Exercise during Pregnancy - Forget the Moms, its Benefits for Baby!

Research was published last week about the positive effects of exercising during pregnancy on the brains of new-borns. It is an angle that doesn't often get covered, the focus usually being on the benefits to the prospective mums, or on the damage you can do to your baby while exercising. How refreshing to have a positive slant from the babies point of view.

The scientists gave one group of moms an exercise programme, where they had to do three sessions a week exercising at moderate intensity (where they were out of breath). The other group were told not to exercise.

After birth, as the new-borns slept on their mums knees with a special electrode cap on their heads, brain activity was measured. The brains of the babies born to the exercising mums were better at distinguishing different sounds then the other group. This is an indication of neurological maturity, or basically an indication that their brains were better developed. What’s more, studies of toddlers up to 5 years of age have shown those born to exercising mums had bigger vocabularies and higher IQs then those born to non-exercising mothers. 

This is a victory for exercising moms-to-be. On a few occasions I was accused of doing too much during my pregnancy and people said I was selfish and going to harm my baby. Yes I exercised quite a lot, at one stage during the second trimester I was doing approximately 10 hours / week. I don’t think everyone should be doing this much, but I  do think the standard recommendation of 30 minutes 5 times a week is really the bare minimum women should consider. Now we have research to prove how good it is to get out there and do it not just for ourselves but for our babies.

Tori is now 17 months old and indeed already has a broad vocabulary. I tell people it’s because of all the exercise I did. Only problem is she has also picked up a few inappropriate words, courtesy of my mother, when Tori was trying something particularly dangerous while she was babysitting!

Exercise during pregnancy – Lea-Ann Ellison challenges the boundaries

Last week a weightlifter and mum of two, Lea-Ann Ellison, sparked a bit of a media storm when pictures of her weightlifting at 8 1/2 months pregnant went viral. Opinion, as is always the case when it comes to anything to do with pregnancy, was highly polarized.  Some people thought she was great, rushing to her defense; others were absolutely disgusted and accused her of being irresponsible. What struck me most about the whole thing though was the fact it highlighted something that has been bugging me for a long time.

People think they are open-minded, and now the vast majority “support” the idea that exercise during pregnancy is beneficial. But all you have to do is barely scratch the surface and the hypocrisy emerges. It turns out that to the majority of these people think exercise during pregnancy should be limited to walking, pregnancy yoga or gentle swimming. Oh, and I did I mention, definitely not weightlifting! The benefits of moderate (not gentle!) exercise during pregnancy are numerous. It prevents back pain, reduces risk of gestational diabetes and obesity, reduces complications during labor and boosts recovery post-partum to name but a few.

The pictures of Lee-Ann horrified a lot of people attracting comments describing what she was doing as “sickening” and “a good way to lose your baby”.  The reality is these pictures were only shocking to most people out there as they are physically incapable of doing what Lea-Ann was doing, pregnant or otherwise, and have no concept of what is involved. This woman is an experienced weightlifter and this is her day-to-day stuff. The best comment I read in support of her was from a guy in a forum and said it all really: “The woman looks as strong as horse so what's the problem?”

Lea-Ann just exposed a nerve, and forced people to confront what they really think about exercise and pregnancy. When I was pregnant last year, one of the things I noticed was many people, though they supported the concept of exercise during pregnancy, were of the opinion it was only OK to do something as long as you had been doing it before you got pregnant. I frequently heard the comment “its OK for you to exercise, you are used to it”. This is rubbish! There is absolutely nothing in the scientific literature to suggest that women shouldn't start exercising during pregnancy, even if they have never lifted a finger before. The benefits far outweigh any perceived risk. The only rule women need is “listen to your body”. I myself only started weightlifting when I was pregnant – it was great for self-esteem, it prevented too much extra fat deposition, it enabled me to recover very rapidly after the birth and I ended up with a pair of toned arms to die for!

In Lea-Ann’s own words, "I strongly believe that pregnancy is not an illness, but a time to relish in your body's capabilities to kick ass."

I loved the pictures, they show a beautiful strong woman, comfortably lifting weights, with as much effort as another pregnant woman would use hanging clothes on the line.
 

Safer Cycling for 'Bump on Wheels'

Being a bit of a cycling nut, I was reluctant to hang up my wheels during my pregnancy. In the very early stages I continued to cycle as normal – there was nobody to tell me different and I wasn't asking. Denial actually worked very well for me for the first while. However, a bit of a scare and a near miss when tearing down a hill on my mountain bike made me sit up and take notice. At this point I decided it was time to face the music, and when the line appeared on the pregnancy test confirming that I was indeed two months pregnant as I suspected, I decided the mtb had to go, or at least riding it on steep and technical trails. Cycling safely when pregnant is about risk minimisation.

However, I really didn't see why I couldn't continue on the road bike but felt I needed some advice and support to do it. I knew the general attitude out there for pregnant woman was “anti-bike” so cunningly picked an easy target to ask for help – my coach. He was already well on board as we were working towards competing in the world track cycling masters the following October. I came clean one evening after training. Being the third person to know I was pregnant after my hubby and mother, he was a bit shell shocked to say the least and told me afterwards he felt ambushed! 

                       Cycling at 7 months - luckily I never got too big!

I convinced him I needed to keep up a reasonably amount of saddle time if I was realistically going to have any chance competing the following autumn. He could see how determined I was so had no choice but to help me. Not having a clue when it came to pregnant women let alone ones who wanted to ride their bikes he turned to a friend of his, an elite cyclist who had trained through her pregnancy for advice. 

He produced a set of guidelines to enable me to continue cycling safely which I stuck to the fridge and followed religiously.  They were common sense but it really helped to have them listed. When I stuck to these guidelines I felt I was doing something to stay safe and was happy to be on the bike. They were as follows:

•     Safety is always about attention to detail. Risk can’t be eliminated but it can be absolutely minimized.

•     You should always cycle in your comfort zone but be mindful that that can change week by week as pregnancy progressed

•     Slightest hint of frost - no ride at all.

•     Avoid cycling that involves uneven surface or where there is risk of collision with trees or rocks. 

•     No more group rides - too many variables and we can’t put your safety into other people’s hands. Also you can’t control the pace to suit you in a big group.

•     No rides on your own either! You need someone with you and their job is to look after you. When cycling as a pair you are more of an obstacle and safer from traffic. The rider must match your pace, whatever that is on the day. Finally your buddy can cycle behind you when you single out to allow cars to pass or if the road narrows, staying outside and a few feet behind your wheel therefore forcing any overtaking cars to take a wide berth.

•     Nutrition - more than ever you need to have sufficient drink to stay hydrated and food for energy. You should snack frequently as you will need extra calories and also it will prevent low blood sugar and lapses in concentration, keeping you mentally switched on and safe.

•     Means to fix a puncture would be good. Or at least bring someone to do it for you!

•     Only cycle on quiet roads without heavy traffic. Better to drive out a few miles to the quieter roads and cycle from there if necessary.

•     Finally don’t worry if you feel you’re going too slow, remember being pregnant is like training at altitude so you will reap benefits even from these easy paced spins.

Of course every pregnancy is different and what you can do at any stage relates to the size and position of your bump. For my part I was lucky and the bump didn't expand sufficiently to stop me and I was able to cycle right up to the end. I treated every cycle as if it was my last, not knowing whether I would able for it the following week. Time ticked by and all of a sudden I found myself out on a 50km spin on my due date! I decided at that point it was time to call it a day so it was without any regrets I said goodbye to my road bike for a few weeks. I got my sneaky fix from the odd spinning class during the ten days I was overdue! 

Why try maintain exercise regime through 1st trimester

No matter how “easy” (I use this word in the relative sense) a pregnancy is, nearly all women have had at least some nasty side effects during the first trimester. I was one of the lucky ones in that I didn’t have to spend most of it hanging over the toilet bowl but I did feel “off” for most of the three months with occasional waves of nausea thrown in for good measure. Not to mention the insane tiredness. I had always thought women were exaggerating about this until I fell pregnant – and promptly found myself falling into bed at 9 pm every night!  

Even though I really wanted to keep up my exercise regime throughout my entire pregnancy, I found the motivation to get out and do something during the first trimester was at an all-time low. I never had problems with motivation before and was always one to enjoy training, skipping out the door with enthusiasm. All of a sudden I was taking the long-cut home so I wouldn’t have to drive past the gym and feel guilty, or deliberately misplacing one of my runners.

However, the fear of losing my fitness won over and drove me out the door and I discovered something really strange as the time went on. Even though I really didn’t want to go for a spin on my bike or to lift weights in the gym, once I got going at all I felt better. And even better then that I felt normal. The “off” feeling was kept at bay for the rest of the day. Strangely I wasn’t as tired either, managing to stay up until 10pm some nights post-exercise session! 

There is a more important reason for maintaining exercise during the first trimester, especially if you want to continue with your exercise right through pregnancy. One of the effects of exercising at this early stage is that it greatly stimulates the early growth of the placenta and the extent of its blood supply. These adaptations increase the capacity of the placenta above normal, allowing the baby to cope better with any stress, exercise induced or otherwise in later pregnancy. Exercise during this early stage also enhances other facets of the maternal adaptations to pregnancy, such as improving the ability to dissipate extra heat through increased sweating and breathing rate. These benefits provide a nice margin of safety which allows women to train harder later in the pregnancy when we generally feel more up for it. 

I’m a big believer in listening to your body when it comes to exercise and used this as my main guide when I was exercising throughout my pregnancy. However the first trimester is one case where the body needs a little gentle encouragement on some days or even a sharp kick in the backside to get going!

Does having a baby enhance athletic performance?

There I was, the Monday morning after the National Track Cycling Championships basking in the glory of my two medals from the weekend.  I was a bit dazed. This was out of character for me. I didn’t win stuff at national championships. Or at least I used not to until I had a baby! What the hell was going on? On that Monday I wandered around (with a big grin on my face) and pondered it all. The most shocking win at the weekend was the bronze medal in the pursuit after riding two personal best times – I knocked a whopping 14 seconds off my last recorded competitive pursuit (6 weeks previous in the Olympic Omnium) in the first round and the time was good enough to see me into the bronze medal ride off – this had not been part of the plan! My coach had said to me beforehand that was the worst thing that could happen – that I’d get into a bronze medal ride off against someone I had no chance of beating and would have to grind out another 3k at my limit – it would ruin my chances to win any of the match sprinting. Which I had spent most of my time training for. Whatever the plan was it went out the window and there I was in the ride-off. And I hadn’t just scraped in. I had qualified third, just 1 second ahead of my opponent. It mightn’t have been the plan but at that moment I decided to hell with the sprinting – this was the medal that counts the most to a track rider. The pursuit is a true test of personal endurance and character. You have to push hard and dig deep during those 4 or so minutes of hell to keep the wheels on the cart or should I say on the pursuit line!

The pursuit is about a perfectly measured effort, and the best riders ride every lap in exactly the same time. I had done this and stuck to my schedule rigidly in the first round –a near perfect 6 x 37 second laps. But the adrenalin and emotion had me all over the place in the ride off. I went out like a rocket and my first lap was 35 seconds – way too fast to sustain – I had to wind it back rapidly and hope to god that burst hadn’t depleted my tank. I wanted it so much! At 2 laps to go my legs were screaming stop, but I gritted my teeth and just dug deep for that last kilometer. When I crossed the line I didn’t even know I had it – I was seeing stars! It turned out I did have it – by a comfortable 3 seconds in the end – and not only that, but a new PB a whole second faster than the 1^st round! I collapsed on the grass in the center of the track and tried to soak it all in. And yes the sprinting was a write off after that! My elation was complemented nicely on day 2 by a beautiful silver medal in the 500m time-trial. And another personal best time to boot.

I wondered why I was all of a sudden doing so well considering my training had been seriously interrupted by pregnancy, and having the baby by emergency C-section. Was it post pregnancy hormones? Many female athletes claim that after you go through childbirth your pain threshold increases and this helps performance – sure I didn’t feel a thing with the section! I hadn’t even had one proper contraction. So I have discounted that. Perhaps it’s the hormonal changes related to pregnancy and postpartum. But on investigating this there doesn’t seem to be too much good evidence to back this up. I did a lot of training right through my pregnancy, but not so much high intensity stuff and I had to completely go cold turkey on exercise for afew weeks after the section to allow my body to heal. I’m sure the training during my pregnancy kept a nice base fitness going for me but this wasn’t enough to fully explain my improved performance. Its part of it for sure – I believe the body is under a serious physiological stress as a consequence of all the pregnancy related changes, therefore and kind of training while in this state is probably akin to training at altitude. But more importantly there’s something else – being on maternity leave basically allows you to behave as a full time athlete! As a mom minding one baby, you get to hang out a lot. Resting those legs, allowing them to recover. The biggest stress in your day is trying to figure out where to go for coffee or what to have for dinner. So quality rest and lack of stress is a natural occurrence in your day. Secondly, you have plenty time to train. And I’m not just referring to when your hubby comes home in the eves and you fire the baby at him in a speedy handover and have cycled down the road before he knows what has hit him! A young baby sleeps a lot during the day. No matter how bad they are at sleeping anyone can get a good hour at least to do something. From two weeks post birth, my first priority when Tori went asleep was to jump up on my bike on the rollers (a form of stationary trainer) and grind out all sorts of bike related workouts. A yoga mat and a medicine ball was good for some core work after.

On hearing this Emma, a sporty friend said to me in exasperation “ I don’t know how you mange to get the time – every time I got the turbo and bike set up Molly is awake and crying again! Its military precision and focus I informed her.  You must prioritize the exercise session over everything else! Attention to detail must only be applied to exercise related paraphernalia. The house may be falling down around your ears, the dishwasher may not be emptied, god knows what that thing is living in the drain in the bath preventing the water going out ... Just put on those blinkers and get moving! Get up on your bike! Workout done hey presto.  There are unfortunate casualties to this approach of course. Just ask my poor husband!

World Masters Champion!

Exercise during pregnancy - a question of intensity..?

When I became pregnant I went on a mission to find some reasonable guidelines as to what I could and couldn’t do in terms of exercise and training. I didn’t know anything about exercise and pregnancy at this point but by enlarge what I did know wasn’t too encouraging. Stuff pregnant friends had been advised rang through my head “you better give up running just in case” one friend and passionate hill runner was told by her GP. “Easy swimming is fine” another assured me or “ Go for brisk walks every day instead of running, cycling etc..”  WHAT?? This was not what I wanted to hear! Brisk walking was not going to produce the levels of exercise-induced endorphins I was used to.

This kind of advice was all well and good for someone who wasn’t too pushed about physical activity, but to someone used to fairly moderate levels of exercise at high intensity it was not what I wanted to hear. I wondered what the hell all the elite athletes at the top end of the scale do? I was sure the likes of Paula Radcliff and Sonia O Sullivan didn’t stop training during their pregnancies. Surely they didn’t just swap running 100 miles a week for easy walks and gentle swimming. I thought I had heard somewhere that Paula in fact had run a marathon while 7 months pregnant in a pretty impressive time!

In my search for information I turned to the 1^st port of call for people looking for information on anything – the trusty internet. This turned out to be a bit of a mission. I suspected that the information must be out there somewhere and that most pregnant female athletes must be following some sorts of training programs, but any concrete reference to what they were doing remained elusive. Googling word combinations such as “athlete” and “pregnancy” and “exercise” and variations of the above yielded results with wildly different advice. Everyone who wrote anything seemed to have an opinion and I could not believe how polarized some of these views were. There seemed to be precious little in the way of advice that wasn’t ultra conservative.

Anyway at this point not finding what I wanted, I put the brakes on and took  a different tack. Being a scientist and also a veterinarian I decided the best approach would to conduct my own scientific literature review to look for good robust peer-reviewed journal articles from a range of physiology and medical journals for answers. The results produced slightly less conflicting views on exercise during pregnancy, but by en large I felt were still pretty cautious in terms of advice. The standard set of guidelines that are referred to in most publications were set by the American College of Obstetricians and Gynecologists (ACOG) first in the 1980’s. These have been recently revised but still remain pretty conservative. ACOG recommend that pregnant women who are free of any complications engage in >  or = 30 minutes of moderate physical activity per day on most days of the week.

During my literature search I was astonished to find that in general there has actually been relatively very little in the way of research on the effects of exercise on pregnant women and their unborn babies in the last 20 or 30 years. I came across one recently written article that explained the reason for this - such research is highly contentious and even deemed in some cases to be unethical. Research to investigate the effects of high intensity exercise on the fetus appears to be particularly fraught with ethical complications, and therefore the number of studies investigating such could nearly be counted on one hand with very few participants in each study.  It is worth mentioning here that based on these limited studies there doesn’t appear to be any evidence to indicate that exercise at higher intensities produces any harmful effects on the fetus, which I found particularly interesting. Despite this lack of evidence, one of the most common suggestions when you seek advice about what level you can exercise at during pregnancy is to reduce the intensity! Really though this is not surprising -The precautionary principle is applied across the board when it comes to pregnancy. This as any women who has ever undergone a pregnancy will know is true, not just when it comes to exercise, everything from supplements to medicines to foods and drink, anything that has not been proved conclusively beyond reasonable doubt to be totally harmless – well you better not!! Just in case that is… No one is going to advice a pregnant woman otherwise for fear of the consequences, if there happen to be any. That’s why taking the approach of listening to your body is probably the best advice anyone can get when wondering what they should and shouldn’t do during their pregnancy: if it feels ok – go for it!