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Athlete With Child
Can You Still Play When
You're Pregnant?
By Monique Cole
Shortly after finishing the Pike's Peak
Ascent 13-mile trail run to the top of the race's namesake 14,110-foot
peak, I discovered I was pregnant. Somehow the sedentary image
of the expectant mother knitting baby booties in a rocking chair
just did not seem to fit.
After consulting doctors, medical journals,
internet sites and other athletic mothers, I continued trail
running into my fifth month, snowboarding and snowshoeing into
my seventh month, hiking, rock climbing and mountain biking into
my ninth month, and swimming laps until just hours before my
water broke. Of course, my maternal instincts kicked in early
and I cautiously participated in each sport at a level I felt
completely confident.
While each woman should consult with
her doctor in creating an individual prenatal fitness plan, there
is no reason why a woman with an uncomplicated pregnancy should
prematurely become a "stay at home mom." Active moms
attest to a better self-image, healthier pregnancy, and an easier
post-partum recovery. While exercise is no guarantee of a short
or easy labor, many mothers believe that staying active gave
them the stamina and muscle awareness to endure labor.
Thankfully, the opinions of the medical
community are evolving. Not too many years ago women were ordered
not to exercise while pregnant, now doctors recognize the health
benefits of an active pregnancy. Conservative guidelines set
in 1985 by the American College of Obstetricians and Gynecologists
(ACOG) restricted aerobic activity to 15 minutes and set a maximum
heart rate of 140 beats per minute. These guidelines were updated
in 1994; instead of recommending exact numbers, ACOG advised
that heart rates and time limits should be determined on an individual
basis in consultation with a patient's doctor. Still, you may
hear doctors continue to quote the 1985 restrictions.
After reviewing the latest medical literature,
Boulder orthopedic surgeon Joanne Halbrecht concludes, "Pregnant
women are not prone to increased injuries during pregnancy, even
though there is increased laxity in the ligaments." However,
those hormones that relax all the body's ligaments without prejudice
in preparation for childbirth can make sports more challenging.
One pregnant friend of mine reported feeling like a marionette
while attempting to hike on her wobbly knees and ankles.
While lax ligaments do not increase
the likelihood of injury, a normal injury can be more risky during
pregnancy. Dr. Halbrecht operated on an elite soccer player who
tore her anterior cruciate ligament in her third month. "She
was significantly disabled," she explains, "Imagine
being nine months pregnant and having to carry around all that
weight on an unstable knee." A serious injury can force
a difficult decision between waiting until after delivery to
operate, undergoing surgery without anesthesia, or risking injury
to the fetus while under general anesthesia.
While most women can safely continue
with their chosen activities (with the exception of contact sports),
Dr. Halbrecht adds, "Being pregnant is not the time to increase
your activity level." Swimming and walking are two relatively
safe activities for sedentary women to start during pregnancy,
but otherwise stick with what you already know.
Doctors often lump skiing in with contact
sports as off-limits during pregnancy because of the possibility
of a serious fall. But that hasn't stopped many Colorado skiers,
like two-time pro mogul ski champion Patti Sherman-Kauf, who
are confident in their skiing abilities. "I was more afraid
of other people hitting me," she says, explaining that she
always quit skiing early before the time when most accidents
occur and her husband Scott would often act as body guard.
Early in her first pregnancy, Sherman-Kauf
started shopping around for a doctor who was knowledgeable about
athletic pregnancies. "I wanted someone who believed that
women could keep doing things," she says. A female family
practitioner who was a competitive triathlete was her final choice.
Sherman-Kauf's original plan was to
compete on the International Mogul Association Pro Mogul Tour
through her fifth month, but she ended up racing in one event
in her hometown of Vail in her sixth month. "I hadn't placed
out of the top three in years," she explains, "I just
wanted to finish the race to stay in the top three."
Responses were mixed from friends and
spectators who watched ESPN's coverage including freeze-frames
where commentators circled Sherman-Kauf's belly bulging above
her slightly unzipped pants. "Some moms I knew thought it
was awesome; they knew by seeing me ski that I wasn't going 100
percent. Others thought I was crazy," she says.
"I know my limits, I wouldn't have
done anything to jeopardize my pregnancy," Sherman-Kauf
says, adding that she would not necessarily recommend to all
women that they race moguls in their sixth month because each
woman's pregnancy and sports proficiency is different.
She finished the 1994-95 season second
overall and her healthy, 7-pound, 14-ounce son Skyler was born
that June. She also competed through the following pro mogul
season while pregnant with her daughter, Jaelin, who was born
in September of 1996.
Life after kids has continued to be
filled with sports. Skyler started skiing at about 18 months
of age and he and his sister happily tag along on hikes, runs,
and bike rides and on the pro mogul tour in which Sherman-Kauf
still competes and her husband works as an ESPN commentator.
"I have no doubt that my kids will grow up healthy,"
she says. "Not because we push them in sports, but because
that's what they're around all the time."
Sherman-Kauf believes sports are part
of a healthy lifestyle, and that they should be continued through
pregnancy and beyond. "You know you're carrying a child
and you know how precious it is, but that doesn't mean you have
to change everything in your life."
As an expectant mother, only you can
make the final decisions about how many changes you want to make
in your life. After all, even driving to the grocery store involves
some level of risk. Here is some advice, culled from my research,
to help you stay safely active while pregnant, although you should
always discuss your particular pregnancy with your obstetrician
or midwife.
Avoid falls
The bouncing of running and
off-road biking won't hurt your unborn child. Although your fetus
is safely tucked away in a pool of amniotic fluid that rivals
the best mountain bike suspension systems, extreme trauma or
direct blows to the abdomen could cause miscarriage or injury
to the fetus. Always do sports well within your ability and avoid
contact sports.
Heart and breathing rates
During pregnancy a woman's blood
volume increases by 40 percent and her heart and respiration
rates also increase. Too high a heart rate can starve your fetus
of oxygen-rich blood. ACOG advises women to consult with their
doctor to set maximum safe heart and respiration rates. Some
women have safely used the "talking rate" during pregnancy,
maintaining a level of activity such that they can still carry
on a conversation.
High Altitude
At high altitude where the air is thinner, you and your fetus
are more likely to become oxygen deprived. You might want to
postpone any high altitude adventures, or at least give yourself
time to acclimate before exercising - one Boulder doctor recommends
that for each 2,000 feet above 5,000 feet of elevation, you take
one or two days to acclimatize.
Heat
Anything that raises your body
temperature above 102°F can be hazardous to your developing
fetus. In hot weather, schedule workouts for the early morning
or late evening, wear cool clothing, and drink lots of water.
Some doctors recommend limiting aerobic exercise to a half-hour
because afterwards core body temperature begins to rise, causing
a risk for birth defects. And definitely avoid hot tubs and saunas
while pregnant.
Food and water
Doctors recommend eating an
extra 300 calories and drinking eight, 8-ounce glasses of water
per day during pregnancy. You will need much more if you are
active.
Clothing
For some sportswear, you can
get away with borrowing your husband's clothes or buying extra
large tops. Active maternity wear can be purchased at A Pea in
the Pod stores or through Wolf Wear Fitness Apparel in Lafayette
(800-530-3992). At long last, a true maternity cycling short,
complete with chamois, is available through Terry Precision Cycling
for Women (800-289-8379).
Equipment Concerns
Sometime around the fifth month,
cyclists will find their quads bouncing off their bellies. By
adding a stem with an extra high rise to a mountain bike, you
can ride all the way to the delivery room. Skiers need to remember
to adjust their binding settings for their increasing weight
and snowboarders may find step-in bindings more convenient than
attempting to bend at the waist to strap in.
Each woman will feel differently, both
physically and emotionally, about her pregnancy. Don't feel pressured
to run a marathon in your eighth month just because your friend
did. While some athletes confidently continue near their pre-pregnant
levels of activity, others feel better downshifting from running
to hiking, for example, or from competing seriously to just entering
events for fun. The key is to listen to your own body for cues,
and do what feels right for you personally.
Sidebars:
Warning signals
If you experience any of the following, cease activity and call your doctor:
- pain, especially abdominal
- vaginal bleeding
- dizziness
- shortness of breath out of proportion
to activity
- rapid heart rate at rest
- back pain
- pelvic discomfort
- difficulty walking
Problems Precluding Exercise
(Based on 1994 ACOG Guidelines)
- high blood pressure
- early rupture of amniotic sac
- too-early labor during prior or current
pregnancy
- weak cervix or cervical cerclage
- persistent bleeding in second or third
trimester
- slow fetal growth
Resources
"Fit & Pregnant: The Pregnant Woman's Guide to Exercise,"
by Joan Marie Butler, RNC, CNM; Acorn Publishing, New York, 1996
"Running on Full" - http://lifematters.com/rofintro.html
Melpomene Institute - http://www.melpomene.org/pregnant.htm
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