'Run Mama Run' director's diary 2: Sarah Brown's OBGYN weighs in on training
"Run Mama Run" is a film series created for the espnW Film Fellowship, presented by Walmart. Filmmaker Daniele Anastasion was chosen for her documentary series about elite runner Sarah Brown, who was training to make the 2016 U.S. Olympic track team while pregnant. The film will be presented as a five-episode digital series in Summer 2016.
Brown maintained a modified training regimen throughout her pregnancy -- she ran 12 miles the day before she gave birth. Anastasion asked Brown's OBGYN, Dr. John Gonzalez, about his recommendations for pregnant women who are exercising. (Of course, you should consult your own doctor to discuss any training regimen -- whether you're training for the Olympics or not.)
Daniele Anastasion: There's a common misconception that women should put their feet up and not do any physical activity during pregnancy. Why is that?
John Gonzalez: Many people bring their emotions to it. "Oh, you're pregnant, you should lay down and put your feet up. Here's a cup of tea." However, that's not appropriate. Women should be active during their pregnancy and, if possible, should be exercising during pregnancy as well. Studies show that exercising during pregnancy can be a benefit. We do know for example if pregnant women are not active, they are more likely to develop blood clots during pregnancy, and they are at increased risk of diabetes and inappropriate weight gain.
DA: What are some of the other benefits of exercise during pregnancy?
JG: There are some studies that have come out that suggested that exercising during pregnancy decreases your risk of having a Caesarean section. There's some literature out there as well that have suggested that exercising during pregnancy reduces the risk of developing diabetes during pregnancy.
DA: What's a typical rule of thumb for exercising while pregnant?
JG: Common sense rules a little bit. If you exercise during pregnancy, you should be able to talk while you're exercising. If you find that you're short of breath, you're over-exercising during pregnancy.
DA: How did you come up with guidelines for Brown, who's probably doing more physical activity during pregnancy than most pregnant women?
JG: Sarah is a special case. She is an Olympic-level athlete and they are not a dime a dozen, so recommendations in her case had to be individualized. For example, one of the things that we did in Sarah's case is that we ordered an ultrasound every three weeks to check on the appropriate fetal growth to make sure the baby was growing appropriately.
DA: How high can your heart rate safely go when you're working out while pregnant?
JG: In the old days, physicians used to tell their patients that your heart rate should never get up above 140. Well, that was dropped years ago by the American College of Obstetrics and Gynecologists. There's no such recommendations anymore. From the literature, we actually recommended that while training, Sarah's heart rate should only reach up to about 80 percent of her maximal heart rate. Keep in mind that the maximal heart rate for every person is going to vary.
DA: What happens if you go above 80 or 90 percent of your maximum heart rate?
JG: Some studies suggest that if women approached 80 or 90 percent or above of their maximum heart rate, that they would actually see changes in the baby, where a baby's heart rate would actually slow down or we'd actually see changes to the blood flow of the uterus. That's why we recommend keeping a heart rate below about 80 percent.
DA: What are some other things to watch out for while exercising during pregnancy?
JG: You want to be well hydrated and make sure you don't work out in very hot circumstances. You don't want to raise your core temperature too high. If you have elevated temperatures, like if you're sitting in a sauna or a hot tub, you might increase your risk of developing neural tube defects or spinal cord abnormalities in your baby.
Women who are pregnant and want to start an exercise program during their pregnancy should see their physicians and work out an individualized program with their doctors. There are some medical conditions that pregnant women should not exercise with. You need to be working with a physician that is aware what the American College of OBGYN recommends as far as guidelines for exercising during pregnancy.