Running Through Pregnancy Trimester by Trimester

By: Allie Surdovel, Karla Bruning

“Pregnancy is a marathon," says Dr. Ivonne Escudero Smith, an obstetrician and gynecologist at OBGYN Medical Center Associates in Houston, Texas, part of PriviaMedical Group. She's also an avid runner and marathoner.

“When you run a marathon, those first 3 miles suck. That's the first trimester. Then you get into a rhythm and feel good. That's the second trimester. Then you hit 'the wall' around Mile 20. That's 34 weeks pregnant."

It's a perfect analogy. As a mom-to-be, I ran through good times and bad. In many ways, it helped me prepare for the rigors of birth and motherhood.

“Happy mom, happy baby, happy family," Smith says. “Exercise helps you in so many ways, both for your physical and mental well being. I never see any downside in my athletes. Mentally, they're just healthier. When they start having aches and pains, it doesn't bother them as much. They have a better attitude toward the end when it gets tougher and more stamina to push out the baby."

The American College of Obstetricians and Gynecologists encourages women with uncomplicated pregnancies to get at least 20 to 30 minutes of moderately intense exercise every day, in consultation with your doctor. Continuing a running routine can lower the risk of gestational diabetes, preeclampsia, cesarean delivery and other complications; strengthen your heart and blood vessels, which work overtime during pregnancy; ease symptoms like back pain and constipation; and shorten labor times.Babies benefit, too, registering healthier hearts, less fetal stress, better stress tolerance, lower fat mass and more mature brains.

Your mental health gets a boost, too. Research shows a single workout can improve your mood during pregnancy.

"You are one run away from a better mood," says Dr. Carly Snyder, who specializes in reproductive psychiatry, hosts the radio show and podcast, "MD for Moms" and is an attending physician at Mount Sinai Beth Israel Medical Center in New York City. She's also an avid runner, who says she continued through two pregnancies.

“Running alleviates anxiety, clears your head, propels you forward—literally and emotionally," Snyder says. “It's a nice, quiet time to home in on what's important, to let go of things that aren't. As long as you allow yourself to modify your distance or your pace, there's only benefit from continuing to run. Being pregnant shouldn't hinder your ability to take that time for yourself.

Smith suggests finding a physician who also exercises to support and guide you. And pay attention to signals your body sends.

“Listening to your body is really important," she says. “Many athletes—their philosophy is, 'No pain, no gain.' When you're pregnant, you have to listen to that little voice that tells you to slow down. You have to modify your activity a little bit. If it starts hurting, you have to stop.

"Here's how to face the challenges of running through pregnancy, trimester by trimester.

First Trimester

Surging hormones affect nearly all your organ systems.

“That first trimester hits you like a wall. Your body is going through major changes and you're feeling things you've never felt before," Smith says. “Your pregnancy hormone is doubling every day until you get to 10 weeks. You have 40 to 60 percent more blood going through your vessels, through your heart."

Meanwhile, your oxygen demand shoots up thanks to a bump in metabolism and oxygen intake. Your heart and lungs have a much heavier workload, causing windedness, extreme fatigue, nausea, mood swings, headaches, sore breasts and more. I experienced all, seemingly overnight. One day, I easily knocked out 8 miles; the next, I struggled to run at all.

Don't worry; your fitness is just taking a breather. But the feeling of going from hero to zero can be demoralizing.

“It's important not to compare yourself to your pre-pregnant state," Snyder says.“Pregnancy itself is a marathon. You have to pace yourself through it. Your body is doing this humungous thing and that takes a lot out of you. You're not going to run as fast. You're not going to run as consistently. You may not have as much energy to go as far. Allow your body to do what it can."

If you don't feel link running at all, don't force it.

“The nausea, the profound fatigue makes it really difficult to get out there and run,"Snyder says. “It can be a real conflict. Runners tend to be motivated people. We like to run. But then there's this feeling of, 'I really don't want to get off the couch.' Some days you stay on the couch and some days you go out for a run. And that's OK."

Sashea Lawson, 38, says she ran until the week before giving birth and is currently running through her second pregnancy.

“The hardest part was definitely the first trimester fatigue," says Lawson, who blogs atSassy Fit Girl. “I would feel so tired after doing any activity."

Lawson went from covering 30 to 45 miles a week while training for the New York City marathon to 15 miles per week while pregnant.

“I did what's called 'sexy pace,' which is 10-plus minutes per mile," Lawson says, noting she was surprised by how quickly her heart rate spiked and how much she sweat. “My body would overheat if I attempted to go fast. I had to decrease my pace drastically to make my runs manageable and enjoyable."

Overheating was a concern for marathon world record holder Paula Radcliffe, who trained through two pregnancies.

“The biggest thing is not overheating, keeping enough hydration and food," Radcliffe told me in September 2016 at the Disneyland Paris Half Marathon, whichIran while five months pregnant. “It's great that you can run through pregnancy and you shouldn't be scared to because you naturally scale down the intensity and you listen to your body a lot more. Of course, your number one priority is: make sure that the baby is OK.

"Her advice? “Don't try to run a personal best."

Smith agrees. “Stay hydrated, keep listening to your body and keep moving," she says.

I found that I could handle about half my usual training load at a much slower pace. I often ran while nauseated, preferring fresh air to ease my retching and vomiting. Smith says that's perfectly OK.

“If you're slowly gaining weight, you're OK to run," Smith says. “If you're able to hydrate and not lose weight, your baby is going to be fine. But if you're losing weight, pull back and call your doctor."

Other warning signs include bleeding, contractions, leaking, dizziness and fainting,Smith says. Call your doctor before forging ahead.

Second Trimester

“Smooth sailing" is how Lawson describes the second trimester.

Why? Hormones level off and your body acclimates to all its physiological changes.“You go from an uphill slope to a plateau," Smith says. “You get used to the higher level of hormones and blood. Your body accommodates the new you. That's why you feel better." It amounts to less nausea and fatigue, and more energy to exercise.

“For runners, that means we can lace up more often," Snyder says. “It's a great opportunity to go outside, get out of your head and enjoy something that you enjoyed previously."

With my breath and energy back, I managed to complete an open-water swim, 5K and half-marathon during the second trimester. I felt strong and enjoyed what I saw as bonding time with my baby. I felt like I was sharing something special with her—my secret to life. I'm not alone.

“I loved that my body was able to continue doing an activity that I love and share my journey with my little one," Lawson says.

But your body begins a series of anatomical changes that will grow, literally, over the next few months. You might experience aches in your back, chest, abdomen or groin as your body adjusts for your developing baby. You might also feel a constant need to pee, thanks to added pressure on your bladder. I simply hit the treadmill more frequently for easy bathroom access.

While I managed to avoid many aches, intercostal pain under my ribs proved problematic. My chest muscles struggled to support my burgeoning bosom while I ran.Thankfully, there was a simple solution: maximum support sports bras, something I'd never needed before.

Many of these pains are OK to run through, Smith says. “But talk to your doctor," she adds. Keeping an open dialogue with your obstetrician can help assuage any fears and avert complications.

Third Trimester

Those anatomical changes will ramp up in the third trimester, Smith says. A few symptoms can be especially difficult for running.

“A lot of pregnancy is like, 'Whoa, what is going on here?'" Snyder says. “It's an incredibly scary thing but that's OK. Be OK with the fact that it's scary."

You might feel renewed shortness of breath, for example. Your organs—including lungs and diaphragm—feel the squeeze as your uterus expands to make room for a fully formed infant. The more space baby takes up, the less room your organs have.

Swelling presents another challenge. “Everything is swollen," Smith says, noting nerves can get impinged. Some women feel sciatic nerve pain in their lower back, hips, buttocks and thighs from the baby's extra weight and position. Others have muscular lower back pain caused by a changing center of gravity. A pregnancy support band can help, especially while running.

Gravity pulls that swelling to your feet and ankles, too, Smith notes. My feet became so swollen that most of my shoes didn't fit. The only kicks I could get into were sneakers with the laces barely tied.

Finally, your baby will “drop," moving to a lower position to prepare for delivery. “You have the head right there down in your pelvis," Smith says. “The pressure is intense."

That's when I stopped running entirely, around my 38th week. It was too uncomfortable.I walked instead, until my doctor induced labor at 42 weeks.

“Walk if you need to," Snyder says. "Give yourself the freedom to go slow. Even if you're not running, you're still allowed to have that time for yourself."

That proved most difficult mentally. Throughout my pregnancy, running was the one thing that helped me feel like me. It was like an alien had taken control of my spaceship.

“Our bodies change so much, which is completely out of our control," Snyder says. “It's still your body. It doesn't feel like it, but it's still there. Running can remind you of that. And that feels good."

It certainly did. Running helped me feel ownership over an ever-changing vessel. The last four weeks when I didn't run were the toughest for me. Of course, some women area ble to run right up until the day they give birth, like Radcliffe did with her first pregnancy. Others find it more of a struggle.

“Every woman deserves the opportunity to enjoy her pregnancy," Snyder says. “You're carrying such precious cargo. You deserve to enjoy that time. If you're not, ask for help.Speak to your OB or a trained mental health professional who can help you."

Whatever approach you take, work with your doctor as a partner in your pregnancy.Then you and your baby can reap the benefits of staying active through your months asa mom-to-be.


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