Running During Pregnancy and the Postpartum Period

In this podcast episode Coach Angie shares tips on running through pregnancy and the postpartum period. Special guests include three moms (a nutritionist, a strength coach, and a pediatrician) who share stories and advice on training for a marathon after having a baby.

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Big thanks to Coach Jenn Giles, Coach Athena Farias, and Dr. Christina Piron for joining us on this episode!

Running During Pregnancy and the Postpartum Period

There can be many challenges associated with running during pregnancy and returning to running in the postpartum period. This journey will be unique to every single person and there’s no “one size fits all” template. Remember that the recommendations that we’re giving here are not a substitute for the advice of your healthcare provider.

My Story . . .

Running during pregnancy and the postpartum period is not something that is currently fresh on my mind. My youngest son just turned 12 so it’s been a while since I’ve been through that myself, but I do remember much of what the process was like.

My third son, Liam, born October 1st, 2010. I either ran or cross-trained up until the day he was born.

With my first two pregnancies I wasn’t a runner yet although I did try to workout regularly and stay active. The third time around I had just come off running my second marathon (where I was excited to break 4 hours) in the fall of 2009 so I had a high fitness base going into the pregnancy.

I was able to continue running my normal mileage at an easier intensity until around 22 weeks into my pregnancy. At that point my round ligaments couldn’t take the impact anymore and I had to transition to doing all low impact exercises.

It was a big mental adjustment for me not to be able to run all the way through pregnancy but my body had different ideas and I chose to listen to it. I’m always happy to hear when women are able to run through their entire pregnancies.

9 Month Long Endurance Event

During pregnancy the primary goal is doing what you can to have a safe and healthy experience. There is a lot going on in your body at this time. Even during the 1st trimester (which is up to 13 weeks) your body may not outwardly look that different but it is working hard on fetal development and it’s important to respect that.

Most women experience some degree of fatigue or low energy during this time and often some morning sickness or generalized nausea and food aversions. Internally, the maternal cardiac output increases by 30-50% and blood volume doubles. Breathing rate also increases during exercise, especially during the 3rd trimester (which is week 27 and above) when you have a larger body mass to sustain.

It’s important to listen to your body and be okay with the fact that you’ll have to slow down and possibly even stop running temporarily. I’ve heard it said that pregnancy is a time to “train for two, not for you.”

I recently saw some information in Instagram from The Fit Midwife that said,

“Not all heroes wear capes! Did you know that pregnant women live nearly at the limit of human endurance?

Researchers from Duke University studied athletes such as elite runners and cyclists in the Tour De France in a bid to identify the absolute limit of human endurance. Their research showed that the human body can cope with a maximum energy expenditure of 2.5 times its resting metabolic rate (which on average is around 4,000 calories).

What is so interesting about this is that when it comes to pregnant women, at their peak their energy expenditure is around 2.2 times their metabolic rate. So, in a nutshell, growing tiny humans means your body is pushing the boundaries of your human capabilities in a way only otherwise experienced by exceptionally elite athletes.”

Pregnancy is basically a 9 month long endurance event!

Is it Safe to Run During Pregnancy?

Experts have varying opinions on what is safe and advisable during the pregnancy and the postpartum period. If you have a chronic medical condition, a high risk pregnancy, or history of miscarriage then you should always act with more caution and follow the advice of your doctor in regard to exercise.

  • But in general aerobic exercise like running has been proven to be safe during a normal pregnancy and most women don’t need to lay aside their running or strength training routine during this time.

Another thing to keep in mind is that every pregnancy is unique even if this is not your first child. This is a time to exercise more caution and listen to your body. Now I certainly don’t advocate laying off all exercise for nine months but it isn’t a time to take on bigger challenges that you’re not conditioned for either.

Pregnancy, childbirth and the postpartum period are much like a marathon experience and require a lot of patience with the process.

The American College of Obstetricians and Gynecologists (ACOG) which always takes a very conservative approach and states that,

“Continuing to run or do other aerobic activity during pregnancy for 30 min on most days of the week can reduce backaches, constipation, bloating, and swelling; prevent or treat gestational diabetes; increase your energy; improve your mood; improve your posture, muscle tone, strength and endurance; help you sleep better; and improve your ability to cope with labor pain.”

They also say,

“If you were a runner before you became pregnant, you often can keep running during pregnancy, although you may have to modify your routine.”

So if you’ve been running regularly before pregnancy then it’s fine to continue running at that level with less intensity during pregnancy as long as you listen to your body and adjust accordingly. However, pregnancy is not the time to train for a marathon for the first time or try and set PR’s. Your body needs to be invested in the healthy development of the baby.

Challenges You Might Face

The body will also present different challenges during the three trimesters of pregnancy. During the 1st trimester nausea, exhaustion and dizziness can be common. During the 2nd trimester the center of gravity shifts, joints and ligaments get looser and women may start dealing with bladder pressure, urinary frequency and occasionally stress incontinence.

You will see a wide range of what people can do during pregnancy and this was true for me as well. During my 3rd pregnancy I experienced a lot of fatigue in the 1st trimester (which is very normal) and felt great during the 2nd trimester.

I was able to do a half marathon and 15k during this time. However, once I got to around week 22 my center of gravity had shifted enough that it was putting a lot of pressure on the round ligaments. Even though I was wearing a belly support band any high impact activity caused a lot of discomfort. So I transitioned to low impact actives such as using the stationary bike, elliptical, yoga and strength training. In fact, I worked out by cycling and some strength training the day my son was born.

General Advice during Pregnancy 🤰

  1. Focus on training for a healthy pregnancy. Having a healthy baby is the number one goal and personal running goals will take a backseat during this time.
  2. Listen to your body. In your head you may think you should be able to still run a certain pace or distance but it’s important to slow down. Don’t feel pressured to keep running through your pregnancy if you don’t want to and don’t feel pressured to stop if you feel good.
  3. Don’t neglect core strength. Keeping your back, abdominal, hip and pelvic floor muscles strong will give you a more comfortable pregnancy and easier postpartum recovery. Just make sure not to do exercises that diminish blood flow to the uterus like those that require lying on your back or doing things like crunches from the 2nd trimester on. You also don’t want to hold your breath during exercises.
  4. Make sure to wear comfortable and supportive exercise clothes. You may need a larger size of running shoes as your feet can relax and swell during pregnancy. Compression socks and a belly support band can also be helpful for more support and to promote better blood flow.
  5. Your center of gravity shifts during pregnancy which can feel a bit more unstable at times.  Make sure that you don’t run frequently on uneven surfaces or highly technical trails. It’s also important to warm up and cool down carefully. Relaxin, the hormone that relaxes your ligaments, is way more elevated during pregnancy and this will result in looser joints and ligaments that can make you more vulnerable to injury.
  6. If you have the following symptoms at any time during pregnancy be sure to stop exercising and contact your healthcare provider immediately. Things to watch for include: abdominal cramping, vaginal bleeding, dizziness, chest pain, calf pain or swelling, or uterine contractions.

The Health of the Baby

Is there any evidence that athletes have healthier babies?

Obviously there aren’t any guarantees but generally a healthy mom results in a healthier baby. Studies show that exercise during pregnancy lessens back pain, prevents excessive weight gain, improves sleep quality, and reduces delivery complications and time spent in labor. In addition, exercise during pregnancy results in babies that have healthier blood vessels even into adulthood and helps protect against heart disease.

A study from the University of Montreal found that the babies of mothers who exercised had brains that were more active and mature and had advanced neurodevelopment. Infants are also less likely to be underweight, have better heart development, and better heart rate variability. They also perform better on tests of fine motor skills and had advanced coordination. This may be due to better blood, oxygen, and nutrient flow through the placenta.

Postpartum Recovery

Let’s shift gears from pregnancy to the postpartum period. The timing of when you start exercising again post-pregnancy depends on how much you exercised during the pregnancy and what type of delivery you had. If you had an uncomplicated vaginal birth you will be able to begin exercising sooner than someone who experienced complications or had a cesarean birth.

Evidence shows that safe and appropriate exercise postpartum helps prevent urinary incontinence and uterine prolapse. It also promotes blood flow to avoid complications like varicose veins, leg cramps, edema and blood clot formation. Improved circulation promotes healing of pelvic tissues and strengthens uterine and pelvic ligaments and tendons. As an added benefit, exercise in the postpartum period has been shown to decrease the incidence of postpartum depression.

General postpartum exercise recommendations include starting back slowly by walking several times per week and doing light core and pelvic floor strengthening exercises. Your joints and ligaments are going through a big transition post-delivery and your center of gravity will start shifting. Be sure to take it easy for the first 2-6 weeks (or whatever your doctor recommends). Listen to your body and proceed accordingly.

If you do start running during the first 6 weeks make sure that you take it slowly to avoid getting injured. Even if you were an avid marathoner you don’t want to jump back into heavy training right away. Your abdominal muscles will be very lax and this can throw your running form off and lead to back discomfort or other injuries. You’re also at a higher risk for stress fractures during this time. Be patient with yourself and remember that it’s important to rebuild a solid running base. Don’t take shortcuts and get injured.

My Postpartum Return to Running

At the Little Rock Marathon 5 months after having a baby.

My goals post-pregnancy were simply to let my body recover and slowly build back my running base. I walked during the first 1-2 weeks postpartum and then in the coming weeks slowly added in some running intervals to my walks.

It was all about building back endurance before speed. I did deal with some plantar fasciitis at first and had to build slowly to keep this from getting worse.

I did do a marathon 5 months after my third son was born but I took it easy the whole time and walked the second half of the race. Then came the process of building on my new running base, regaining strength, and gradually dropping my times down.

I believe this gradual process was what enabled me to set a marathon PR around 19 months later.

Top 3 Things I Learned After Building Back from Pregnancy

The process of training during pregnancy and the postpartum period is such a learning experience. Here is what I personally learned during this phase of my running life:

  1. Pregnancy can make you a tougher and smarter runner. For me, running a marathon is way easier than childbirth. But both pregnancy and running raise your pain threshold, help you develop patience with the process, and make you realize that you can handle more than you think.
  2. Be comfortable with the decisions you make and take it a day at a time. I was pregnant for a 4th time in 2012 and lost the baby at 18 weeks. It was natural to wonder if my running had anything to do with this miscarriage even though the pathology report showed that the baby suffered from a genetic condition. Still, it was a very tough period of time as we dealt with this loss and as I had to again rebuild my running base. Having the habit of running was very helpful to me both physically and emotionally.
  3. I learned not to just train for races but to train for life. Being a strong and healthy person is so much more important to me than making a certain race goal. I want to run the rest of my life and enjoy all the unique opportunities and experiences running brings my way.
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