Running and keeping fit during pregnancy can help to alleviate the side effects of pregnancy such as swollen ankles, constipation, excess weight gain, and general aches and pains.

Pregnancy is a natural condition. We don't have to stop our lives for 9 months. The major consideration is the health and well being of both the mother and unborn child.

Training and pregnancy

When you first started training in pre-pregnancy days you learnt to push through the barriers set up to warn us that something was hard such as tired legs, aching muscles, gasping for air, becoming overheated. As you learnt to push through these barriers, each run got a little easier, you progressed and (hopefully) got the results you were after.

During pregnancy everything changes - we now have to really listen to our bodies. In contrast to how we trained before pregnancy, when we are tired, we stop, we should not get overheated during exercise and we should never run or exercise out of breath.

Here are some basic guidelines:

• ALWAYS discuss your wish to exercise with your health professional before doing any exercise however fit you are.
• Never exercise for longer than 40 minutes at a time unless you have discussed it with a health professional.
• As a general rule the heart rate should stay below 140 beats per minute. This should be an aerobic effort, and mean you would be capable of talking if necessary.
• Never exercise in hot conditions unless there is adequate ventilation.
• Always stay hydrated during exercise.
• If weight training, use machines where possible and do not use free weights.
• Do not do strenuous stomach exercises.
• Do not exercise in a lying down position after the first trimester. This can block an adequate blood supply to the baby.
• Exercise regularly (3 to 4 times a week) rather than intermittently.

Why do we need to be so careful?


We need to make sure we are exercising in a suitable environment because the baby does not cool down until we do. When we exercise, our temperature rises and unless we make sure it is easy to cool down, the baby can become overheated, which is dangerous. It is therefore best to avoid exercising in a unregulated environments and overheating.

During pregnancy our ligaments slacken to enable us to give birth naturally. This means all our joints have a wider range of motion and can lead to muscle strains very easily. Aim to stay within your normal range of motion especially when doing resistance exercise with weights. Keep exercise intensity low, as the baby's heart rate will increase with yours.
  During the first trimester many women feel very tired and sick. The baby is being formed and is developing all its 'bits and pieces' so rest during this time is vital. Only exercise if you feel up to it. Aim to walk or swim if other forms of exercise feel too strenuous as this will keep you in the swing of things. It is quite hard to pick up again after 3 months of inactivity.

The second trimester should be better. Generally women are over morning sickness and feeling OK. This time could be used running or at a gym.

The third trimester is when many women feel too uncomfortable to run because it can set off mild contractions in the uterus. It is therefore a time when women look for alternative forms of exercise. There will usually be ante-natal exercise classes in your area, run by trained instructors who can make sure the exercise is appropriate for you.

Indoor cycling is good but beware of getting too hot. The risk involved with riding a bike outdoors on the roads has been one I was never prepared to take. Motorists are so unaware of cyclists and with your balance altered from pregnancy an accident could have disastrous consequences. Swimming is a gentle form of exercise that you can continue up until term. It gives you a wonderful weightlessness feeling and a good stretch workout. Throughout pregnancy avoid sports and activities which involve a risk of injury to your stomach such as fast ball sports, contact martial arts etc.
Clothing

Here are some tips for choosing clothing to exercise in while pregnant:

• Do not wear restrictive tight clothing.
• Ensure that the material is lightweight and can 'breath'.
• Wear a good support bra.
• When the weather is cold, wear several layers so you can peel them off as you warm up, rather than a heavy sweatshirt that would have to stay on getting you too hot.
• Wear shoes that have good cushioning to allow for your weight gain.

Post birth issues

There may be an overwhelming urge once the baby is born to rush back into running and regain previous fitness levels. There is a lot to take into account before this can happen though.

1. The joints and relaxin - Relaxin is the hormone that increases flexibility of the joints during pregnancy. It is still there after giving birth up to about 6 weeks. This is prolonged in women who breast feed their babies. As in pregnancy, care must be taken not to go outside your normal range of motion when exercising.

2. Post natal posture - During pregnancy your posture undergoes many changes. This posture can increase the risk of injury to the spine and pelvis as the stomach muscles are not strong enough to help with realignment. As the hormone relaxin is still present the spine is not supported in the usual way.
  3. Abdominal muscles are obviously very weak and require a lot of attention. A caesarean delivery should not slow down recovery of these muscles. During the surgery muscles are separated to remove the baby, the rectus sheath is then repaired and the muscles realigned. The muscles should then recover in the same way as for a vaginal delivery.

4. Loss of speed and endurance - During pregnancy, fitness can be maintained, however speed and endurance are sacrificed. Going straight back to pre-pregnancy levels of training would be too much and could lead to an injury. You need to begin with short sessions and build up gradually. Speed work should not be introduced until at least 6 weeks after the birth.

5. Pelvic floor exercises are one of the most important things to do and can be done from day one. These are the muscles that relax to allow you to give birth and need tightening to prevent an incessant need for the loo during exercise. Include these daily - your midwife should give you a sheet of exercises to follow.

6. Rate of return to exercise - Obviously the rate at which you can return to your normal schedule is very individual, and is primarily governed by your current state of health. Excess weight gain (more than 2 stone following birth), pre-eclampsia, high blood pressure, gestational diabetes, and any other medical condition that needs attention could slow your return.

This does not mean you 'will never be fit again' as is the belief of some women post childbirth, just that you will need to take things more slowly and regularly consult with your GP.

Presuming a relatively uncomplicated birth and reasonable health you should be able to start very gentle exercise a week after birth.
Guidelines for exercise after pregnancy

Week 1 (i.e. in the second week after the birth)

Walk up to 20 minutes. Unhurried, flat terrain. Think about posture. Walk tall, hold your stomach in and pull hips/pelvis forward. Repeat three times on alternating days.

After walk, stomach and pelvic floor strengthening exercises as given by the midwife. These can be done daily.

Week 2

Increase walk to 30 minutes. One walk up to 40 minutes. Walk as you feel, if you feel like going faster then do. Follow the walks with stomach and pelvic floor strengthening exercises as for last week and alternate days.

Week 3 and on

If you are feeling fine with the walks and your health is OK, you could now introduce some jogging on alternate days for 20 to 30 minutes. Walk/jog as you feel.

After having a baby your stomach can often feel bruised and running can accentuate this feeling. If it is too uncomfortable speak to your GP.

• Remember you should be able to maintain a conversation at your maximum pace.
• Keep up the stomach and pelvic floor strengthening exercises.
• On the days when you don't run, walk as before.
• Always have one day without exercise to rest.

Continue this regime until your 6 week check. If you feel comfortable in weeks 5 and 6, you can lengthen the jogs to 40 minutes, 1 or 2 times weekly.

Post 6 weeks
  Once you have passed 6 weeks you are ready to resume training 'proper', providing you have had the OK from your GP - have a look at the training plans in the training section for some ideas on training. It is advisable not to aim for anything too long initially, such as a marathon. Shorter distances (5K, 10K) will enable you to complete a full schedule of training to cover speed, endurance, strength etc. to gradually build up a fitness base again.

If you have gained excess weight during pregnancy, be careful of too much intensity and distance while running, as the extra weight can put stress on your joints. Aim to lose the weight gradually, especially if breast feeding. It is quite normal for it to take up to 9 months to lose any excess gained. Non-weight bearing exercises such as cycling, swimming, stepper, rowing etc will all build your fitness and assist in weight loss without undue stress on joints - have a look at the article on cross training in the training section for ideas.