Pregancy is Not an Illness

Oh my gosh, she’s pregnant! Is she shaking the baby? I heard she passed out and fell off the treadmill last week and is still running! Hopefully she is not lying on her back during strength training. I know that is not healthy for the baby! Why don’t you rest? You are so small! Are you doing ok? She is running too hard! It can’t be safe.

These are just some of the comments I hear throughout any given day: at work, at the park, on the trail, and even in line at the grocery store when I’m caught donning workout clothes with my pregnant belly. For many years, pregnant women were advised to abstain from any exercise during pregnancy. It was thought that such exertion could be harmful to both a mother and her baby. But times have changed; however, I still rarely hear any positive reinforcement about my choice to continue a safe and medically approved running routine during my pregnancy outside my closest friends and family. Last week was the very first time, at a local run, someone has shared encouragement: it came from, you guessed it, another female runner, who was informed enough on the benefits of exercising during pregnancy. You look strong and so healthy; how do you find the energy to continue your running routine during pregnancy? This was such a rare and nice comment; I will never forget it. She really did not have to say anything – just the smile she gave me as I ran by let me know she understood – I am used to expressions of shock or disbelief. In fact, I have found myself not making as much eye contact or giving waves on my running route to avoid “the look.” But why are these positive experiences so rare? Why must the pregnant runner/exerciser face negative preconceptions when there is so much research supporting the benefits of running and other low impact exercise on the pregnant mother and fetus? Today, doctors recommend healthy women, who have exercised frequently prior to pregnancy, to continue exercising during pregnancy. And studies show that “pregnant women benefit from regular physical activity the same way as non-pregnant subjects.” Some days, It is challenging enough to get out the door to run much less having to hear naysayer’s voices in your head with their skepticism and irrational comments. I want pregnant women to feel empowered during pregnancy, to feel strong, and to feel assured about their decision to continue their running routines under their doctor’s care. My goal is to provide you with some research and personal narrative on how running can be apart of a very healthy pregnancy and birth.

During my first trimester, I experienced some nauseousness and sensitivity to certain foods and smells along with fatigue. The only antidote that helped me, both physically and mentally, get through those 14 weeks: running and eating nutrient dense foods. Granted, I will be honest with you: starting the run was hard, but after I figured out that I felt symptom free after 10-15 minutes, I was hooked. My nauseousness was lifted, and I once again finished another run feeling healthier and stronger. So I went back for more – even though it was tough in the beginning. So obviously, I continued to get my bum out the door, just to feel better! During this time, I cut my running back to 4-5 runs a week and ran completely by feel with no evidence of my pace/mileage which helped me really listen to my body. On the other hand, If I was fatigued before a run, I switched days I ran or would cut back the time. But most of the time, I felt better after that initial 10 minutes. In fact, “Doctors agree that exercise can improve and/or prevent some of the most common ailments associated with pregnancy, making for a much healthier and possibly safer experience.” Furthermore, a recent study published by the Institute of Movement Sciences and Sports Medicine at the University of Geneva, in Geneva, Switzerland, found that “regular physical activity has proven to result in marked benefits for mother and fetus. Maternal benefits include improved cardiovascular function, limited pregnancy weight gain, decreased musculoskeletal discomfort, reduced incidence of muscle cramps and lower-limb edema, mood stability, and attenuation of gestational diabetes and gestational hypertension.” With this information, how could one pass up the opportunity to go for a run? Personally, I never had any expectations except to move my body and clear my mind for a small period of the day!

The second trimester was the best as far as motivation and strength -as expected. Every pregnancy is different. With my first daughter, Samantha, I had hardly any adverse symptoms. My second pregnancy has been very different with many more symptoms throughout the entire pregnancy such as continued nauseousness in the mornings, heartburn, constipation, restless leg syndrome, and a lower sitting baby creating bladder and round ligament soreness. However, as promised by all the literature, I still felt much better during weeks 15-28. I ran 5-6 time a week, and many runs got up to 60 minutes consistently. Some days were slower (about 8:45-9:00 minute pace) while others where below 8:00 depending on how I felt. My mission, once again, was to move my body, not run a PR. I did no workouts (intervals, tempos, or any real intensity) and didn’t feel bad about going slower or skipping days that I felt low energy. I also began partner personal training (with my big sis, Jerren) once a week for an hour at Emerge Fitness Training in St. Charles under the tutelage of my brother Matt Pirtle. With a heavier chest and belly, I more than ever need posture correction and strength exercises to combat late pregnancy back pain. During pregnancy, the abdominal muscles become weaker which can also contribute to back and muscle pain, so strengthening the core safely is a must to feel your best throughout and after the pregnancy. These workouts are going to help me maintain a comfortable existence during pregnancy, stay strong through my natural labor (hypnobirthing), and bounce back faster after delivery.

Currently, I am 32 weeks and in my third trimester (weeks 28-40). New developments in my running routine include more bathroom breaks (sometimes behind trees..opps, I mean come on, if I didn’t pee fast, I would never have time to actually run!), round ligament discomfort increasing, some morning tummy troubles, and a definite increase in fatigue sending me to take naps on the weekends when I can! All these symptoms have caused me to cut back to 4 days of running the past two weeks. In fact, last week, instead of going to the park to run, I took a much need nap: the baby must be growing a lot as confirmed in my baby books – she is growing a ½ pound a week at this point in order to fatten up and me about 1 pound a week. On an experiential note, I ran a 5k last weekend at the zoo; my first and only race during this pregnancy. My family does this race every year with the kids, and after we celebrate my birthday in the zoo. I started the first half mile at a 9:30 pace with my mom, but couldn’t get used to the crowd around me, so I took off. I ran a 22:20, mainly so I could win a darn Cheetah stuffed animal for my daughter by placing in the top three in my age group. I felt fine, but the next two days, my round ligament pain was very apparent! No more races or faster running for me. This baby is sitting so low that she is bouncing on my bladder like it’s a trampoline and stretching the lower ligaments of my tummy – especially when I run. I took a few days off- not sure if I would be able to comfortably continue my running routine through the last 8 weeks of my pregnancy. I tested my running shoes several days latter, and voila, all systems were back in order. Well, at least back to where I was before the 5k. I still have to stop and pee every 10 minutes and wear spandex to help with the round ligament soreness, but it is still comfortable enough to continue. I will take it one run at a time. So week 33, here I come!

I will keep you all posted on how the rest of the pregnancy goes. In the meantime, I would like to provide some solid research on pregnancy and running. After all, being a worry-wart mommy, I am constantly having to educate and reassure myself that what I am doing is not only safe but beneficial for my baby and me.

Fetal Benefits

• Improved stress tolerance and advanced neurobehavioral maturation.
• The offspring of the exercising women were significantly heavier and longer than those born to women in a control group.
• The offspring of those mothers who started exercise early in their gestation are leaner at 5 years of age and have a slightly better neurodevelopment outcome.
• One review concluded, current evidence appears to indicate participation in moderate to vigorous exercise during pregnancy may enhance birth weight, with caution that vigorous exercise could result in lighter offspring.
• A prospective study of more than 800 pregnant women found that the babies of those who expended a mean of 2,000 calories/week in leisure time physical activity were significantly heavier at birth than those of non-exercisers.

Pregnant Exercisers Benefits

• Most pregnant women restrict their mobility and their participation in routine activities, but studies have provided that daily exercise programs can reduce chances of miscarriage by 40%
• Moderate exercise such as walking, running, and cycling can prevent pregnancy induced hypertension
• Women who started exercise early in pregnancy, their placenta grew a third faster in mid-pregnancy and had about 15% more blood vessels and surface area at term.
• Exercise can also prevent early onset labor, premature rupture of membranes, and can even help shorten the duration of labor.
• A study showed that women who exercised during pregnancy felt better during the first trimester that those who did not exercise as exercise acts in concert with pregnancy to increase heart rate, stroke volume, and cardiac output.
• It has been observed that exercise during pregnancy helps mothers to loose pregnancy weight faster; it decreases aches and pains associated with pregnancy; reduces severe trauma from episiotomies and also reduces the number of caesarean sections.
• A study of chances in lung function tests during pregnancy have shown that women who were engaged in daily exercise programs developed adaptive changes in lung functions in the antenatal period.
• Lesser weight gain and fat retention; improved attitude and mental state; easier and less complicated labor and quick recovery are among the other advantages of exercise during pregnancy.

General Precautions

• All pregnant women, regardless of fitness level, should take precautions against dehydration and hyperthermia.
• Avoid exertion in hot, humid environments
• Drink fluids before, during, and after exercise
• To avoid compromising fetal growth, caloric intake must be adequate to meet the combined demands of pregnancy (additional 300 calories /day) and exercise (additional 100 calories /mile).
• Studies do reveal that there are no known added benefits, and more potential complications with vigorous exertion. Oxygen consumption during pregnancy is higher during pregnancy, limiting the ability to perform higher intensity tasks.
• Regular exercisers need to be advised to heed signs of fatigue and curtail workouts short of exhaustion to reduce potential risk of hypoglycemia.
• According to American College of Gynecology guidelines, careful evaluation should be done to determine if exercise is appropriate for pregnant women who have cardiac disease or restrictive lung disease.
• Participation in sports, volleyball/tennis, or any activity with the potential for causing abdominal trauma should be avoided.
• Exercise during the first few days of exposure to high altitude is also not recommended due to the reduced availability of oxygen.

Warnings Signs to stop exercise and seek medical attention

• Excessive fatigue
• Pain in the back or pubic area
• Dizziness
• Shortness of breath
• Palpitation
• Decreased fetal movement
• Persistent contractions
• Rupture of membranes
• Vaginal bleeding

References

ClappJF 3^rd, Simonian s, Lopez B. The One Year morphometric and neurodevelopment outcome of the offspring of women who continued to exercise regularly throughout pregnancy. AM J Gynecol 1998; 178:594-99

Clarke, Michael. The Benefits of Running While Pregnant. Active.com Copyright © 2013 HYPERLINK “http://www.activenetwork.com/” \o “Active Network | activenetwork.com” Active Network, Inc.

Pivarnik J. Potential Effects of maternal physical activity on birth weight: brief review. Med Sci Sports Exerc 1998; 30:400-6.

S.A. Faziani. Protocols for Exercise During Pregnancy. Journal of Pakistan Medical Association. April, 2004.

Jackie Pirtle-Hall ran for Francis Howell North, Mizzou, and Lindenwood before co-founding the FLEET FEET-sponsored Runnababez racing team.  Jackie's post-collegiate running resume includes victories in the GO! St. Louis and Illinois marathons and a 70th place finish in the 2012 Olympic Trials Marathon.