Exercise and Pregnancy. They go together like peanut butter and jelly, Tina (Fey) and Amy (Poehler), red wine and fill-in-the-blank; take two great stand-alones and put ‘em together for magic! The benefits of exercise are mammoth and – barring any medically indicated reason to avoid exercise – those benefits are especially important during pregnancy. There is so much to say in this arena that we’ll lay it out in several bits this month and even into the months that follow.
Take last year’s SMF launch link to the most recent ACOG Guidelines on Exercise During Pregnancy (ACOG, American Congress of Obstetricians and Gynecologists):
The American Congress of Obstetricians and Gynecologists issued an updated set of guidelines for exercise during pregnancy in 2002, suggesting that in the absence of medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended (“patient-friendly version” here).
And our comments:
This represented a significant step forward at the time, but as we learn more about both exercise and pregnancy, there are calls to refine these guidelines ever further to define “moderate intensity”, and to develop parameters for strength training and caloric expenditure. In the meantime, the bottom line for nearly all of us is to keep moving (or start moving!)!
If you read the guidelines closely, you’ll see their recommendations include the provision that healthy moms can continue to run. Well, what happens when you mix diabetes and running during pregnancy? Magic? Hmmmm…..we asked someone with firsthand knowledge to weigh in.
Happy Partners In Perinatal Health Conference Day,
As I write this, I have officially entered my sixth month of this adventure called pregnancy. The last 24 weeks have flown by, despite the obscene number of pregnancy driven appointments I have had to balance into my schedule. Obscene because of being deemed “high risk” the moment that little plastic stick read positive; “high risk” simply because of having type 1 diabetes for 27 years (I have no shame in turning 31 next month).
Despite my active lifestyle (which, aside from omitting running, I have maintained throughout pregnancy…hold out for this one), eating a balanced diet, and maintaining a healthy body composition, our baby was automatically at risk for heart defects, higher birth weight, and on and on…. So I embarked on this 9-month journey feeling pre-judged by modern medicine, which was overlooking that I entered pregnancy far healthier than many of my peers.
I have run the gamut of doctor’s visits, probably having more medical appointments in 6 months than most individuals have in 6 years; bi-weekly OB visits, supplemental ultrasounds, monthly endocrinologist check-ins, EKGs, 24 hour urine collection, seemingly excessive lab work, remedial dietician counseling (remedial is being generous; remember, I’ve had diabetes for 27 years and am healthy. I must know something about nutritional basics by this point.), retinopathy testing, and pulmonary function testing. Let me state, that to date, every test has come back negative or normal. And despite the gauntlet of things I am “at risk” for, it wasn’t until our first prenatal class that anyone ever addressed the changes that can affect my musculoskeletal system. Keep in mind, this class wasn’t mandatory, or even recommended. I had to seek it out.
Of this 1.5-hour class, 20 minutes were allotted to a physical therapist addressing the changes women’s bodies undergo due to pregnancy and childbirth. This PT was candidly addressing the pelvic floor! Yippee!! I was so excited to hear this information being shared with a room of pregnant women and their partners. I was impressed, initially, and am still grateful that a childbirth class is addressing pelvic health issues. But sitting in this auditorium, I had to clench my husband’s arm to stifle my auditory response to this advice regarding exercise…”If you were a runner before you became pregnant, you can continue running during pregnancy.”
Yes, running during pregnancy is safe, for the baby! But here was a medical professional, specializing in women’s health, still coming up short in providing complete information to patients. Early on in my pregnancy, I decided to proceed with a 5K for which I was already registered. Being fortunate enough to have previously worked alongside an amazing Women’s Health PT group, I knew the risks running while pregnancy could create…..urinary incontinence, painful sex… but I decided to pick up my pace a couple times, anyway. Though only a few weeks along and with zero visible changes to my body, I thought I wouldn’t notice any difference. I was wrong. I was very aware of the strain the impact placed on my growing (unbeknownst to me and the 1000s of other runners around me) uterus. I can’t imagine how any woman would not be aware of this sensation, especially once she was further along than my meager initial weeks.
There is still so much to be learned regarding the pelvic floor, by both the general population and the medical community. Especially considering that an activity (which can be modified and/or stopped) that can create such significant side-effects to a woman’s body are still recommended.
There is no reward given specific to running while pregnant; no status of being akin to She-Ra (you children of the 80s remember He-Man’s kick-ass twin sis, right?). Trust me; now that I’m showing I get impressed looks simply by crossing the threshold into the gym. So when we meet our little one this August, I want to reflect and know that I did everything I could to prepare our baby’s body and my own….And come this fall, I know I won’t have forgotten how to run.
Kathryn Fierimonte, MS, CSCS, LMT
Kathryn is an exercise physiologist, strength and conditioning specialist and massage therapist in Oceanside, CA. In all of these roles, she has worked with women before and after pregnancies and childbirth and women with pelvic floor disorders. Bullish by nature, these work experiences have only strengthened her opinion about what it means to take care of herself during her first pregnancy and she is more than happy to share these opinions with any clients, friends, or co-workers who will listen. This is her first post for Share MayFlowers.