You don't have to look far to see pregnant women exercising. They are everywhere: in our yoga class, lifting weights at the local health club and jogging the trails and streets of every community. However, many women continue to ask if it’s okay to run and exercise while pregnant. The short answer is, yes. According to Dr. Karen Nordahl, physician and co-author of Fit to Deliver: Prenatal Fitness Program, “A woman can run as long as she feels comfortable and has no pregnancy or orthopedic complications.” In fact, women who were regular runners before becoming pregnant usually find they can run long into their pregnancy and for some, right up until delivery.”

If you weren’t a runner before you became pregnant, however, now is not the time to start running. Instead, try walking, stretching or a prenatal exercise class at your local community center.

In Dr. Nordhal’s Fit to Deliver, she discusses the importance of a prenatal fitness program for both mom and baby. According to Nordhal’s studies, a fitness regimen for expecting moms usually translates into strong, healthy women who have more comfortable pregnancies and an easier time in the delivery room than their more sedentary counterpart. The benefits are far reaching, from reduced rates of pregnancy-related diabetes and high blood pressure to fewer C-section deliveries and shorter labours. Furthermore, tests show that when infants are born to exercising moms develop motor and language skills earlier – and more effectively ­- than their playmates.

Nutrition tips for pre and postnatal women

Registered sport dietitian Dallas Parsons says that, “Overall, the recommendations for healthy eating for the general public are the same for pregnant or lactating women.” Here are some of her suggestions:

• Emphasize whole grains and cereals, plenty of brightly coloured fruits and vegetables, low-fat dairy or dairy alternatives and lean meats, fish, poultry or other protein sources.
• Women need 3-4 servings of dairy or other fortified dairy alternatives per day (1 serving = 1 glass of milk or other fortified beverage, ¾ cup/150 ml yogurt or ¾ oz/50g cheese).
• Daily, choose good dietary sources of iron: meat, poultry, fish, cream of wheat, enriched breads and cereals, fortified tofu, white and red kidney beans, spinach and oysters.
• Eat a meal or a snack every two to three hours.
• Snacks should be foods that fit into one of the four food groups.
• Drink at least six glasses of fluids, including water, per day (you want to have urine that is pale in colour). Proper hydration is especially important for women exercising during pregnancy, and while breast-feeding, to ensure that milk supply is maintained.
• During the first trimester, women who are not exercising need approximately 100 additional calories per day (the equivalent of one extra snack). During the second and third trimesters, women need an additional 300 calories per day (the equivalent of two additional snacks or slightly larger portions at meals). If a woman is running, she will need to take in even more calories, depending on exercise duration and exertion level.
• It is recommended that women listen to their bodies and allow appetite to guide food intake. This means making healthy food choices as often as possible and listening to internal hunger cues (avoid being influenced by external stimuli, such as social pressure).

Words of Caution for the Pregnant Runner

While most women are able to exercise regularly while pregnant with few problems, it’s important to run smart:

• If you are a non-runner who is now pregnant, this is not the time to take up running. Instead, try other activities such as walking, swimming or prenatal yoga classes (discussed later in this article). These activities will be less of a shock to your changing body than running.
• Monitor any pelvic or abdominal discomfort. If you do experience such pains or if you are spotting after running or high impact activities, speak with doctor as soon as possible.
• If running is too uncomfortable, try walking, swimming or pool running. These are great activities that put less stress on the body and joints yet still provide the benefits of exercise.
• Use your common sense: avoid exercising in environments that are overly hot or humid, and avoid even mild dehydration.
• Make sure you’re not working too hard, by using the talk test. If you find it difficult to speak, you are pushing yourself too much. If this is the case, stop and take a break until your breathing resumes to a normal rate and you can easily converse.
• Physicians no longer suggest that pregnant women check for maximum pulse rates during exercise. There is no evidence that it is necessary to restrict exercise when your pulse rate reaches some predetermined level.
• During the later stages of pregnancy, most women feel a “shift” in their center of gravity. This means your balance is reduced. If you find running uncomfortable at this point, it’s time to stop and try something else. If you are able to run up until delivery, avoid bumpy terrain and limit running to flat surfaces.

Tips for Breast Feeding Mothers:

Find a proper sports bra at a good running store. Today, there are many styles and sizes to meet the needs of every woman.

• Be sure to breast-feed or leave expressed milk before going for a run. This lightens your breast tissue and makes running more comfortable. Also, the baby will be full and happy during your run.
• Some reports suggest breast milk after running has increased levels of lactic acid, which may alter the taste. But many lactating moms say this is not a problem.
• Take a water bottle and stay properly hydrated – essential for nursing mothers. Signs of dehydration include dark coloured urine, dry lips, mouth and skin.

Expecting moms exercise to:

• Improve energy levels
• Fight postnatal depression
• Prepare for the stress of delivery
• Improve sleep
• Reduce the chance of gestational diabetes and pregnancy-induced hypertension
• Maintain healthy weight gain
• Help oxygenate the blood (which improves energy levels)
• Promote muscle tone (which helps in the delivery process)
• Reduce common complaints such as leg cramps and constipation
• Lower blood pressure

Besides running; what can I do to stay fit?

As Physiotherapist Denise Morbey says, “It’s important for expecting mothers to listen to their bodies. For some women, regardless of fitness level, running during pregnancy is just too uncomfortable. For others, their doctors have advised against it for health reasons. But don’t become frustrated – think of this as a time to try new activities. Cross training can help maintain total body fitness until you resume your regular running routine. Remember, this isn’t the time to be concerned with improving your fitness. Staying active and healthy are better goals.

Here are some ideas:

Swimming:

• a great non-impact workout
• assists in maintaining aerobic fitness, upper body strength, muscular endurance and breath control.

Yoga:

• maintains energy, strength and flexibility
• uses static stretches, movement, breathing and relaxation techniques
• encompasses many different types of classes that ensure a variety of workouts
• having fellow participants and an instructor provides support and networking

Lifestyle activities:

Everyday activities can also increase your energy level and short bouts of daily activity may fit more easily into a busy schedule than some cross-training activities. Here are a few examples:

• gardening, raking leaves and mowing the lawn
• housework such as cleaning, vacuuming, dusting and dishwashing
• using stairs and walking whenever possible rather than using elevators, escalators and moving walkways
• walking during lunch breaks

Commonly asked Prenatal Questions:

What do I do about my increasing breast size?
According to Physiotherapist Denise Morbey, “Breast size increases during pregnancy and even more so afterwards, when breast feeding.” Morbey recommends that pregnant runners wear proper-fitting sports bras and notes that a T-back shoulder strap increases directional support.

My feet are growing – why is this happening?
Increased weight means increased stress on the feet, so pregnant women need to pay attention to footwear. Shoes tend to break down sooner so it’s important to replace old runners. If you’re unsure about the support your shoes are providing, check with a footwear specialist at your local running store.

My balance is terrible now that I’m pregnant; what can I do to improve this?
“With increased weight gain in the abdomen,” says Dr. Karen Nordahl, “a woman’s center of gravity shifts. But although balance is more of a concern, it’s not necessarily a limitation to running.” Trying balance training through yoga, or just standing on one leg and alternating, are just two of the ways you can do this. As well, avoid trails with rocks and roots in order to minimize the risk of falling.

I’m pregnant and concerned about running because of the loosening of soft tissues. What should I do?
Soft tissues loosen with pregnancy, though as Dr. Nordahl points out, “running helps maintain a strong pelvic floor and stabilizers.” Still, it’s important for pregnant runners to be aware of their body. “Women should stop running if they experience any pelvic pain when standing or landing on one leg.” If you don’t stop, says Nordahl, “this can cause shearing of the sacroiliac joint.” Pain may also occur in the belly due to the ligaments being overstressed during the impact of running. And soreness in the knees, hip joints, low back and feet should not be ignored. If you are suffering from any of these problems, consult your physician and discuss eliminating the stress of running on land in favour of pool running.

Note: This article is an excerpt from the revised edition of The Beginning Runner’s Handbook, available in bookstores January 2005. Greystone Publishing, Vancouver, BC, 2005

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