Advice for the Expectant Runner

Wed, 12 Oct. 2011 - 8:53 p.m. MT
Credit: ARA Staff - American Running Association

We've come a long way from the 1960s and 70s when obstetricians advised a woman "with child" to sit on the sofa and put her feet up for nine months. Just one example of the sea change can be found in the medical journal Epidemiology, which in 2002 suggested that regular, vigorous exercise during pregnancy could reduce the risk of preterm birth. The American College of Obstetricians and Gynecologists (ACOG) now recommends that women with uncomplicated pregnancies get 30 minutes of moderate exercise daily.
One pioneer in amassing clinical data is James F. Clapp, III, MD, who in 1996 found that five years after their birth, the children of exercising mothers scored higher on intelligence tests and had less body fat than children of sedentary mothers. He went on to write an influential book that debunked myths about the jostling motion caused by running, and even published photographs of women jumping and performing squats with free weights in their third trimester.
Still, misapprehensions persist. For example, in 1985 the ACOG issued a heart-rate-based guideline on exertion that advised never letting your heart rate climb above 140 bpm. By 1994, this guideline was abandoned in favor of perceived-exertion models, but it still emerges from time to time as a useful rule of thumb. It is therefore important to inquire about current guidelines and determine the level of familiarity your doctor is with exercise, and better still, with running.
To better determine an appropriate exercise plan during pregnancy, start by asking these questions.
Is your running consistent? While starting an exercise program (with doctor consent) during pregnancy is likely a fine idea, it might be better to begin with walking if you have not been training regularly in the months prior to your pregnancy. Three times a week for 20 minutes or more for at least six months constitutes a “consistent” base; most readers of this publication are probably well beyond that mileage level.
Do you eat a balanced diet? A “yes” to this means a diet loaded primarily with fresh fruits and vegetables and whole grains, plus healthy fats like nuts and flaxseed oil, and plenty of protein to aid recovery.
Do you get a regular period? This is important because it relates to your overall fertility. Runners who tax their bodies to the extent that it decreases menstruation may increase miscarriage risk.
Are you willing to be flexible about your workouts? This is of enormous importance. Contraindications to exercise include temperatures above 85 degrees, and in general listening to your body’s need for plenty of rest. When we overheat, blood rushes to the skin to help cool us down. This pulls blood away from the uterus, risking harm to the developing fetus. You must be willing to reschedule a run on a hot day, or take it into an air-conditioned, treadmill environment. Similarly, there are just days when fatigue overcomes expectant mothers. The body knows what’s best for the baby, and in the same way that “readiness to run” is a condition sought in any training plan, it is essential to remain open to cancelling a planned run in favor of an afternoon nap.
Have you had three or more miscarriages? If you answer “yes” to this question, you should cease running until you have consulted a reproductive endocrinologist or other infertility specialist. A “no” in this category and a “yes” in all others means you can go ahead and schedule a pre-pregnancy physical to rule out any underlying health problems and hopefully proceed to running. During the various stages of pregnancy, there are other considerations as well and so carefully monitoring your regimen is still important.
Exertion Guidelines
It’s best to stay away from distance and speed challenges during your pregnancy, and during workouts to always remain well-attuned to your exertion. As already mentioned, don’t go by heart rate, as this guideline is outdated; go by perceived exertion, according to the following, known as the Borg Rating of Perceived Exertion (RPE). The scale begins at 6 (no exertion) and ends at 20, which represents as hard as you can possibly exercise. Never run to the point of exhaustion. To maintain fitness, stay within the range of slightly- to moderately-hard. If you can easily carry on a conversation during your running, you are within safe limits.
No exertion
Extremely light
Very light
Somewhat hard
Hard (heavy)
Very hard
Extremely hard
Maximal exertion
During the first month of your pregnancy, your running may feel the same as ever. You may also feel easily out of breath, or even feel as ever only to find your time slower by several minutes at the end of a run. It doesn’t matter. There are no absolutes in pregnant training, and p.r. goals remain elusive anyway. The beauty of the Borg RPE is its individualized nature. If you normally run 8-minute miles over 10K and slow down to 9 minutes per mile during pregnancy, you may exerting the same effort—it’s okay to slow down. The important thing is to keep your RPE between 12 and 14.
Additional Notes
A proper warm-up is vital to your “expectant running”. Your muscles must be warm enough to avoid injury, with blood flow sufficient to avoid dizziness. Walk for 2 to 5 minutes, then jog 2 to 5 minutes until you have gradually obtained your regular pregnancy pace. Allow a 5-minute cool down consisting of slow jogging or walking to slowly return your body to its resting heart rate. Again, blood circulating throughout the body instead of pooling in the legs will help ensure you avoid dizziness. Lightly stretch to prevent injury.
Always stay hydrated, never try to run through any kind of pain, and plan on requiring shoes one-half size larger than your pre-pregnancy running shoes. It’s best to avoid NSAIDs such as ibuprofen as well as aspirin during your pregnancy, as large quantities can interfere with the baby’s heart development and blood clotting ability. Stick to the often-touted RICE treatment for exercise-related aches and pains: Rest, Ice, Compression, and Elevation.
Finally, if you experience spotting, running is contraindicated until you consult with your doctor. There are several types of this sometimes common occurrence during pregnancy, and it’s important to make a determination that running will be safe for you and your baby going forward.
(Runner’s World Guide to Running & Pregnancy by Chris Lundgren, 2003, Rodale, $14.95)
(RUNNING & FITNEWS®February / March 2007 • Volume 25, Number 2)

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