running shoes as your feet can relax and swell during pregnancy. Compression socks and a belly support brand can also be helpful for more support and to promote better blood flow.
Your center of gravity shifts during pregnancy which will make a woman more clumsy. Make sure that you don’t run on uneven surfaces or technical trails. It’s also important to warm up and cool down carefully. Relaxin, the hormone that relaxes your ligaments, is working throughout pregnancy and will result in looser joints and ligaments that can make you more vulnerable to injury.
If you have the following symptoms at any time during pregnancy be sure to stop exercising and contact your healthcare provider. Things to watch for include: abdominal cramping, vaginal bleeding, dizziness, chest pain, calf pain or swelling, or uterine contractions.
Recovery
Let’s talk about recovering from birth. Obviously giving birth can be quite rough on your body, especially if you have a C-section or other challenges. What did you do to minimize the impact of the blessed event and how did you recover to then go on and qualify for Boston!?
When you start exercising again post-pregnancy depends on how much you exercised during the pregnancy and what type of delivery you had. If you had an uncomplicated vaginal birth you will be able to begin exercising sooner than someone who had a cesarean.
But in general, start back slowly by walking several times per week and doing light stretching. Your joints and ligaments are going through a big transition post-delivery and your center of gravity will start shifting. Be sure to take it easy for the first 2-6 weeks (or whatever your doctor recommends). Listen to your body and proceed accordingly.
If you do start running during the first 6 weeks make sure that you take it slowly to avoid getting injured. Even if you were an avid marathoner you don’t want to jump back into heavy training right away. Your abdominal muscles will be very lax and this can throw your running form off as well as lead to back discomfort or other injuries. You’re also at a higher risk for stress fractures during this time. Be patient with yourself and remember that it’s important to rebuild a solid running base. Don’t take shortcuts and get injured.
My goals post-pregnancy were simply to let my body recover and slowly build back my running base. I mainly walked during the first 1-2 weeks post-partum and then slowly added in some running intervals. It was all about building back endurance before speed. I did deal with some plantar fasciitis at first and had to go slowly to keep this from getting worse. I did run a marathon 5 months after my 3rd son was born and since I was still carrying around some extra weight and breast feeding it was my slowest marathon to date. Then came the process of gradually dropping my times down. My current PR came around 19 months later.
Running Base
Do you think your experience and base of training helped you in the whole process?
Yes, previous to my 1st pregnancy I wasn’t running regularly and I ended up gaining a lot of weight and not making the healthiest food choices. I truly believe that having a strong fitness base and continuing to exercise during my subsequent pregnancies made me stronger, increased my pain tolerance, and made me more patient with the process.
Health of the Baby
photo credit: Elizabeth Brixton, Flickr Creative Commons
Is there any evidence that athletes have healthier babies?
A healthy mom results in a healthier baby. Studies show that exercise during pregnancy lessens back pain, prevents excessive weight gain, improves sleep quality, and reduces delivery complications and time spent in labor. In addition, exercise during pregnancy results in babies that have healthier blood vessels even into adulthood and help protect against heart disease. A study from the University of Montreal found that the babies of mothers who exercised had brains that were more fully developed.
Post Partum
Do you think your running helped you through the post partum and other mental challenges?
Yes, running was a good outlet for me and gave me both a mental and physical boost, even while dealing with sleep deprivation. Evidence shows that exercising post-partum helps prevent urinary incontinence and uterine prolapse. It also promotes blood flow, to avoid complications like varicose veins, leg cramps, edema and blood clot formation. Improved circulation promotes healing of pelvic tissues and strengthens uterine and pelvic ligaments and tendons.
As an added benefit, exercise in the postpartum period has been shown to decrease the incidence of postpartum depression.
Finding Time as a Mom
Mom’s tend to struggle more with finding time to train. How do you work in family?
I think Moms also often struggle with feeling guilty about taking time for training and it may also require getting creative to fit those runs in. It helps to surround yourself with a good support system whether it be your significant other, family member or friends.
It worked best for me to train early in the morning. I would run before my husband left for work (often before he was out of bed). That way it didn’t get pushed aside by the busyness of the day. But I often did cross training by attending yoga classes at the YMCA where they had a nursery or by doing exercises at home. I often had to pause midway through a workout to take care of needs or have a kid crawling on me but you can find a way to make it happen.
I think if I were to do it again I would invest in a treadmill which can make fitting those runs in a lot easier.
Top 3 Things Learned
What are the top three things you’ve learned from the process of training and pregnancy? If you had to do it all over again would you do it differently?
Pregnancy can make you a tougher and smarter runner. For me, running a marathon is way easier than childbirth. Both pregnancy and running raise your pain threshold and make you realize that you can handle more than you think.
Be comfortable with the decisions you make and take it a day at a time. I was pregnant for a 4th time in 2012 and lost the baby at 18 weeks. It was natural to wonder if my running had anything to do with this miscarriage even though pathology showed that the baby suffered from a genetic condition. Still, it was a very tough period of time as we dealt with this loss and as I had to again rebuild my running base. Running was a very helpful coping mechanism for me and I can’t say that I would do anything differently.
I’ve learned not to just train for races but to train for life. Being a strong and healthy person is so much more important to me than making a certain race goal. I want to run the rest of my life and enjoy all the unique opportunities and experiences running brings my way.
My third son, Liam, born October 1st, 2010. I either ran or cross-trained up until the day he was born.
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