1. I would like to know what the red flags are for running during pregnancy. For example, under what conditions should I stop a run in progress? When should I scale back my mileage in general? I know people always say “listen to your body”, but sometimes it seems like my body is speaking a new language! Sarah C.
If your pregnancy has been complication-free (i.e. no placenta previa, preeclampsia, short cervix, etc.), then no matter how far along you are, there’s no real reason to scale back your mileage as long as you’re feeling good and running comfortably. Many women, however, find that as their pregnancy progresses, they begin to experience more and more pelvic pressure and at some point it simply becomes too uncomfortable to continue running. For some of them, reducing the amount of mileage or the number of days they’re doing weekly allows them to continue running for at least a few weeks, and sometimes even months, longer. But, every person and every pregnancy is different so what works for one individual won’t necessarily work for another.
However, if you’re experiencing significant pelvic pressure and regular uterine contractions when you’re not exercising, this may be a sign that you need to substantially decrease your running and exercising in general or stop altogether.
When you’re out on a run, if you experience painful uterine tightening (painless tightening of the uterus can be totally normal), or if you’re having vaginal bleeding or you feel fluid leaking, it’s best that you stop running immediately and call your doctor as soon as possible for evaluation of these symptoms.
2. I’m running the NYC marathon on November 3rd and will be about 32+ weeks on the day of the race. I’m not really nervous about overheating or dehydration or anything like that during the race, but I am worried about 2 other things: (1) I have a retroverted uterus, so I’m concerned about back pain. Is it ok for me to take Tylenol during the race? (I miss Advil!); (2) Braxton-Hicks. I’m a first time mommy and if I felt something like contractions during the race…(hopefully I’ll be able to differentiate what they are) can I still continue to finish the marathon if I walk? They do go away right? Tara Lynn V.
A retroverted uterus is one that is tilted backwards within the pelvis. At about 12-15 weeks, when the uterus grows outside of the pelvis, this condition will usually resolve itself so this shouldn’t be a problem for you on the day of the race. Even in those instances where this isn’t the case, women who have a retroverted uterus normally don’t experience more back pain than other pregnant women. However, if you’re experiencing pain during the marathon, regardless of the source, Tylenol is safe for you to take. You may also want to consider wearing a maternity belt during the marathon to take some of the strain off of your back, but make sure that you try it out on a few long runs beforehand, because as I’m sure you’re aware, you never want to try something for the first time (shoes, socks, energy source) on race day.
If you do start experiencing contractions during the marathon, it’s a good idea to slow down and walk for a while. If they truly are Braxton Hicks contractions, they should lessen in intensity and eventually go away. If, however, they don’t go away and instead increase in frequency and intensity, they’re not likely to be Braxton Hicks and you’ll need to stop at that point. You can reduce the chances that you’ll experience contractions of any kind on the day of the marathon by making sure that you maintain an adequate state of hydration both before and especially during the race.
3. Heart rate guidelines….fact or fiction? Kristin M.
One of the biggest myths that is still out there regarding running and pregnancy involves heart rate restrictions. Unfortunately, there is a stubborn group of people (including some physicians) that continues to preach that pregnant women should never allow their heart rates to exceed a certain level, usually 140 beats per minute (bpm). This is despite the fact that the American College of OB/GYNs (ACOG) abandoned any recommendations regarding heart rate restrictions years ago because individual heart rates can vary so widely in response to exercise.
What ACOG recommends instead is using the Borg Rating of Perceived Exertion (RPE). The Borg RPE scale is a way to measure the intensity of physical activity using a 15 point scale, beginning at 6 and ending at 20 where level 6 represents no exertion at all (i.e. watching television, reading) and level 20 represents a maximal exertion that can only be sustained for a short time (i.e. an all out sprint at the end of a race).
ACOG recommends that pregnant women keep their exertion level in the “somewhat hard” category, which correlates to a 12-14 on the Borg RPE scale. In practical terms, this would equate to a moderate running speed where breathing and heart rate are both elevated, but it’s still possible to carry on a conversation without too much difficulty.
Elizabeth Stevenson-Gargiulo, D.O., F.A.C.O.O.G. has been in private practice as an obstetrician/gynecologist in Dallas, Texas for nearly 12 years and has taken care of dozens of women who ran during their pregnancies. She is a veteran of nine marathons (including two Bostons) and ran through her entire pregnancy right up until the day before she went into labor. Together with her husband, Tim Gargiulo, a former nationally ranked road racer and finalist at 5000 meters in the 1996 U.S. Olympic Trials, they provide encouragement and information about pregnancy and running to women on their website www.runningthroughpregnancy.com.
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