Exercise And Pregnancy
Staying in Shape During and After Pregnancy

I've taken some time off serious training before. Plantar fasciitis, iliotibial band syndrome, pulled hamstrings, Achilles tendonitis, general fatigue, the flu I've had it all.

And, most recently, I came down with the one thing many female athletes get somewhat anxious about: I had a full-blown case of pregnancy.

Like many women, it was never a question of my wanting to start a family. I’d always pictured myself someday having children. The big question, however, was when was the "right time”?

For an athletic woman in the prime of her racing career, pregnancy can seem like a threat to everything you’ve worked so hard to achieve. Does it mean kissing the letters "PR" goodbye?

Does it mean standing on the sidelines watching other people race while you get fat and out of shape? Or, worse yet, does it mean that life as you know it will no longer include long runs on Sundays or challenging yourself in new events each year?

Indeed, there is always another marathon around the corner, another triathlon for which to train. Taking a season off to start a family, however, doesn’t mean you have to stop participating in these events altogether. And it certainly doesn’t mean you have to stop doing the things you love.

Staying fit during pregnancy is important. Provided you are not high-risk, working out is important to the health of both mother and baby. If staying fit and racing are important to you, you can continue to do the same things after the birth of your child.

Committing to an active and fit lifestyle means setting priorities, both personally and as a couple/family.

Keeping it together during pregnancy

For many people, the word "pregnancy” goes hand in hand with the word "craving.” The only craving I had during my pregnancy was to work out to exhaustion, something I knew I couldn’t do. But I knew I could maintain some level of fitness — most likely more than what others led me to believe.

By setting a personal goal of daily workouts, I was able to swim, bike and run myself through nine months of pregnancy. While the running slowed and the miles tapered, I made sure I hit the pavement at least once a week. I continued low-impact exercise, teaching Spinning class three days a week and swimming two days a week, up until the day I delivered.

Contrary to popular belief, pregnancy is not a prescription to stop exercising but rather an important time to maintain fitness. Much of the available information regarding exercise during pregnancy cites outdated guidelines from the American College of Obstetrics and Gynecology (ACOG) that (prior to 1994) advised women to keep their heart rates below 140 beats per minute.

Since walking up a flight of stairs spikes most pregnant women’s heart rates well above that, it is difficult for many women to get a good workout following that guideline.

In 1994, the ACOG changed it, advising women to exercise "at a moderate level.” Of course, this will vary from woman to woman. I used the "talk test” to keep myself in check — keeping my intensity at a level that still enabled speech.

In an opinion published earlier this year, the ACOG stated, "In the absence of contraindications, pregnant women should be encouraged to engage in regular, moderate intensity physical activity to continue to derive the same associated health benefits during their pregnancies as they did prior to pregnancy.”

It is recommended that non-risk pregnant women exercise for 30 minutes a day up to seven days a week, just like their non-pregnant counterparts.

Timothy Hernandez, M.D., a family practice physician who sees a large number of pregnant women in his practice, says exercise is equally important for body and mind.

"Anything a woman can do to make herself feel healthy and strong will help her both during and after pregnancy,” Hernandez says. "The psychological effects of moderate exercise can instill confidence and prevent depression both preterm and postpartum.”

The ACOG does offer a few guidelines for exercising while pregnant. Moms-to-be should avoid getting their core body temperature too high because unborn children cannot cool themselves through sweating. Additionally, the guidelines emphasize proper hydration, which speeds the ability for both mother and baby to stay cool. Pregnant women should also drink 6 ounces of water every 15 - 20 minutes of exercise and avoid getting to the point of feeling thirsty.

Of course, expectant mothers should stop exercising and contact their health-care provider immediately if they experience pain, bleeding, faintness, irregular heartbeat, pelvic pain or difficulty walking. It is also a good idea to find a health care provider who supports an active lifestyle to discuss your options with.

Labor and delivery

Several months of training go into the preparation of running of a marathon, which takes most people three to five hours to complete. Considering labor usually lasts much longer than that, it makes sense that women should "train” for labor as an intense physical and mental event.

Although the results are not conclusive, some studies have shown women who exercise during pregnancy have shorter labors as well as a decreased need for induction and painkillers during labor and delivery. Women who know their physical and mental limits and who have worked out during pregnancy are also more likely to go into labor feeling confident and ready to face its demands.

One woman on the iVillage Pregnant and Staying Fit bulletin board wrote, "I think that my workouts helped me both physically and mentally during labor and delivery. I had a longer labor than I expected (24 hours start to finish), but I never really felt exhausted until I was about half way through my hour of pushing at the end. And that was where the mental edge kicked in. It gave me the strength to continue to push with all my might even when I thought there was nothing else in me.”

I am confident my level of fitness helped keep my spirits up during labor and delivery as well. By drawing from my own personal experience, I was able to keep my mind confidently focused on the task at hand, alleviating the need for an epidural or painkillers.

Postpartum

Postpartum exercise helps restore a new mother’s sense of identity, particularly if she was athletic before pregnancy. It helps women shed the extra weight gained during pregnancy, restore cardiovascular fitness and improve mental stability.

Physically fit moms generally recover more quickly from childbirth, both mentally and physically, than unfit moms.

Waiting to get a doctor’s approval for postpartum exercise can seem eternal. The American College of Obstetrics and Gynecology notes that the physiologic effects of pregnancy may persist for up to six weeks postpartum, advising gradual resumption of activity as tolerated. That window may be longer for women with complicated pregnancies or deliveries.

With an infant at home, it may be difficult for a new mother to find time to exercise. However, it can be done: Many gyms offer on-site daycare for parents, parents can swap babysitting with one another, jogging strollers free up time for runs. There is also the option of in-home fitness equipment and videotapes.

Breastfeeding moms must plan exercise around feeding and/or pumping. By feeding or pumping just before exercise, women can avoid the discomfort and high levels of lactic acid in breast milk (which some studies have found is less preferable to infants).

Take care getting back into regular workout routines. The effects of increased levels of relaxing make it very important to stretch well after exercise. And don’t be frustrated by seemingly decreased endurance levels. It all comes back very quickly. My running pace increased significantly during my first few postpartum runs.

Maintaining your lifestyle

So far, so good. My daughter was born in mid-May, and it took me 2.5 weeks to resume running and biking. Of course, I started off slowly and listened to my body, but it felt great to get out there so soon. I attribute my quick recovery to having stayed physically fit throughout my pregnancy.

My biggest fear has not materialized. We have a beautiful daughter who has changed our world — but only for the better. My husband and I continue to live the active lifestyle we did before.

To be good parents, we know we must keep our identities and continue to do the things we love. We will still participate in marathons, triathlons and long-distance endurance events. It just takes planning.

Maybe one child is all we will have. Maybe not. However, if we do not have more children, it will not be because we fear a big lifestyle change. It can be done. Having children means giving them the gift of who you are.

It’s important to keep your own identity, both during and after pregnancy. It’s important to share what you love with those whom you love. And it can be done. Healthfully. Responsibly.

Laurie Kocanda and her husband, Tony, have finished numerous marathons as well as Ironman-distance triathlons. They welcomed 8-pound-5 ounce Cadence into the world on May 17, 2002. Laurie will be running Twin Cities Marathon this fall.