Tuesday, September 22, 2009

Exercise and My First Trimester of Pregnancy

Now that I'm almost at the end of my first trimester (I'm at week 14 right now), and everything looks pretty good with my developing baby, I felt like it was time to start sharing with you all my experiences in the weight room during these first three months.

Many of you probably already guessed I was pregnant by the nature of some of my recent posts, but before I was ready to start telling my own story, I wanted to make sure everything was going well (and so far, so good).

First off, this pregnancy was completely unplanned and unexpected. In fact, I was told most of my life that I'd likely never be able to have children due to issues I had with my cycle (more on that later, but in short, I was amenorrheic for 5+ years with no completely clear explanation.... no, I wasn't too skinny, I didn't undereat, blah, blah, blah.... I had chronic yeast and bladder infections in my teens, and I was recently on bio-identical hormones for 15 months). So, it was to my utter and total surprise when I randomly decided to take a pregnancy test at home when my period following cessation of my bio-identical hormones didn't come as expected and I saw two lines instead of one!

I'm guessing I became pregnant at the end of June/beginning of July, RIGHT AFTER I had graduated from my 1 year dietetic internship AND just completed my 5 year PhD. Pregnancy was the last thing on my mind. All I really wanted to do was to start a normal, non-student life for the first time EVER, and get my body back, as I had lost it along the way while writing my PhD dissertation and doing my internship at the same time this past year.

The first signs I was pregnant were about 7 days after implantation: I started feeling uncontrollably tired any time I set foot in the gym (any time I started exerting myself physically). My training partner even made fun of me and thought I was just trying to be a wimp. But, I honestly couldn't even do what I wanted to even though I set up a great training program to get me in awesome bikini-shape.

Then, it was about a week later that I took the pregnancy test and almost passed out in shock: "Me? Pregnant? Never! Ahhh!!!!!"

It took awhile for me to adjust to what was happening, but then I decided that it was all good and that I'd now work on building a 'super baby'. For nutrition, I turned to all the recent pregnancy nutrition research for guidance (such as choline supplementation, which isn't widely known about), and tried to maintain a good diet. I'll talk more about diet in another post though (I had a few weeks of extreme sugar cravings... yuck).

For training: I didn't really know what I was supposed to do and not do for exercise, especially for strength training. I was confused by the older pregnancy and exercise advice to keep heart rate low during exercise (less than 140 bpm to keep body temp below 38C). But this advise was then revised due to new research showing that women who trained at higher body temps and heart rates had no ill effects on their babies.
The book, Women in Sport by Barbara Drinkwater, and The Pregnant Athlete Chapter has some good information about strength-training exercise for pregnant women and basically says that if a woman exercises strenuously prior to pregnancy, she can do almost that during pregnancy, up to a certain extent. According to the authors, there are risks to the fetus of overly strenuous strength exercises such as:
  • decreased maternal blood glucose values, especially later in pregnancy (it's more common for pregnant women to develop hypoglycemia during exercise as the baby grow larger due to the baby's increased demand for glucose);
  • reduced uterine blood flow which would be an issue for both the mother and fetus - however, the baby is protected from this more than the mother because the placenta has a high oxygen extraction rate
  • increased maternal body temperature in response to exercise - however, research on this shows that women become more efficient at dissipating heat as pregnancy progresses
Overall (from Women in Sport), women who exercise during pregnancy are advised to:
  1. Avoid prolonged or strenuous exercise during the first trimester (I can attest to that because you're so darn tired and nauseous in the 1st trimester)
  2. Avoid isometric exercise or straining while holding your breath
  3. Avoid exercising in warm/humid environments (I had to have a fan on me in the gym almost every time I trained...)
  4. Avoid the supine position after the 4th month (I've been bench pressing as much as I can now...)
  5. Avoid activities that involve physical contact or danger of falling (mountain biking is contradicted, to my demise... even though I still mtn biked up until a few weeks ago).

My experiences
1) Oh, the Fatigue:
For me, I wanted to continue weight training with the same intensity that I had been doing before, but that just wasn't happening. As I said, I was extremely fatigued in these first three months. I made it my goal to go to the gym everyday after work, but on some days I was just too tired, and opted to go home and simply walk with my dogs outside. Then, other days, I'd get to the gym (with my eyes closing on my way there) and have to take a power-nap in the parking lot before I started working out. One time, in the gym where I train clients out of, I got there a bit earlier than my appointments, and took a George Costanza Nap - I put my gym bag on the floor under a desk and completely passed out for 20 mins; it felt great.

Also, about 1 month into the pregnancy, was my husband and I's one year anniversary. We got married in Vermont last year and so planned on returning there to do a long weekend of hiking in the Green Mountains. This was all fine and dandy (I love camping), but my body had a really hard time getting up those mountains... I just had no energy at all. My husband even had to get behind me when the mountain was steeper and help push me up. It was pathetic.... but understandable.

2) Recovery: Another issue I was having after I did get in a good workout (this involved exercises like heavy front squats, med ball slams, chip-ups, bench press, ropes) was that it was taking me a lot longer to recover both between sets and after the session was over. I'd be sore for 2-4 days, where I only used to feel like that if I'd take a long time off the gym. And, between sets, I'd have to rest for much more than 2 minutes sometimes just to catch my breath.

3) Strength & Stamina: In this first month, my strength stayed relatively the same, but my stamina suffered. I often cut a workout short because I just didn't have the energy for it.

4) Nausea: I was extremely nauseated from about week 5 to week 10 (I know that's not that bad as some women have it for many more weeks with even worse symptoms). As such, sometimes it was really hard to get in a good lift because all I wanted to do was eat something to ease my upset tummy. Thankfully I never vomited, and thankfully, I found some great remedies that really helped ease the nausea such as Sea Bands and a few different homeopathics.

5) Back & hip pain: I was diagnosed with a Grade 1 spondylolithesis (basically a broken spine) at L5/S1 when I was 15 years old as a result of my gymnastics training. At the time, my back doctor told me that if I got pregnant, I'd have really hard time with the pain I normally experience, especially as I got bigger. Well, I experienced my first bout of really bad back pain at about week 8 after my husband and I flew to MN to visit family. All the sitting and the lack of good shoes totally threw my back and hips out of place. My physical therapist has now recommended that I start wearing a SI belt on a chronic basis to help with my hip and back instability that's progressively becoming worse through the pregnancy.

6) Core Strength and Kegels: Also because of my increased demand for a strong core, pelvis and glutes (due to my back issues in combo with pregnancy), I've really kicked up my core and glute training. Additionally, I'm finally learning how to correctly use my kegel muscles which I think is a department I was sorely lacking in before. Some of the key core exercises I'm focusing on are: bird-dogs, prone and side bridges, staggered kneeling cable chops and rows, swiss ball jacknives, and front body-loaded exercises such as Zercher squats and front squats.

Now that I'm nearing my second trimester I'm starting to kick my intensity back up. For the past two weeks I've been training pretty hard 3 days a week. On the other days, my training is light or it's outdoors with my dogs or on my bike.

I'm looking forward to these next 6 months and will share with you what's going on. Thank you to all the women that shared their pregnancy & exercise experiences. I am still working on this for an article, but need to collect some interviews from gynecologists and researchers.

Ok - now I'm off to teach boot camp tonight.... doing all the work I can while I'm still functioning normally.


Jaya said...

Cass - congratulations! I know that you will provide the best ever interim home for your baby! It's definitely not "pathetic" that you struggled with your hike. Your body is doing amazing things around the clock!
Also, I have a short story to share that I hope inspires you a bit:
Earlier today (!!!) my sister delivered her first child after 4 hours of totally natural labour. She went in with total trust in her body and its design, and walked to and from work (about 11k round trip) every day until around 8 months. I'm sure you will have a very positive experience and a great pregnancy, but a tale of smooth labour never hurts! Apparently my Mom couldn't even tell if she had the baby - she looked that good! I am ridiculously grateful to be in this gene pool :)

TosaJen said...

Congratulations on your pregnancy! Both of mine were heavily planned, and I didn't have any of your underlying injuries to deal with, but otherwise, things sound very familiar. :)

I found that understanding statistics and research were my friend, because I couldn't control anything about the baby other than how I took care of myself and what I chose to worry about. There are so many scary things that can happen, but usually don't or that can be helped by self-care.

I hope the mid-term energy kicks in for you soon.

Tree said...

Hey congrats on the pregnancy! I found you thru Stumptuos.com, and really enjoyed reading about what another mama-to-be is doing for exercise. I'm subscribing to your feed, so keep the workout updates coming!

I had to quit running because it was making me dizzy. But at 23 weeks I'm still walking, swimming, and doing some prenatal vinyasa yoga, which is really rocking for me right now.

Hope you get your energy back soon!

Stine said...

Excellent stuff! I also found this through stumptous.com.
I'm pregnant too, 2nd trimester (end of week 15). I have had almost no "problems" so far, except that I no longer like coffee. I was also uncertain of what kinds of exercises I could do as pregnant, and started looking for answers. I did have an idea that most of what I heard was myths and old wives tales. So I bought a good book, which unfortunately for you is only in Norwegian (and, by the way, I'm Norwegian). In short, it says continue as usual, but listen to your body (same as for non-pregnant i think).
About the "avoid supine position" as bench press - it is very individual. If one feels nausea, she should stop exercising while lying on the back. It is due to the weight of the baby etc, which puts pressure on a big vein (vena cava). If we feel no nausea while lying on the back, it's ok to continue bench press etc.
I still do ab rolls (don't like sit ups). Haven't seen (or felt) Diastasis recti yet - the splitting of the straight abs. Same thing here - as long as I feel ok, I'll continue.
I actually finally learnt dead lifts almost two weeks ago. Been doing squats, but really wantet do learn dead lifts. I told the instructor I was pregnant and that I shouldn't be lifting max weight, and he (male, about 50 yrs and experienced) was very ok with everything.
Today, I'm biking home from work. It's 30 km, hilly, and I'll be using 2 hrs, give or take 15 minutes.
I do get a bit more tired and thirsty from exercising now, but that's totally normal for being pregnant. I just take the time needed and drink more water (and eat good food after training).

I'll also subscribe to you blog!
Good luck with your pregnancy!

Nicole P said...

Hi Cassandra :) Congrats on the pregnancy - it looks like we are almost at the same point in our pregnancies as I am at week 14 too.

My husband and I got married in June and then we set off on our 2 month honeymoon around the world - we wanted to start 'trying' straight away and then if it happened, it happened.

Um, yeah well it 'did happen' and I found out I was pregnant the day after we finished the Inca Trail in Peru at high altitude! Let's just say that the high altitude in Peru and Boliva didn't agree with me and the baby!

I have had it fairly easy so far aside from being tired and very emotional. I have cut down my weight training to 2 days per week cause I train early morning and then the other days I run, walk, do kettlebells and pilates twice a week.

Having had put on a good 6kg whilst on our honeymoon, my body growth has been an adjustment. But as my good friend says - you're growing a baby and you will lose any excess weight once the baby is born :)

I look forward to reading more of your journey :)

Nicole xx

Katie Munger said...

Congrats! The good news is that you should be able to work out a lot harder soon. I felt awesome 2nd trimester, you get your energy back. And since you aren't huge yet, you can still do most of what you want to do in the weight room.

I am looking forward to hearing what you do for your exercise routine. I had no idea what I could and couldn't do when I was pregnant so I was my own experiment. The only thing that I can say to avoid is the slideboard, I tried to do intervals on it with my athletes around 7 months (big belly and bad anterior tilt) and it led to some bad nerve pain shooting down the legs and a waddle (worse than the one you expect)!
I am smiling about you being upset to cut out the mountain bike, my husband made me stop riding the trails too and that was the one thing that I missed the most during pregnancy. And now with a baby it is hard to get away for a couple hours on the trails as well.

I can't wait to hear about your workouts. Good Luck!

Katie Munger

Cassandra Forsythe said...

Stine! Thank you for sharing your experiences! The book you have sounds great. I wish I could read Norwegian :)
That's good to know about the supine positions - I'm then going to keep doing exercises in that position until I can no longer. :)
One woman said to me that she wonders if it's really that serious to avoid supine exercises when the OBGYN keeps you on your back for at least 10 mins at a time (or when you're getting an ultrasound)

Cassandra Forsythe said...

Nicole, Tree and Katie:

Thank you for your comments!

Nicole: I looked over your site - you look great right now! My increased chest size and thickness through my middle is making it a bit more obvious each day that I'm expected even though I too haven't popped. :)

Katie: I'm am really starting to feel better now that I'm in the second trimester. I've really upped the intensity of my workouts. I just hope my appetite starts to calm down .... hahah :) But, I doubt that. Also, I hope getting back on my bike is a lot easier - perhaps my hubby will take him/her on his back :) we'll see....

Idaca said...

Thank you for posting this. It's REALLY reassuring to hear from someone who's just been through what I'm experiencing.

I'm just 5 weeks in and still doing weights (although I've refocused a little bit more on my posterior chain and core). I've had to cut out intervals due to dizziness and just being too pooped. The morning sickness kicked in a week after implementation but so far I've managed to get by on icy cold fruity protein shakes.

Hiit Mama said...

I am so glad to have found your blog. It is so inspiring that women are working out and going into pregnancy strong and healthy.

I am now 25 weeks pregnant with my second son. I am working out with slight modifications, but essentially the same weights and cardio routines. I also eat a mostly Paleo type diet.

I just wanted you to know that I worked out up until the day I gave birth to my first son and had 2 hours of hard labor and 15 minutes of pushing. I breastfed and don't remember any recovery time. I guess I felt like I naturally snapped back into shape (with workouts of course).

Keep goinig girl and it will be great! By the way, by about week 20 I started feeling like a newly invigorated woman.

Cassandra Forsythe said...

Thanks Ladies for your comments!

HIIT Mama: wow! I hope working out will make my delivery that easy too! Thanks for the inspiration!

Mary said...

Hi Cassandra,
CONGRATS! I hope you do post again soon about your period/hormone issues. My periods have stopped even though I'm the healthiest I've been in a while on the exercise/nutrition front, and no one can explain why. I'm having trouble finding a doc who believes in bio-identical hormones, so I'd love to hear about your experiences. Thanks, and again, congrats!

Anonymous said...

Congratulations, and hope your pregnancy is progressing well.
I'm 33 and 2 months post-partum with my 3rd child and just wanted to post a word of caution regarding pelvic prolapse.
I lifted up until 2 weeks before delivery and ran until 7 months pregnant. I followed all of the guidelines you've listed and felt incredibly strong and healthy both mentally and physically.
All 3 deliveries have been spontaneous vaginal deliveries and largely uncomplicated. Now I'll get to the point.....
I've been diagnosed with bowel and bladder prolapses, both of which will likely require surgery in the future.
I just want to stress how important it is to be VERY aware of your form during pregnancy and post-partum, and also to urge you to REST after you have your baby. We are told to take it easy after giving birth, but not specifically why: because you are still healing. I resumed exercise 2 weeks after having my baby at an intensity I'm now aware was much too high. It's possiblethis exacerbated something which could have otherwise have been really minor.