Two For The Road

run-preg

“It was a beautiful winter day – snowy but sunny – and I felt great running on snow-packed roads. I was as pregnant as possible – for that evening, I gave birth. I had gone out for a five-miler, but I felt I could have run forever. No matter how much time passes, I can still mentally put myself on that road. A perfect run on a perfect day.” (From Joan Samuelson’s Running for Women.)

Okay, so you’re not an Olympic champion like Joan Benoit Samuelson – fair enough. But if you’re a pregnant runner who wants to maintain her fitness, then your running needn’t suffer. While adhering to certain fundamental principles to ensure your health and that of your baby, as an expectant mum you can enjoy the pleasures of running much the same as in your non- expectant condition. And who knows, maybe you too will reach Samuelson’s state of bliss even before your baby’s born.

First and foremost, it’s crucial to listen to your doctor’s advice. Complications during pregnancy are rare, but if they do arise they may prevent you from carrying on with your training, no matter how committed and motivated you are to running. A frank and open discussion with your obstetrician – particularly about your exercise programme – is essential to guarantee a healthy pregnancy. A supportive doctor who recognises the benefits of an exercise programme will not only listen to your concerns, but should also address your individual needs, although you should never hesitate to seek a second opinion if you’re uncomfortable with your doctor’s diagnosis. Your well-being and peace of mind, as well as the livelihood of your baby, are at stake, so don’t be afraid to speak up.

If you’ve been given the green light to run, then proceed with cautious enthusiasm, says Dr Rod Jaques, medical advisor to the British Triathlon Team at the British Olympic Medical Centre. The health benefits to women who exercise while pregnant have been well documented. They include: less lower-back pain; reduced amounts of analgesic at delivery; fewer instances of operative deliveries; and fewer cases of post-natal depression. What’s more, women who exercise during pregnancy gain less weight, have improved mood and sleep patterns and lose weight more rapidly after giving birth. Although now is not the time to begin a running programme, if you’re already an experienced runner then there’s no reason to stop – just modify.

How intense is too intense?
Dr Jaques notes that concrete answers to the questions of “how much and at what intensity?” will never be found on the research block, since scientists will be hard-pressed to find a woman willing to subject her pregnancy to such experiments.

The best evidence doctors can come up with is based on animal testing. “Although we can’t make that leap into the human world based on the animal experiments, we can try to extrapolate the effects of high-intensity exercise during pregnancy, interpret the data and apply the results to human beings,” he says.

Dr Jaques advises women to keep their heart rate at or below 140 beats per minute (bpm) while exercising. Experiments on pregnant dogs suggest that running at an intensity greater than 70 per cent VO2max (the point of maximum oxygen capacity) for two hours or more is potentially damaging to a litter of puppies: dogs forced to run at such an intensity and duration gave birth to a high proportion of runts and with a greater number of abnormalities in the litter. “Big babies do better, smaller babies do worse,” notes Dr Jaques. “If the dog studies are anything to go on, then high-intensity exercise must be avoided to ensure the health of the baby. Use 140 bpm as a ceiling.”

Furthermore, recent studies conducted on sheep – in which they were made to exercise at 70 per cent of their VO2max – revealed that the animals experienced a significant rise in their intrauterine temperature (the temperature within the womb).

Although the human implications are admittedly frightening, the doctor additionally noted that both the sheep and their offspring were perfectly fine at delivery. “Researchers have determined that a rise in intrauterine temperature would have to be fairly prolonged to produce damage,” Dr Jaques explains.

Chill out and relax
Some research shows that an internal body temperature above 101°F may cause birth defects in the developing foetus; yet other studies fail to confirm these findings. Given such conflicting reports, however, most experts agree that a pregnant woman must keep her core body temperature at a recognised safe level (below 101°F) to protect her unborn baby from potential birth defects, particularly to the foetus’s central nervous system.

What can an expectant mother do to stay cool? In addition to keeping your heart rate at or below 140 bpm, experts advise you to train outdoors, rather than indoors on a treadmill where the wind’s cooling effect is eliminated. If you are inside, be sure the area is well ventilated; keep the windows open and consider investing in a fan or two. Avoid running in very warm and hot conditions. Pregnant women should never run to the point of breathlessness or exhaustion – it’s important to work to a comfortable level and not overdo it. You should additionally ensure that you remain very well hydrated before, during and after a run. Dr Jaques advises pregnant athletes to drink 100ml of water every 15 minutes during a run, and to keep pumping the fluids afterwards.

During pregnancy, a woman’s body produces the hormone relaxin, which relaxes joints and ligaments. Loose joints and ligaments can make you more susceptible to injury, and the gradual widening of your hips will change your biomechanics and make your feet more likely to overpronate (roll excessively inwards). Easing gently into a run and stretching properly afterwards will help to prevent injuries, as will choosing shoes with increased stability and cushioning.

According to the National Childbirth Trust, during the first trimester of pregnancy you may experience increased tiredness, nausea, breast tenderness, pressure on your bladder and constipation. Many of the side effects of pregnancy are due to the sudden rush of hormones in your body. Yet many women surveyed by Dr Jaques report having ‘a wonderful time’ when running through- out their first trimester. Be sure to map out toilet stops along your route, wear a supportive bra and stop running if you feel too tired at this stage. Weeks 0-14 are crucial as far as your baby’s development goes. At week five the foundations of the brain and the spinal cord are growing, and at week six the head begins to form, followed by the chest and the abdomen. By the 10th week the heart will be pumping blood to all parts of the body and the internal organs will be functioning. Your ‘little runner’ is now completely formed, and just needs to grow.

From weeks 14-28 your pregnancy begins to show, and your breasts grow as milk-producing cells develop. Your pregnancy is now fully established and your baby is well formed; you should be feeling more energetic, and any naturally occurring sickness will lessen. Many women experience lower-back pain at this time due to the increased pressure on their pelvis; this may contribute to other unexpected pain such as knee strain. With the added weight your running gait may change, so be alert to terrain and traffic while running.

Properly formed, your baby now looks like a real human being – and behaves like one: moving limbs in response to stimulation from the brain and exercising his or her muscles. At any time between 18 and 22 weeks you may feel the baby moving.

During the last lap of pregnancy your weight-gain – finally – will begin to slow down. You may feel the need to use the loo more often as your uterus presses down on your bladder. You may also experience a shortness of breath and your feet may swell, making running quite taxing. Dr Jaques notes, “It would take a heroic woman who would consider running during this stage of pregnancy. Physically, it’s extremely challenging.” Concentrated weight gain at the bottom of the sternum and pubic bone makes it difficult biomechanically to run. Add to that the increased back pain, and running begins to seem a rather uncomfortable and painful – thgouhg not impossible – proposition. At this point it may be time to consider alternatives to running, such as swimming, cycling, low-impact aerobics or walking. At 28 weeks your baby will be about 14 inches long and will weigh about two pounds; he or she will be gaining weight rapidly, and from week 36 will put on around an ounce a day.

Getting back to your old routine
Returning to your pre-pregnancy running form largely depends upon two things: the type of birth you experience and your fitness level. In a normal vaginal birth – if too much blood wasn’t lost at delivery – a woman can most likely begin exercising again when she feels no pain. It’s advised to wait at least two days before beginning any aerobic exercise. According to Joan Samuelson’s Running for Women, exercise begun any sooner may increase bleeding and delay a full recovery.

If the birth was a Caesarean section, consult your obstetrician. Doctors say you should give yourself at least a week before any light exercise, and at least three weeks for intense exercise. Residual scarring and bleeding may interfere with your ability to return to proper form as soon as you may like. Remember to take it nice and slow. Low-impact exercises, such as walking and swimming, are good choices to ease you back into shape.

Dr Jaques explains that a woman may begin vigorous training from six weeks to three months following delivery – three months is more likely if there were any complications, but since everyone is different it’s important to listen to your own body and not to push it if you aren’t fully healed.

After pregnancy, the increased plasma volume in your bloodstream may spur on recovery. After being mentally starved of running, you may have an increased appetite for it. With less time on your hands now that your little one has arrived, concentrate on quality sessions, which lead to an improved running performance.

Milking The System

If you’ve decided to breastfeed your baby, then here’s some good news: it seems exercise does not affect the quality or quantity of a mother’s milk. That’s according to Fitness Matters, an informative, award-winning website dedicated in part to expectant athletes.

It’s been widely reported that breastfed babies are less likely to suffer from gastrointestinal problems, diarrhoea, respiratory problems, ear infections, pneumonia and food allergies, than formula-fed babies.

Although an American study reported that many babies refuse post-exercise milk because of high levels of lactic acid, experts at Fitness Matters contend that the study may be flawed, since the milk samples were given by bottle, and many breastfed babies simply won’t take a bottle if they’re not used to it.

Fitness Matters offers the following tips for women who run and choose to breastfeed their babies:

  • Breastfeed your baby before running;
  • Keep note of your weight loss. If you’re losing more than one pound a week then add nutritious snacks to your diet in between meals;
  • Eat healthy, well-balanced meals and stay properly hydrated.
  • For more information on breastfeeding, contact the La Leche League, an international support group for mothers who breastfeed their infants.


Eight Golden Rules

Here are the golden rules for any expectant runner:

Talk to your doctor or midwife
Find out their attitude towards combining exercise with pregnancy.

Train, don’t strain
Forget about speedwork and long endurance runs. Pay attention to your level of exertion, and mind your heart rate and temperature.

Don’t overheat
Run in the most temperate part of the day. Drink plenty of fluids before, during and after a run, even if you have to visit the loo more.

Know when to say when
Stop running if you begin cramping, gasping for air or feel dizzy. If you experience pain or bleeding or your water breaks, get medical attention immediately.

Consider your options
If running is becoming uncomfortable, try walking or swimming – an activity that doesn’t introduce new stress to your body.

Dress for success
Wear appropriate clothing to avoid overheating. Don’t wear tight-fitting clothes.

Eat well
Be sure you’re getting enough iron, calcium, folic acid and other essential nutrients.

Go easy
Running to the point of exhaustion doesn’t do you or your baby any good.