Monday, January 11, 2010

Slow Is The New Fast

What happens when you go from putting together a race schedule for the upcoming season to finding out you are pregnant? Are you still an athlete? Can you still be an athlete? Should you workout when pregnant? How far? How fast? How often? Where do you find these answers?

I want to write about this because the information out there is so scattered and limited. Hopefully this will be helpful to those who are or who plan to get pregnant. Maybe my experience will help you make sense of your own. If you are not interested in being a pregnant athlete, check out for this week, come back next week. If you are, read on these next few days and enjoy.

DISCLAIMER: I am not a doctor. I am just an e.l.f. You should always consult with your doctor about exercise activities during pregnancy.

The first thing I realized is that there is not a lot of information out there about athletes that get pregnant. And if you workout every day, more than once a day, you are an athlete and not the average woman. You will find immediately when you are pregnant that everything out there is for the average woman.

You are not the average woman.

When I started thinking about getting pregnant, I started reading – anything and everything about athletes that went through pregnancy. I had every intention to continue with my fitness activities through pregnancy. And I had good reason. Here are just a few of the benefits of exercising in pregnancy:

Strengthens your pelvic floor muscles for labor, reduces the risk of labor complications, leads to a quicker and less painful labor, reduces the chance of birth defects, increase the chance of delivering a baby with higher APGAR scores, improves your immunity, relieves stress, improves calcium absorption, reduces pregnancy-related discomforts, increases energy, leads to less excess weight gain.

Not convinced yet? Dr. James Clapp (who studied athletes in pregnancy), found that women who exercise until the last day of pregnancy will have shorter labor – by more than 30 percent. 65 percent of exercising mothers will deliver in less than 4 hours. The risk of C-section is reduced by up to 75 percent. And, you are more likely to go into labor a week earlier than planned.

What about after birth? Babies born to exercising mothers will be more fit. The nervous systems of these babies seems to work better. At five-days old, they appear calmer, more alert and more adaptable. They require less attention. They have less colic. They may begin to talk earlier and have accelerated mental development. Why? Exercise seems to improve the growth and efficiency of the placenta; and delivers an improved blood and nutrient supply to the baby (Allred, 2000).

Despite this – and oodles of other research supporting the benefit of regular exercise during pregnancy - one thing you will find when you are pregnant is that everyone has an opinion of what you should or should not do. My mother in law told me I should buy a $65 tub of stretch mark cream from A Pea In a Pod. My own mother thinks I need to drink lots of milk and eat more ice cream. Their differences aside, the one thing both mothers agree on is that I should stop running. Why? Because ….. and there is a blank. There really is no reason other than: you should stop running.

That’s it. That’s all they had for me.

Maybe they were right, I wondered. But I knew that wouldn’t be right for me. If I do not exercise (read: MOVE like we humans are intended to do), I do not feel right. I feel off, uncomfortable and at unrest. I like being fit. Triathlon is just an outlet for loving fitness. It allows me to put purpose to something that I enjoy doing every day. And I was not about to give that up because I was...GASP!...pregnant.

But I agree, it is much easier to sit on a couch and let my ass grow bigger into the couch for the next 9 months. Trust me, I get how a woman can easily put on 50 pounds in pregnancy and not even see it coming. You feel beyond fatigued. It’s like training for Ironman on tranquilizers. You feel out of control because you quickly realize for the next 9 months you have no control: you will get bigger, you will change, life will change. And, you are scared. Because of that you read books and listen to other people. You convince yourself you are hungry because the books say your appetite increases. You convince yourself it is ok to refuse exercise because you are going to get fat anyways plus everyone is telling you to slow down! Rest! STOP RUNNING! You tell yourself it’s ok to eat dessert every night because you are eating for two. Pregnancy is a slippery slope. If you are not careful, you could slip right down it into a big bowl of hot fudge every night because it’s ok, honey, you’re pregnant. Treat yourself.

What a bunch of horseshit! This is pregnancy, not a prison sentence. Pregnancy is not a disease state, it is simply a stage in life. It is not terminal, it is not forever. There is a finish line. This will be over in less than 10 months and I am not going to throw away 34 years of taking care of myself for 10 months of green light to eat dingdongs, cookies and muffins from morning to night. I’m not eating for two, I am eating for twice the nutrients and quality. I am not needing 1000 more calories a day for a person that is less than 2 inches long in the first trimester. Pregnancy is not permission to stop taking care of myself. Heck, its reason to take care of myself that much more!

And because of that, exercise is a part of pregnancy.

Plus research supports that exercise should be a part of pregnancy. There is no research to support that exercising increases your chance of miscarriage, complications or birth defects. NONE. In fact, the opposite is true. The less fit you are, the more weight you gain, the more health complications you will have during and after pregnancy.

But, when athletes are involved, you have to ask how much is too much? Come on, we are athletes. Two a day workouts are not an absurdity, they are a part of every day of the serious athlete. So, is two workouts a day too much? Who would know? How long is too long? What about how hard? Do you really have to keep your heart rate below 140? What happens when it hits….141.

DO ME AND THE BABY JUST EXPLODE?!?

The best thing you can do is arm yourself with information. Read books. Lots of them. Take in the information and filter it for yourself. Unfortunately, most pregnancy books with chapters on exercise are not very helpful. Most of these books encourage you, as a pregnant woman, to exercise. And most consider exercise to be 20 to 30 minutes of physical activity 3 times a week while keeping your heart rate under 140 bpm.

Seriously? That’s the amount of time I spend walking my dog to take a crap – and that is considered exercise? And 140 bpm? These days, I can reach that easily going up the stairs!

You should know that those guidelines are outdated – very. In 1994, the ACOG revised their guidelines to suggest that pregnancy women only limit exercise intensity and lower their target heart if the woman is high risk. In other cases, regular exercise at a mild to moderate intensity is recommended.

Key word: regular. Sporadic exercise is actually viewed as harmful during pregnancy because of the inconsistency. Like exercising as a normal athlete, consistency leads to adaptation. Without it, exercise is a stressor, especially to the pregnant woman.

Of course there are guidelines. In other words, use common sense. You should not engage in anything that compromises your safety or balance during pregnancy. As far as triathlon goes, you should probably avoid cycling. I know a lot of pregnant women cycle out there. And it’s really just a personal judgment call. Personally, I do not think it is worth the risk of falling or crashing.
Pregnancy is also not the time to start significantly changing things. If you haven’t been running 20 miles a week, now is not the time to start. Use common sense, simple as that.

Other than that – guess what – there are no guidelines. There is no magical number of hours you can or cannot workout a week. No formula. No secret training plan. You have to decide for yourself. Your fitness level, your comfort level. You have to find a new normal for your body. And, more than ever, you have to listen to it. Your body, that is.

In figuring all of this out, I found it helpful to talk to other athletes about their experiences in exercising through pregnancy. From recreational runners to professional athletes. Their stories are out there. I started reading, asking, searching for answers and in the end finding myself a little frustrated. Talk to anyone and everyone and what you will find is this one thing: everyone has their own experience. One woman’s 3-hour ride might be another woman’s bed rest for 8 weeks. Another women’s 8 mile daily run is yet a different women’s run for 5 miles for 3 times a week. And what you realize is that what so-and-so in such-and-such a place does during their pregnancy has nothing to do with me. You find yourself caught between being a competitive person in spirit to a pregnant person in body. It’s an interaction of desire and knowing better. You have to just know better and listen to yourself for the next 40 weeks.

That is the magic formula.

And that brings me to another point: if your body is used to two-a-day workouts, 8+ hours of “training” a week, I think that ceasing that or drastically changing it is a stress on your body. Change is stress and stress is not good. Joan Benoit Samuelson once said that for athletic women, being told not to exercise during pregnancy can be more stressful than the exercise itself. My motto was to keep on being who I was and just listen to my body that much more.

After all of that reading, researching, questioning and thinking, where did it leave me? Did I feel any more comfortable doing one workout a day let alone two? Is this really ok? And sometimes, the guilt was the worst part. I would find myself feeling good after a swim, thinking I could go for a short run but then second guessing myself with, should I...really…?

Sigh.

Ask the question, there is no answer. Other than what your gut tells you and what your body says. And that is the best guide - how you feel during and after the workout. Sometimes how you feel before, but I often disregarded that because you will feel like ass for most of the first trimester. Varying levels of ass, but ass indeed. If I could get into a workout and it felt ok - I kept going. If I felt tired afterwards, I did too much. If I felt better, then I did everything just right.

I also made peace with myself - as a pregnant athlete. In pregnancy you are an athlete but you are a different athlete. You are like a kinder, gentler, less competitive version of your athletic self. And that is ok. For now. I accepted that what I was doing was really no longer training. It was just working out. Staying fit, having fun, feeling good. There were no performance goals or measurements that needed to be made. For now, working out was about staying healthy and promoting peace of mind.

Perhaps the best reasons.

And, I made peace with the fact that I was going to get slower. Especially running. That was a hard one to swallow. I can swim slow, I can bike slow but run slow - does not feel right. But I accepted the inevitable. Slow is the new fast. For now. Research has shown that by the end of the first trimester you will lose 10 percent of performance ability due to nausea and fatigue. By the end of pregnancy, you have lost 50 percent of performance ability due to weight gain and changes in body composition. However, while you might be running 2 to 3 minutes slower per mile you are still gaining the same cardiovascular benefit. Fitness can be maintained (Allred, 2000).

For daily workouts I did set limits. I like boundaries. They keep me safe. Setting your own limits requires understanding what is happening in the body when pregnant. Your resting heart rate is about 10 to 20 beats per minute higher. Your blood pressure should go down. Blood volume increases by 40 percent. Lung capacity increases yet breathing is more difficult. Your cardiovascular capacity increases along with your heart rate and body weight. Heart rate is up but effort might be down. So, your fitness level will seem low. However, you are actually more fit just by being pregnant. Pregnancy itself is like armchair training – your blood volume increase so much that by the end of the first trimester, it is like the equivalent of blood doping. Not only that, but these effects lasts 6 to 12 months post –pregnancy, which may account for the post-partum “boost” in performance that some athletes have.

Indeed, I set limits with my heart rate. Early in pregnancy, heart rate is high for effort level. But around week 5 to 6 I felt like heart rate was more reliable and would be helpful to use as a limiter. I’ve been monitoring my heart for years, I know how it responds. So I set a limit within the middle of my "zone 2" for the bike and run (this did not mean I forced my heart rate up there, rather I did not fear implosion if it crept up there). Those are the two places where I feel like the work shifts from I could do this all day to I might be pushing it. While some say rate of perceived exertion is more reliable than heart rate, especially in early pregnancy, I felt comfortable having heart rate limits. The exception was swimming, where I went by effort, pace and draft. Regardless of the numbers, my rule was really to do what felt comfortable. Because if I was comfortable, the baby was comfortable.

I also set time limits. Remember, we are working with guidelines here that suggest 20 to 30 minutes of exercise. 3 days a week. There are no guidelines. You have to invent them for yourself as an athlete. Personally, I was comfortable with 45 to 75 minutes of exercise per day. Not every day. Not all at once. I would usually start with 45 minutes. Then add more of a different sport later if I was feeling good. Sometimes I would just do 30 minutes and that seemed like enough. Rare days when I felt alarmingly zippy I might do a total of 90 minutes. Beyond that I did not see the point. Additionally, I felt it would be harmful to the baby in terms of nutritional or heat distress. Nutritional because it becomes difficult to replace calories when you exercise too long; I did not want to pull nutrients away from the baby. As for heat distress, since most of my workouts were in the basement, I had 2 fans pointed at myself at all times. You want to avoid letting your internal body temperature go above 101 degrees (measured rectally - fun!) especially in the first 9 weeks when most birth defects occur.

Beyond the limits, I was free to do what I wanted. I didn’t set a schedule each week and I wasn’t coached. I made it up as I went. What I did depended on how I was feeling that day. Days I felt good, I ran. Days I felt normal, I biked. Days I felt not as good, I swam. Days I felt really bad, I took off. I always tried before I wrote myself off for a day. Something was better than nothing. And, usually by 15 minutes into the workout I felt so much better than when I started that I kept going.

So how did it go for the past 12 weeks? I’ll write more about it this week. Until then, here is a list of books I found helpful for understanding more about exercise in pregnancy:

Exercising Through Your Pregnancy by James F. Clapp III, MD
Entering The Mothering Zone by Alexandra Powe Allred
Expecting Fitness by Birgitta Gallo
Fit and Pregnant by Joan Marie Butler
Runners World Guide to Running & Pregnancy by Chris Lundgren
The Women Triathlete by Christina Gandolfo

17 comments:

ADC said...

Great post. Very informative, thank you.

Michelle said...

Hi elf,

I just had this conversation at the ob/gyn. Okay, she started the conversation by telling me I was at an advanced age and I need to work on getting myself knocked up. Fabulous.

Anyway, I asked about continuing workouts. I am a wanna be triathlete...but I am a marathon runner. My dr said I should continue workouts through pregnancy. They should be slower. She had a patient who ran 5 miles everyday of her pregnancy until the 8th month when she had to drop to 2 miles. He labor/delivery was a big whopping 1.5 hours.

I think you are doing things just right. Not that I am a dr nor do I play one on tv!!!

Eisparklz said...

I'm sure that you found this already in your research hunt, but Lisa Jhung had a blog that she wrote called Baby Steps on Runnersworld.com. There were some interesting discussions of women reading the blog, as well as some helpful gear (belly straps, etc) once your belly starts to grow.

Congratulations! And don't worry about writing about your pregnancy - you're fun to read no matter what the topic is.

Alicia Parr said...

Well put.

I would like to add a note about the feelings of anxiety and guilt, especially in the first trimester. Those are NORMAL and (I believe) influenced by the hormones coursing through a pregnant woman's bloodstream. They are not a reliable indicator that something might be wrong, although they are adaptive in that they help the woman moderate behaviors that MIGHT carry higher risk to the fetus.

Having said that, I think following some personalized guidelines for exercise is a great way to approach the situation. Just as you have done. We are all different based on our personality characteristics and type of fitness we carry into gestation, and our personal activity guidelines should reflect these variances.

Again, this is a great post for newly pregnant athletes to read. Kudos.

CharPopp said...

Hey elf -
This is great, and exactly how I'm trying to approach the exercise thing throughout our fertility journal. I'm asking alot of my body with IVF, meds and the mental / emotional roller coaster that I think approaching exercise in this way makes alot of sense. Thanks for sharing your journey!
~Char (jpopp's wife :-)

Angela and David Kidd said...

I'd like to have a little conversation with Dr. Clapp because I was still running, swimming and riding (only on my trainer) up until the day I was induced and I was 10 days late, had an incredibly LONG labor and ended up with a c-section. But Zach was super strong and healthy and I had a text book pregnancy otherwise and I think that was largely because I continued to work out the entire time.

I agree there is no advice that works for everyone. You have to listen to your body. If you are tired, slow down. If you are too hot, cool off. And most importantly, if you need to use the bathroom - GET THERE QUICKLY. The importance of having a bathroom nearby only increases as your size increases.

And I used that super expensive cream from A Pea In The Pod and I have no stretch marks. I don't know if the cream is actually responsible for that but I sure as hell will be spending my money on that cream if I am pregnant again.

Melissa said...

Thanks for this post Liz! I was hoping you would write about exercising while pregnant. I read Dr. Clapp's book and found it really informative, going to check out some of the other ones you listed.

Just this weekend I got my first unsolicited advice in the locker room of "you shouldn't let your heart rate get elevated" when I was talking to a friend about running while pregnant. Come on people...

"being told not to exercise during pregnancy can be more stressful than the exercise itself." That's a great quote.

Di said...

Congratulations!

What a great post and very informative.

Good luck with your pregancy.

Dianna

Pedergraham said...

Oh yes, the nearby bathroom. That is why so many pregnant ladies like to get out on the trails and run. Behind every tree is a potty! I wish I was 6 years younger. This would have been great to read before I had my daughter.

Sara said...

Just because curiosity killed the cat what WAS on your race schedule for this year pre-baby excitement?

Really looking forward to reading the rest of your take on pregnant athletes, I have had a few friends go through this experience with mixed results just as you are describing.

E.L.F. said...

Galena, Pigman, Quartermax, Evergreen, Chicago, Long Course Nationals hoping to qualify for Long Course Worlds next year. As you can see, only one long race at the end of the season. I wanted to go short and have fun. Also stay mostly local.

Mary IronMatron said...

You're all good.
The real fun is how to exercise AFTER you deliver...
I can't wait for those posts!
For now, live it up!!!!
Another benefit--although you're already through this I think--I thought running helped curb the nausea of the first trimester.
:)

SteveQ said...

A good resource is http://sealegsgirl.blogspot.com/
she's a physician who trained throughout her pregnancy; she's a little obsessive about weight (I think she only gained 15 lbs. during her preganancy), but she knows her stuff.

Mer! said...

You couldn't have worded it better....I had an OB who basically just said do what you think is reasonable...the 140 heart rate is OLD INFORMATION..... for me: honestly, the fear of miscarrying was enough to make me slow down (quite honestly)---so, I did.

Everyone's body is different and I think we just have to do what we feel is right.

My OB said to keep these general guidelines and I tended to agree with them:
1. Don't get dehydrated
2. Don't exercise to the point where you feel like you're going to explode (ie, track workouts)

So..I stuck with those...I wasn't comfortable riding my bike because it's a time trial bike and being in aero all the time just wasn't comfortable.

The stats: I swam twice in pregnancy, ran til I was 28 weeks (waddled after that) and only rode til I was about 10 weeks..

Anti stretch cream: Burt's Bee's "Mama Bee".....loved it!

Delivery: ..epidural =0...and 16 minutes of pushing!

As you're learning the info is SO hard to find..some of it I just ended up going with my own brain and what I thought would be smartest!!

You're doing awesome!!!! Even "just for being an ELF" =0 Enjoy the moments!!!

Mama Simmons said...

Running definitely helped my early pregnancy nausea. I think the only time I *didn't* feel nauseous was while I was actually running.

I didn't use any expensive creams and have no stretch marks. I heard stretch marks are a hereditary thing- so if your mom didn't get them, then you won't either. But that's just what I heard- no scientific evidence or anything. Just anecdotal.

Katie said...

Just to add $0.02 from another triathlete who just finished my first pregnancy a month ago:

-I didn't use any creams (just regular old body lotion) and got no stretch marks. I too hear that they are hereditary, tho' both my mom and sister got them and I did not. (score!) Maybe a relatively low pregnancy weight gain helped?

-"Nutritional because it becomes difficult to replace calories when you exercise too long; I did not want to pull nutrients away from the baby." I have heard that the way our bodies work is that, if we are not eating enough, the baby is nourished FIRST and it's we who take a hit nutritionally or energy-wise. Not that I'm trying to talk you out of being careful to eat enough - definitely not. Just FYI. You will almost certainly feel hungry/fatigued before anything comes close to depriving your baby.

-I kept up good sturdy workouts (ie. 4-mi runs, 2500yd swims, 40-min stationary bike rides, 6 days/week) until the day before I went into labor (3 days late) and still had an avg length labor (25 hrs, 2.5 hrs pushing). It still hurt like hell. BUT my recovery was awesome and my baby was strong and healthy - I attribute both to working out.

Congratulations and I look forward to reading about your adventures in an active pregnancy!

Katie said...

Mary IronMatron - yes! The blog I really want to read is the one on how to exercise after delivery!