The Myths of Exercising during Pregnancy - The Facts on the ACOG Guidelines

Running for Two - Running during Pregnancy

Tips for Running during Pregnancy

Recommended Reading

The Myths of Exercising during Pregnancy - The Facts on the ACOG Guidelines

MYTH #1:

Women cannot workout during pregnancy if they did not previously engage in an exercise program before becoming pregnant.

FACT: The 1994 American College of Obstetrics and Gynaecology (ACOG) Guidelines for exercise during pregnancy stated: During pregnancy, women are permitted to continue to exercise. The 2002 guideline states, "Healthy pregnant women are encouraged to engage in at least 30 minutes of moderate exercise on most, if not all, days of the week." This is a significant difference in language. Pregnant women are not only allowed to exercise, but are in fact encouraged to do so. It is important to remember that this new recommendation is the same one made to women that are not pregnant.

MYTH #2:

Women must keep their heart rate below 140 bpm (beats per minute) when working out.

FACT: Unless your personal physician advises against this, assuming he or she is aware of the 2002 ACOG Guidelines for Exercise During Pregnancy, this is not a current recommendation. This is actually an old recommendation developed in 1985, and was a conservatively estimated number then. In 1994 the ACOG lifted the restriction on intensity and duration for exercise because there was no evidence that a heart rate greater than 140 beats per minute caused harmful effects for the baby. Patients are advised to follow the "talk test" to determine exercise intensity: if you are able to talk normally while exercising, your heart rate is at an acceptable level. 

MYTH #3:

Women can NEVER lie on their back after the first trimester of pregnancy.

FACT: After the first trimester, pregnant women should avoid the supine position (lying face up on their back) as much as possible. However, it does not state NEVER. Some women experience discomfort in this position. Remember: If the mother is comfortable, the baby is comfortable. If you do not experience dizziness or discomfort in this position, you may exercise on your back but in a very limited capacity. The individual exercise should take no more than 1-2 minutes, then roll to your side and perform a series of exercises there.   

Running for Two - Running During Pregnancy

The American College of Obstetrics and Gynaecology (ACOG) Guidelines state "If you were a runner before you became pregnant, you often can keep running during pregnancy although you may have to modify your routine." They do, however, recommend that pregnant women talk to their doctors. If you are new to running, now might not be the best time to start and you may want to wait until after you have had your baby. If you have ever been pregnant, you know that pregnancy is a physically stressful activity that your body and joints might not be ready for.  

A run and many other forms of aerobic exercise offer the following benefits to pregnant women:

• May help prevent or treat gestational diabetes
• Increases your energy
• Improves your mood
• Improves your posture
• Promotes muscle tone, strength, and endurance
• Helps you sleep better

As mentioned earlier, you should always check with your doctor before embarking on an exercise routine. But if he or she gives you the 140 bpm limit, be prepared to ask for an explanation-- and perhaps diplomatically mention that the ACOG has lifted that restriction. The best indicator of how hard you should work is to be competent in assessing your exercise intensity. Experts now suggest using the Rate of Perceived Exertion (RPE) Scale, also called the Modified Borg Scale. This scale ranges from 1 to 10, and is a self-assessment. When pregnant, you should exercise between level 4 (Somewhat hard) and level 6 (Hard).

Sample RPE Scale

As a pregnant runner, there are certain things you should keep in mind before you put on those running shoes and head out that door. Each stage of your pregnancy will bring with it different experiences and challenges you'll need to be aware of; here are some things for you to consider.

First Trimester
Nausea and fatigue are very common during early pregnancy. In fact, half of pregnant women have both nausea and vomiting. And although going out for a run might be the last thing you feel like doing, exercise will in all likelihood make you feel better. Listen to your body, make sure you aren't pushing yourself too hard, because sometimes rest is more important for you and baby. Still, many times, if you can get yourself out the door for even a short run, you'll feel better and have more energy for the rest of the day. The fresh air during an outdoor run can also help relieve nausea and insomnia, another common problem associated with pregnancy.

Depending on how much you were running before becoming pregnant, you might have to reduce your mileage a bit and pay close attention to how you're feeling. Now is also the time to eliminate anaerobic workouts such as sprints. Your body is already working harder to provide enough oxygen for you and baby, and anaerobic workouts can force you to use oxygen that should be going to your baby.

You may experience a lot of nausea during the first half of your pregnancy but find that running helps you feel better (even if it is only temporarily). It will increase your energy and help you get through the day.

Second and Third Pregnancy
As your belly grows, your center of gravity will also change, leaving you more susceptible to falls. Be careful: now is definitely not the right time to explore new gravel trail.

You may notice your pace slowing down considerably with progressing pregnancy. As the baby grows, your diaphragm has less room to move leading to shortness of breath. This may be mentally tough for runners who are used to pushing themselves to run further and faster. Just remember that irrespective of whether you can run a 15-minute mile or 10-minute mile, your commitment to continue to exercise has positive benefits both for you and your baby!

As your pregnancy progresses, you are likely to experience things like back pain, swollen feet and ankles, and increasing pressure on your bladder. A maternity support belt may help, especially during exercise.

If you start feeling Braxton Hicks contractions (described by some women as a tightening feeling and as being similar to menstrual cramps by other), stop immediately and walk. Once the contractions stop, you can usually start running again, albeit more slowly.  

Stop running or jogging immediately and call your doctor if you have any of the following symptoms (as stated in the ACOG guidelines)

• Vaginal bleeding
• Dizziness or feeling faint
• Increased shortness of breath
• Chest pain
• Headache
• Muscle weakness
• Calf pain or swelling
• Uterine contractions
• Decreased fetal movement
• Fluid leaking from the vagina

Tips for Running during Pregnancy

Although you should keep many of the following tips in mind at all times, they are particularly important when you're pregnant. 

• Ensure you are properly hydrated before, during and after the run. Dehydration may decrease blood flow to your uterus, which can cause premature contractions.
• Invest in a good sports bra as it is important to give your growing breasts the support they need. You might have to go up another size as your pregnancy progresses. 
• Always warm up properly before you run, and cool down and stretch at the end of your run. Stretching may help prevent injuries, but be careful: relaxin, a hormone produced during pregnancy, loosens joints and ligaments, making you more susceptible to injury and overstretching.
• Because of the increased pressure on your bladder, it's a good idea to plan your outdoor runs around a bathroom stop (or two!).
• If you are going for a run outdoors, always let someone know your route and when you expect to return. Avoid running in isolated areas or on high-traffic streets. Safety should always be your top priority, so carry a mobile in case of an emergency or always run with a buddy.
• Make sure you're wearing well-fitting shoes that give your feet plenty of support.
• Your center of gravity is shifting as your belly grows, leaving you more vulnerable to slips and falls. For safety, stick to running on flat pavement.
• If you lose your balance, do your best to fall correctly: Try to fall to your side or on your behind, to avoid trauma to the abdomen. Or put your hands out to break your fall before your abdomen hits the ground.
• Consider running on a track as your pregnancy progresses. Not only is the track surface easier on your joints, but you may feel safer running somewhere where you won't get stranded in case of an emergency.
• If you feel too tired to go for a run, listen to your body and take a break. Being sedentary is unhealthy, but pushing yourself too hard is also harmful.
• Never run to the point of exhaustion or breathlessness. Pushing yourself to the limit forces your body to use up oxygen that should be going to your baby.
  

Remember, that running during pregnancy is a means to maintain your fitness level and not to train for a competition, to win a 10-mile road race or run your best ever marathon. As long as there are no health problems and you listen to your body - work hard but don't overdo it - you can exercise AND enjoy a healthy pregnancy!

Recommended Reading  

Exercise During Pregnancy by the American College of Obstetrics and Gynecology (ACOG)

Exercise in Pregnancy - Women in Sport by Sports Medicine Australia

Fit Facts - Exercise and Pregnancy by the American Council of Exercise (ACE)

Running Goals During Pregnancy (a RunnersWorld article)

When you become pregnant, your running goals should change overnight. Click here to read on.