Being pregnant is an exciting and nerve-racking experience for a woman, and for athletes it can bring a whole world of unknown.
How hard can I push? When should I scale back? And how soon can I return to training postpartum?
I’m here to provide some insight and peace of mind to keep you and your baby in the game, while maintaining safety.
Disclaimer: there are always exceptions to general recommendations, and you should consult with your healthcare provider for specific needs and in the case of any complications present throughout pregnancy.
With that being said, there are many myths surrounding exercising while pregnant, especially at an elite level.
In the recent past, pregnant women were told to decrease exercise or even avoid it all together.
The truth is that exercise during pregnancy has minimal risks and assists with several negative comorbidities of pregnancy, including maintenance or improvement of physical fitness, control of gestational weight gain, reduction in low back pain, and possibly a reduction in risk of developing gestational diabetes or preeclampsia.1
Believe it or not, several athletes (at least 17) have competed at the Olympics while pregnant, and some have even medaled.1
It is a fact that a woman’s aerobic fitness stays the same or even improves somewhat during pregnancy, as long as normal exercise is continued as maternal symptoms permit.1
Another myth surrounding this topic is to never get your heart rate above a certain number while exercising.
Of course there are optimal ranges of heart rate for specific goals of the exercise, but there is no set number to abide by for every individual to avoid risk.
Exercise intensity depends on many factors, including baseline fitness level, goals of exercise, and most importantly how you feel during exercise.1,2 Most practitioners recommend using the RPE scale or rate of perceived exertion during exercise for a more practical and individualized guideline.
RPE is based on the Borg 6-20 scale, 6 meaning no exertion and 20 meaning maximal exertion.1,2 For moderate intensity exercise, the recommended RPE is 13-14, or “somewhat hard.”1 One last common myth is that it is unsafe to run during pregnancy. Experts say it is safe to run right up until you go into labor as long as you and your pregnancy are healthy.2
Most healthcare professionals agree that training while pregnant is safe and should be encouraged, even at a high intensity and elite level. Although it may not necessarily be the time to break records, set PRs, or prepare for competition.
While there are many benefits to continuing a training regimen while pregnant, there are a few risks to be aware of as well.
Dehydration is a risk with intense and prolonged exercise, or exercise in a hot environment. It is important to consume appropriate hydration before, during, and after exercise. Any loss of weight during an exercise session due to fluid loss should be made up before the next exercise session (1 pound [0.45kg] weight loss equals approximately 1 pint [16ounces] of fluid).1
For elite athletes, “overtraining syndrome” is another risk, which presents as rapid onset of fatigue, sleep disorders, lack of weight gain, an increased frequency of musculoskeletal injuries, and persistent tachycardia at rest.1
Another risk is hyperthermia, which has been associated with an increased risk for neural tube defects.1 The parameter associated with this risk is a maternal core temperature of 102.2° F in the first four to six weeks of pregnancy. However, reaching this body core temperature during normal exercise is highly unlikely.1
A study done in a controlled neutral environment during 60 minutes of exercise at an intensity of 55% VO2 max caused a core temperature increase of only 1° F in pregnant women.1 Some scenarios to consider avoiding are running a marathon on a very hot day, “hot Yoga,” and/or “hot Pilates,” or strenuous exercise in a hot environment for an extended period of time.1
In general, the physiologic and anatomic changes of pregnancy return to the pre-pregnancy state by approximately six weeks postpartum.
However, athletes will be happy to hear that the competitive exerciser with an uncomplicated pregnancy, delivery, and postpartum course may resume training within days after delivery, and no maternal complications are associated with resumption of early training.
As an avid CrossFitter and Olympic weightlifter, I can only imagine the constant worry of attempting to train through this experience, or worse, being told by a doctor that I can’t train for an extended period of time.
My hope is that this blog provides valuable information to compliment the specialized situation of athletes and their training routine through pregnancy.
- Raul Artal, MD, FACOG, FACSM. Exercise during pregnancy and the postpartum period. UpToDate. https://www.uptodate.com/contents/exercise-during-pregnancy-and-the-postpartum-period?search=exercise during pregnancy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Published April 4, 2017. Accessed March 31, 2019.
- Bouchez C. Exercise During Pregnancy: Myth vs. Fact. WebMD. https://www.webmd.com/baby/features/exercise-during-pregnancy-myth-vs-fact#1. Published February 6, 2009. Accessed March 31, 2019.