Running during pregnancy

Exercising terrified me when I was expecting Tucker (my 1st kiddo). My doctor gave me the green light early on but I wanted limits about speed and distance to keep my little bundle safe. I searched for research but there were no formal guidelines about how far or how fast I could go. Reading other mom blogs about exercise calmed my nerves, so I thought I'd share my experience. If you're expecting or hoping to be, here's what I learned in the last 5 years. 

At the risk of getting too personal, I've spent the last 5 years trying to get pregnant, being pregnant, or recovering from pregnancy. I had my 1st child in October of 2016 and gave birth to my 2nd child September of 2018. It's been quite the journey and I spent a lot of time scrutinizing the pros, cons, roles, and limits of exercise on conception and pregnancy.   

Formal guidelines

I received a lot of fear based recommendations from other people. Those who aren't in the field (or don't exercise) generally believe exercise is going to harm the baby or mother. I had people warn me that the baby would fall out when I run (yea, that's absolutely not a real thing) or that "it can't possibly be good for you" (also inaccurate).

​If you don't like or want to exercise, it's easy to find non-research based opinions to support your argument. Additionally, the old school believe was to "lay low" during pregnancy.  However, despite popular belief, there aren't many limits and instead, most of the recommendations are about encouraging movement - aiming for at least 150 minutes of moderate exercise week (that means getting slightly out of breath). 

Guidelines have changed a lot throughout the years. Heart rate used to be the limit citing no more than 140 beats / minute. However that recommendation is no longer used - especially for people who are already fit going into pregnancy because the body is accustomed to the work. Most of the guidelines you see now are pretty straight forward (with the exception of certain health conditions) and encourage women to listen to their bodies. And interestingly, there is little to no research demonstrating that exercise increases the risk of miscarriage or pre-term labor (actually research demonstrates the opposite - that being inactive increases those risks). 

The American College of Obstetricians and Gynecologists (ACOG - the expert body on all things pregnancy) basically warns: 

1. Avoid anything where you might fall
2. Avoid contact activities where you might get hit
3. Avoid movements that cause decreased oxygen return (eg, excessive twisting, scuba diving)
4. Avoid overheating

And always check in with your doctor about what's best for you personally. ​

Additionally, ACOG outlines circumstances conditions in which exercise must and might be limited (see respective images below). 

There are a lot of changes going on in a pregnant body that may change how you approach your usual routine (ACOG FAQs here). Namely : 

• Joint Mobility —Pregnancy hormones may cause joints and ligaments to be more relaxed (especially later in pregnancy), and that increases the risk of injury. Be cautious with jerky, bouncy, or high-impact motions. That also means that smart strength training is super helpful so your joints aren't doing all the work. 
• Balance — It's no secret that a pregnant body changes  A LOT. A growing belly shifts your center of gravity which increases the stress on your hips, pelvis, and low back. The change also makes you less stable and more likely to lose your balance.
• Breathing— Pregnancy increases your blood volume and oxygen needs. Additionally, as your belly grows, you experience more shortness of breath as the uterus increases pressure on your diaphragm / lungs. All of which makes it harder to breath, even when you're doing less than normal.

While guidelines are helpful, there's a lot of individuality in "what's right" for a pregnant body  it's often relative to what you are used to doing. But every body is different and even every pregnancy is different. There's also a degree of personal variation in what you're comfortable doing. When in doubt, chat with your doctor and be smart.  

My experience

Before I tell you what it was like exercising during pregnancy, it's important to outline my situation. There are many factors that put me at an advantage, so it's important to recognize that what was right for me may not be and does not need to be right for you. Please do NOT use my personal story as a guide to what you should be doing during pregnancy. 

Here's a bit about me: 

• I've been running year round since 1997 (20 years) and have run ~20 marathons and too many triathlons (losing track over here). Typically run at least 30+ miles / week and often cross train with cycling, strength training, yoga, and occasionally swimming. I LOVE movement to calm my mind and revive my spirit. Running is my therapy of choice

• MASTER OF MOVEMENT : I am an experienced personal trainer with expertise in adaptive exercise - my brain is a library of exercises and I know what the correct movement should look and feel like. I also have a strong working knowledge of physical therapy - when I have an ache or pain, I can quickly recognize if it's due to strength discrepancies, flexibility, or injury and adjust accordingly (eg, I know my hips are my weak point so take a lot of time to keep them strong). 
• LIFE CATERS TO MOVEMENT : I have a predictable job that allows me to escape for a jog at lunch and a supportive husband who also values movement. My kiddo and doggies LOVE running with me - especially early in the morning before it's hot. If anything, they encourage me to run MORE. I live and work in safe neighborhoods with generally great sidewalks and my pregnancies were in spring / summer so there was minimal risk of falling and I had excellent outdoor weather to play. 
• EASY PREGNANCY : Both pregnancies were uncomplicated - no nausea, vomiting, constipation, heart burn, or even low energy and I have no health conditions.
• NOT ABOUT WEIGHT : I have a healthy relationship with food - not at risk of under eating and I readily accepted and at peace with pregnancy weight gain / body changes - running was not about avoiding weight gain.
• NOT MY 1ST PREGNANCY :  with my 1st child, I had to stop running at 29 weeks due to hip pain. Knowing that going in, I was extra careful this pregnancy to keep my hips strong and mobile.
• DOCTOR SUPPORT : Both of my OB doctors supported exercise. My first OB personally loved exercised and did so throughout her pregnancies and encouraged me to do what I love (she moved away between my two pregnancies). When I brought my fears to my first doctor (who was also very active), she reassured me that if pregnant bodies were THAT fragile, the human race would have become extinct long ago.

So let's talk about what it was like moving the last 10 months!

Before pregnancy

Going into this pregnancy, I was active. After Tucker was born in October 2016, I quickly ramped up my running and strength training and maintained ~50 miles / week. I ran a marathon in April 2017 and qualified for Boston (woot woot!). I maintained that mileage by running to and from work, running at lunch, running before work with the pups and stroller, and added in a few days of cycling 20 miles, sporadic yoga, and consistent strength training for the rest of summer / fall. In December 2017, I reduced my volume and intensity intending to start training for the Boston Marathon in 2018.

Trend of # of steps and running mileage throughout the course of pregnancy. Not a big change until the final trimester. NOTE: I got a fancy new watch in January that better tracked running vs cycling as well as # of steps. I was NOT running 300 miles / month in October of 2017...some of that's cycling. 

1st trimester - goal "maintain, don't train"

I found out I was pregnant a few after writing my Boston Marathon training plan. I debated at length whether or not to go forward with training but ultimately decided my plan would be to "maintain, don't train." My long run when I found out I was pregnant was 14 miles, so I decided to maintain that each weekend and general overall mileage of 40 miles / week plus strength and yoga until the race (or as my body would allow).

I could have run more and even attempted the full marathon - there is no evidence saying running that much would cause any harm to me or the baby (especially since my body was used to running that kind of mileage). Part of me wanted to be one of those "crazy pregnant ladies," but I knew my personality well enough that if I trained for the full race, I'd stop listening to my body and instead focusing on hitting numbers. I didn't feel comfortable putting that kind of pressure on my body (or mind). I estimated that I'd be 20 weeks pregnant in April, so set a goal to run 1/2 of the Boston Marathon to celebrate being 1/2 way through the pregnancy.  

My first  trimester was pretty uneventful. I've been lucky with both pregnancies and had minimal nausea and my energy always stayed the same. I did notice early on that trying to run fast was harder and I was out of breath easier. I was hitting 6 and even some sub 6 min miles for my 800 meter repeats, but quickly found my pace slowing down for the same perceived exertion.  I also had a lot more bloating which makes running less enjoyable but not impossible. But all in all, pretty easy to maintain my previous routines.  

2nd trimester - starting to feel pregnant

Most of the 2nd trimester was pretty uneventful. But as I neared the 20 week mark, I was feeling pretty "done" with my weekly long runs of 12-14 miles and ready to relax a bit. I was grateful that I didn't "train" for Boston because I found myself feeling pretty guilty when my body wasn't game for what was scheduled. 

At 20 weeks, I ran 1/2 of the Boston Marathon. It was QUITE the day - pouring rain and frigid. The race itself was easy enough - averaged 8:15 min miles (qualified by running 7:20s). But waiting around for two hours before the race was miserable and I almost bailed. The square in Hopkinton was a swamp of mud and water with no way to get warm other than to huddle as best you can - I couldn't feel my toes or stop shaking. Combine that with a shrinking bladder (yet need to hydrate) and it gets pretty interesting! But once I made my way to the start, found a bathroom, and got running, it was a treat. I trotted along until I got to 13.1 miles and my husband and kiddo picked me up (dressed as superman). 

The remainder of the 2nd trimester was a slow decline of pace and speed. By 25 weeks I couldn't run to and from work anymore - running with a backpack and a growing belly wasn't kind to my back anymore.

By week 26, running after 12pm wasn't working either. I felt like food was sitting heavy in my stomach and pressing on my lungs making it hard to breath. The jostling and twisting of running just didn't feel good. So I shifted all of my runs to before work - which meant taking the kiddo in the stroller and the 2 dogs. As a result, pace went WAY down (but the joy factor went way up). 

3rd trimester

The final trimester was the most entertaining. Each week I felt my body growing and changing. At the start, I was running pretty well. But by 30 weeks, I couldn't run up steep hills with the stroller but flatter sections and down hills were no problem. I continued running most days and lifting weights. 

Everything really changed by 36 weeks - I felt pretty taxed after long runs and lifting weights was miserable. So I dropped the number of days I ran, the distance, walked more, and started using just my body weight to maintain strength and mobility (push-ups, lunges, hip abduction exercises, tricep dips). 

By week 37, my belly was feeling so big that running down hills put a lot of pressure on my pelvic floor. Enter more walking. I also told myself that 3-4 miles was "enough" (even though I felt like I could do more at times). 

In the final two weeks of pregnancy, my "runs" were more and more about walking instead of trotting. Every day I thought "well this is the last day of running" but each day my body cooperated on the flat sections and tolerated 3-4 miles pretty easily. I continued my light strength training and generally felt pretty good!

A few days before the 39 week mark, I started feeling contractions more and more (but not when running). I continued logging 3-4 miles of walking (and even some trotting) until my water broke a few days later.

Where I am now...

As I write this, it's been 2 weeks since the baby was born. Delivery was no joke. After my water broke, labor was fast and intense. Unfortunately the baby was completely wrapped up in his cord and with every contraction, his heart rate dropped. Six hours after getting to the hospital, I had an emergency c-section - which was NOT the way I wanted to deliver because I feared the recovery length and immobility (I had a natural birth with my first).

I had heard horror stories of being couch bound for weeks and the thought of being so dependent on others was terrifying. However the process has been totally different than what I expected: 

• Days 1-2  (at hospital) : Super painful and taking pain medications like it's my job. Walking very slow and minimal - made it down the hall a few times.
• Days 3-4 (at hospital) :  Feeling WAY better physically and opted to leave by day 4. Only on ibuprofen by day 4. 
• Day 5 (at home) : Still taking ibuprofen (but less). Able to move around the house easily and cleaned.
• Day 7 :  Slowly walked 1/2 mile to and from a park with my growing family - felt pretty tired but physically possible. 
• Day 9 : No longer needed pain medication. Able to walk the dogs AND take stroller for 2.5 miles.
• Day 10 -14 : No pain. Walking most days with both kids (carrying the baby front carrier and Tucker in stroller - waiting on delivery of double stroller) anywhere from 3-5.5 miles.

day water broke

2 days after delivery

1 week after delivery

2 weeks after delivery

While I'm able to move with zero pain and lift most anything, I'm very aware that a c-section is an extensive surgery that cuts through many layers of tissue and muscle. It's tempting to go for a slow trot and "see how it goes" but this is one of those circumstances in which "if you think you're ready, give it a few more weeks."  There's a lot of strengthening and repair in my future! But for now, "workouts" are about enjoying the outdoors with my kiddos and pups in the fall weather. 

Moral of the story...

Movement during pregnancy is absolutely possible, but the amount, type, and speed are very individual. What's most important is to pay attention to your body and stay in close communication with your doctor about your concerns. If you struggle hearing signals from your body, consider working with your physician or an experienced personal trainer to provide gentle structure and give your body a voice. 

Stay nourished friends!