Thursday, December 31, 2015

Pregnancy as an Athlete

By Kat Hunter
Austin athlete Megan Wolfe,
23 weeks half marathon

Sometimes I catch myself saying “I used to be a cyclist.” I’m perpetually tired. I’m round. Movement is awkward. People lift boxes for me and discuss the size and shape of my stomach the way they might the changeability of the weather. My identity as an athlete feels like it’s fading into nonexistence as much as my waistline.

But I’ve done all this once before. And if there’s one thing I know about being pregnant it’s that pregnancy is a very temporary state, one that you might even miss when it’s over, just because there was something so unique and…well, connected…about it. For any woman who’s an athlete and pregnant (or thinking about becoming pregnant for the first time), I’ll share this: First, physically you will be back to where you were or better if that’s your goal, and two, you don’t have to be in a huge hurry to do it.

When I was carrying my first child I tried to pitch an article on training during pregnancy to various cycling publications. In truth, I wanted to research and write about it because I wanted to know more myself. I was frustrated by the lack of answers on the subject, even via anecdotal testimony; people were remarkably close-lipped. More often than not the advice I found was, “do what feels right,” and “exercise in moderation.” But what was moderation? And when does a quality interval session feel like anything other than dying?

Dr. James F. Clapp III's Exercising Through Your Pregnancy became a source of great comfort to me. The book represented real research, not just a series of chatty internet articles lacking sources, and it didn’t condemn mothers-to-be for “strenuous” exercise; in fact, the studies listed a number of possible benefits. I interviewed Bradley Price, an OB-GYN (and dedicated triathlete) in Austin who had conducted a study that showed starting an exercise program during pregnancy had noticeably positive benefits even for previously inactive women. Compared to Bradley’s sedentary control group, the group that performed “moderate aerobic exercise” for 45-60 minutes, four times a week, through 36 weeks gestation were shown to improve aerobic fitness, muscular strength, have similarly sized babies with fewer cesarean deliveries, and recover faster postpartum.

I also interviewed professional triathlete Sarah Haskins-Kortuem and former pro bike racer Jen McRae. I tried my best to get an interview with two-time gold medalist Kristen Armstrong, who’d held her two-year-old son up for the cameras after becoming the oldest rider to win an Olympic time trial in London in 2012. I talked to local multisport elites like Maggi Finley and Missy Ruthven. I outlined a number of ideas.

Cyclist and cycling advocate Nadia Barrera de Ramirez,
commuting to work at 29 weeks
And then I gave birth to my son, and the project moved from burning, to smoldering, to on a cold back burner. As time went on I think I became, like others, more reluctant to speak of my experience, both simply because I was forgetting much of it and also because other people are exceptionally quick to judge and criticize when it comes to anything involving babies, born or unborn. Though exercise is now widely recommended for women during pregnancy, the world at large still gets very nervous when you take it beyond a gentle waddle around the block.

You can’t blame people for thinking that way. There’s much we don’t know, and the reluctance to study the subject is understandable given the ethical and practical concerns of experimenting on or with pregnant women; research tends to rely on self-reported results.  In a sense the unfortunate truth for any woman is that she has to become her own guinea pig. Because of this and the fact that every pregnancy and every woman’s body is very different, the advice to “do what feels right” is actually some of the best that you’ll get.

To me, a woman’s evolutionary pedigree is more all-weather workhorse than hot-house orchid; the practice of remaining inert and indoors during pregnancy seems more alien and destructive to our bodies and those of our unborn children than being rigorously active. That was my foundation for training during my first pregnancy, and from there I tried to manage my workouts with a sense of practicality and “moderation” as best I saw it. I made a number of mistakes, of course.

My first mistake was thinking of training during pregnancy in terms of my competitive success post-delivery. From that standpoint it’s not a time to push the envelope; there’s simply no practical purpose. You’re going to have to take some time to recover after the baby is born, whether you deliver vaginally or by cesarean, and regardless, getting back into real race shape is just going to take time. (Less than you’d think, maybe—I was better than I’d ever been long before my son turned one.) In hindsight, I think the real reasons to train during pregnancy are to keep up a consistent routine and to avoid unnecessary weight gain, not to mention emotional happiness and sanity. Maintaining a reasonable level of fitness will make it easier to get back to competition later and will likely help you and the baby manage the effort of labor better.

The hardest thing about training during pregnancy can be learning to trust your own judgment. It helps to find a doctor who understands and supports your goals; sometimes OB-GYNs can sound about as well informed as those chatty internet articles, so if you have one that can quote real case studies and real numbers, you’ve probably got a doctor who’s going to tell you that you’re doing a good thing by working out. (If you have to see an MFM and are in Austin, I highly recommend Dr. Celeste Sheppard at Hill Country Maternal Fetal Medicine.) It helps to be conservative, too, to stop somewhere before you would in a typical pre-pregnancy workout: for example, to not push yourself quite as long or as far, to allow yourself without guilt to stop or slow down when you need to. There’s no reason to put an undue amount of pressure on yourself. You’ll encounter a lot of challenges and changes that you never have before. Because of loosening ligaments and the different weight distribution, for example, you may find yourself more prone to injury. Expect to get slower and to do less as your belly grows, and don’t let this make you feel like you’re failing.

If you’re a cyclist, whether to ride outside and where to ride outside are very personal choices. Be warned that you’ll receive open criticism from family, friends, and strangers. Of course, you’ll also hear stories of women biking themselves to their own deliveries. Where you fall in that spectrum is your own business. For much of the first trimester the baby is well protected by the bones of your pelvis; later, as your belly begins to noticeably protrude, there’s more risk in the event of a fall. Some people say a woman’s sense of balance is compromised during pregnancy as well, especially in latter stages. (I felt awkward but never off-kilter.)

The author at right, roughly one month from
delivery in her first pregnancy
Anecdotally…carrying my first son, I rode outside at near-normal levels of training for the first trimester, racing the state championships (second to Lauren Stephens—no shame there) at five or six weeks pregnant in 2012 and continuing on during the following off-season period with hard group rides and sporadic interval workouts. I tried running but had uncomfortable cramping in my abdomen, so that didn’t last very long. After the first trimester, I started parking my car at the veloway and doing all my training by bike on the track, which is closed to cars. When the position on my road bike became awkward I switched to a slow commuter bike with a very cushy saddle, a rack, and unnaturally high handlebars. I did a combination of trainer and veloway workouts up until delivery (which for me came two weeks after my due date).

I got back on the bike roughly two weeks after my son was born without too much difficulty, though it probably would have been more constructive and healthy to have allowed at least one more week. Weight loss felt slow at first, but eventually I was back to my previous weight without ever having dieted. I breastfed my son for the first year, and with hard training I had zero problems with milk supply—I typically had an oversupply. That, too, was manageable during training, though it meant my weekly long rides were limited to about three or four hours in terms of comfort. Still breastfeeding at around 10 months, I placed sixth in GC at the Joe Martin Stage Race in April 2014. In June I had a significant PR at the Texas State TT Championships and was fastest woman overall. That July when I was in the final stage of weaning, I won the last stage of a pro race, the Cascade Cycling Classic. The momentum and motivation and success of that year following childbirth I have never experienced again and probably never will.

There's some evidence that a mother's blood parameters are improved postpartum for a period of time (Clapp's book discusses this). And then, of course, there are the disturbing rumors of Olympic athletes in the '70s and '80s intentionally becoming pregnant and then aborting the fetuses for the aerobic benefits. Very early on in the pregnancy, possibly even before you know you're pregnant, your blood volume increases. Some athletes have diagnosed a pregnancy just from the sudden drop that occurs in power numbers. You're exhausted until your red blood cell count catches up, and after that you'll feel good again. The idea is you then benefit aerobically from the increased blood volume, but in my experience, both during this early stage of pregnancy and after in the supposedly superwoman period postpartum there are so many other factors coming into play that any improvements are a wash. You're always tired, you weigh more, you have terrible heartburn, your ligaments have gone Gumby, and afterward your body is also busy making milk, you're not sleeping, you can't train as many hours in one go, you're playing catch-up on overall fitness... My power numbers improved steadily well beyond the period of postpartum benefits, so though an increased red blood cell count may have helped alleviate the downsides post-pregnancy, I don't think it was the reason I did so well out of the gate. I think those nine months of rest during pregnancy—mentally and physically—may have been the key to success my first season back. I was just having a lot of fun racing again.

2014 Driveway Series podium, author and son at center
With a second baby, everything is more relaxed, and my goals this time around are very different. I found racing at an elite level with a young child to be really, really hard—more so as time went on because naps were shorter and my son noticed more when I was away. I felt guilty, and I felt differently about things than I expected to; it was a lot harder to take risks when I was racing, to get into that mindset that the finish line was all that mattered. I’m still bothered by the fact that my racing and writing commitments made many of my son’s earliest stages a blur, that I didn’t take more time to marvel at his development into a real person. After racing on a pro team in 2015, I don’t think I’ll ever aspire to that level of competition again.

It can be done, though, and some women do it exceptionally well. The fact that the way has been paved by other members of our gender is nice—what I didn’t realize, when I was going full tilt in that direction, was that I wasn’t going to be doing anything new and groundbreaking; I didn’t have anything to prove about the capability to be both mother and athlete. And this time I don’t even need to prove that to myself: I am a cyclist. I know I will be as much of a bike racer or competitive athlete as I want to be after I give birth, even if I’m near-spherical now.

I might still go more in-depth with this topic one day, maybe listen again to those interviews that were so kindly given and piece them into a story with hard numbers and hard facts and the anecdotal testimonies of other women athletes who went on to continued success post-baby. I think the most difficult part of writing that article may be listening to the recordings of my former self: so full of ambition and yet so afraid of what lay ahead, not knowing that it would be better and also harder than anything in my wildest dreams. If this describes you, too, rest assured that you have much to look forward to. Enjoy the ride.

2014 TX State Championships team time trial -
moms Kat Hunter, Missy Ruthven, and Maggi Finley visible
Austin-area OB-GYNs personally recommended by bike racers and endurance athletes:
  • Claire Hoverman, Hill Country OB/GYN (multiple locations)
  • Celeste Sheppard, Hill Country Maternal Fetal Medicine* (north) [specialist for high-risk pregnancies]
  • Bradley Price (central)
  • Felicia Nash, Women Partners in Health (multiple locations)
  • Joseph Fernandez, Scott & White Round Rock* (Round Rock)
  • Tyler Hancock, Scott & White Round Rock* (Round Rock)
*=recommended by an athlete who has been treated by the doctor during pregnancy

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