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Fit Pregnancy Questions Answered: Interview with an Expert

Posted May 20 2009 1:20pm 1 Comment
Before... 
(Thank youChristinafor all the great photos.)

I expected to still be pregnant when I posted this interview. Alas, I am NOT! As of Thursday, February 12, I am the mother of a SON! You’d think we have our own Jonas Brother by the giddiness of his big sisters. The Boy already has groupies. We’ll talk more about him and my last pregnant workout later this week. For now, I need to get to this unfinished business...

Since this was my most fit (and final) pregnancy, I paid close attention to my body, noting the differences in this pregnancy relative to my last, less-active pregnancy and how workouts have evolved during this pregnancy relative to my unpregnant workouts. I’ve had some interesting observations to be sure, but also some questions, which I can’t stand to go unanswered.

I took my questions to Catherine Cram, MS, who I had the pleasure of meeting two years ago when I was a student in her prenatal and postpartum exercise certification course (which no doubt served as a huge motivator to exercise during this pregnancy). Cathy is the author of “ Fit Pregnancy for Dummies ” and has consulted on various other prenatal/postpartum books, exercise videos and magazine articles. She is also the maternal exercise consultant at Babyfit.com and Pregnancytoday.com. I liked Cathy from the start because of her sensibility, which happens to stem from science and research. It’s too bad most physicians don’t have a grasp of the knowledge she has about prenatal and postpartum exercise.

Assuming my questions could benefit someone else out there, I’m going to allow everyone to eavesdrop on the conversation we had a few weeks back.

Kara: For a year I've been taking a "barbell strength" class. I was almost always sore after these classes. Until I got pregnant. I've even loaded up on weight, taken a class with an instructor who is "Jillian-like," and still, not sore. I've got to imagine this has something to do with pregnancy hormones. Relaxin at work? Something else?

Cathy: I’ve never seen any literature on that.

Kara: Leave it to me to stump the expert.

Cathy: I can make a lot of interesting guesses: Because of the relaxin the ligaments could have more stretch to them. Relaxin is the hormone that effects the connective tissue. It’s why the diastasis recti (the thinning and widening of the connective tissue that joins the two sides of the recti muscle in your abdominal wall) widens, to allow the baby to grow, and it widens the pubic bone about one inch for birth. This can explain much of the discomfort in pregnancy: the pelvic bones have to do a lot more support; the lumbar curve is more exaggerated. Every time the baby has a growth spurt, the bones and ligaments must compensate and stretch. Or it could be a factor of cardiovascular changes and hormonal changes. During pregnancy a woman has a 40 percent increase of cardiac output. With better blood flow you can get waste products out sooner and heal muscles more quickly.

Kara: Those answers make sense to me. So keep lifting?

Cathy: As long as you feel good and the baby is growing normally then you’re fine. Just be careful of the strain part--your body is already at a push point.

Kara: Right. Would not want to push this baby out during barbell strength class. But I know what you mean about feeling maxed out. If I've had a somewhat strenuous workout, I find myself more sleepy and/or tired than on days I go easy or don't workout at all. I'm assuming this is my body's way of needing to recharge. I remember with triathlon training the advice was for every hour of hard effort in training, you should sleep an extra hour. True with pregnancy too?

Cathy: During pregnancy you’re already going through a training event all day long.
It’s like you’ve been wearing a backpack for 30 weeks, which keeps getting bigger and bigger. A month ago your backpack was 10 pounds and now it’s 20.

Kara: Actually, a month ago it was 30 pounds and now it’s 40.

Cathy: That’s a lot to carry around and we’re not even counting metabolic changes. At 30 weeks you’re doing 1/4 more work at the same intensity on top of carrying that load all day long.

Kara: So rest, isn’t actually resting unless I’m completely off my feet and lying prone.

Cathy: Yes, and after a half hour of exercise you will feel as tired, but not necessarily as challenged, as an hour did a few months ago. But as an athlete you know the normal of “I don’t feel like doing this” versus “I ‘m really fatigued.” If you feel like you haven’t recovered from your last workout, then don’t do the next workout. If you feel like activity is what you need, ease up on the intensity. Pay attention to your body. Exercise is good for the baby but you need to put rest in the equation even more than before. Modify. Play around with the equation. Women who do a lot of exercise during pregnancy and don’t rest end up breaking down a lot.

Kara: I love the growing backpack analogy and I think we do forget that we’re working even when we’re not working out. My legs certainly feel that way going up my stairs several times a day. Another thing I’ve noticed in this last month is a lot more Braxton Hicks contractions when I work out. What do I do about those little critters?

Cathy: It’s likely the movement in the abdominal area and weight bearing exercise that triggers the Braxton Hicks contractions. The up and down motion can irritate the round ligaments and abdominal wall. They’re very normal. If you stop they should stop. Just slow down until they go away. Determine where that threshold is in your workout where the contraction starts and then slow down or stop just before it strikes. You might be able to extend the duration you can exercise before getting a contraction. Just exercise right below that threshold.

Kara: It reminds me of heart rate training--to workout out below a certain heart rate threshold to train your body to work harder at a lower heart rate. We could use fetal monitors at the gym like we use heart rate monitors.

Now, about weight gain...I find it interesting that even with working out 4 to 6 days a week, I've still gained as much weight as my sedentary pregnancy. Are women just destined to gain a certain amount of weight during pregnancy--what their bodies need to carry a child--or, am I just eating more to compensate for all the exercise? OR, because of all this exercise, could my placenta possibly weigh 10 pounds? Ummm, 20 pounds?

Cathy: Some women just need to gain more. As long as you’re eating healthy and exercising your body is saying, ‘this is what you need.’ As long as your diet is healthy, it’s pure, healthy weight gain.

Kara (In thought):How healthy are Cocoa Crispies?

Kara: But my placenta will be bigger, right?

Cathy: There is one-third more blood flow in the placentas of women who exercise 5 to 6 days a week, which is why you see fewer complications in labor and birth for exercising women. The baby still can get enough oxygen in stressful labors because it’s learned how to do that over the course of the pregnancy during periods of exercise. It’s your baby’s strength training. Babies of exercising mothers adapt just like mothers adapt to the exercise stimuli. To use weight training as an example: If we do it correctly, we slowly load muscle. Then we rest and the muscle rebuilds to meet that load we put on it. When a woman exercises, the baby is having to deal with little bouts of reduced blood flow that causes the baby to adjust to the reduced blood flow, which gives it a safety valve or reserve for times of greater stress. But we’re talking little bouts; incrementally and carefully. You’re not overloading. As with weight training, if you overload it you injure it. [Note: I distinctly remember getting monitored at some point during labor and the midwife commenting to the nurse about baby's heart rate during a contraction. She said: "Baby isn't phased at all."]

Kara: I’ve continued to exercise regularly through this pregnancy but now I’m unsure how to approach the postpartum period. Do I follow that “nothing for 6 weeks” recommendation?

Cathy: That 4-6 weeks is a vague recommendation and doesn’t take into account each woman’s level of fitness, her postpartum recovery rate and whether or not she’s healing from a cesarean section or birth injury such as a tear or episiotomy. Go by how you feel. If you’re still having fairly heavy bright red bleeding you should hold off on exercise. If you feel energetic enough to try a little go for it. The rule of thumb is, if you have increased bright red bleeding during or after exercise it’s a sign that your body isn’t recovered enough for that level of exercise. A woman can try two things: ease up considerably on her intensity and duration and see if she still bleeds, or wait another week or more before trying to exercise again. Brown spotting postpartum is normal, it’s the change in color and amount that is cause for concern. If you do have increased bleeding then you over did it, or you’re not ready.

Kara: How soon can I get back to that barbell strength class? [Note: I can't even believe I asked this question. Furthest thing from my mind right now...]

Cathy: Do weights on your own first, so you don’t get caught up in the class atmosphere.

Kara in thought:I think what she’s saying here is that even when we know we have nothing to prove, we will be tempted to show off anyway in front of an audience. “Look at me--I just gave birth and I can lift 60 lbs, with my pinkie finger!”

Cathy: During that postpartum period your center of gravity is returning to what it was prior to pregnancy, and your muscles, joints and ligaments are having to adapt to an overnight like change in your body shape and weight. Organs are pressing back into place. Any stress-bearing activity needs to be approached with caution, so just be careful. Give yourself a month on your own before going back.

Kara: Thanks Cathy for your motivation and your continuing enlightenment. You’re a huge help to many mamas and mamas-to-be! 

Oh, and here's that "After" shot!


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re: diastasis recti, Tupler Technique® is research based and proven to close diastasis recti: www.diastasisrehab.com/licensed-pros.html
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