Member Case Study: I'm Pregnant!?! How Can I Train?

author : AMSSM

comments : 1

My doctor says 140bpm HR is my max, but that feels like a walk in the park... I don't know what to do, how to train, and my motivation is waning. Any suggestions?

Question from Miss Bethy

Surprise! Ok, well, not so much of a surprise, but I'm pregnant. So much for the 2006 racing season. I just got started with all this jazz in '05 completing a 1/2 dozen or so 5K's, 1/2 dozen or so 50+ mile bike rides, MS150 ride, and 2 sprint Tri's. Not bad for a first year racing, I think... Anyway, now what???? I'm exhausted all the time, nauseus some of the time but still at the gym as frequently as I can. My doctor says 140bpm HR is my max, but that feels like a walk in the park... I don't know what to do, how to train, and my motivation is waning. Any suggestions?

Answer

First, congratulations, on both your fitness accomplishments and on your pending arrival! If you are truly fit to the level that you say you are, then the recommendations of the American College of Obstetrics and Gynecology don’t really apply. Guidelines such as these need to be targeted to a broad group of women, and there are outliers who come into a pregnancy at a fitness level that would place them in an elite category. Individuals like this can safely maintain activity at a much higher level.

A 2000 meta-analysis in the ACSM Guidelines for Exercise Testing and Prescription showed no significant adverse effects with exercise intensities of 81% of maximal heart rate. Another study from the University of Oslo showed no ill effects from a 3120 kcal/week regimen consisting of 1800 kcal of interval training at a heart rate of 170-180 bpm, 720 kcal of strength training and 600 kcal of endurance training at 120-140 bpm. This same study showed that fitness levels can be maintained at an elite level throughout the course of pregnancy.

Typical recommendations are for 60-90 minute exercise sessions, 4-6 times per week to accomplish this. It should be emphasized that although there has been no “unsafe limit” yet determined, even a maximally fit pregnant woman needs to listen to her body, and should not push herself beyond exercise plateaus established prior to pregnancy.

Variability in training can be maintained in order to maintain interest, but may need to be modified as your center-of-balance shifts into the fourth or fifth month. Maintaining optimal levels of hydration is vital in order to preserve adequate heat controls in the body. Finally, understand that these recommendations are contingent on a normal pregnancy. Pregnancy-related complications that can arise will fundamentally change what is considered acceptable activity. Good luck.

Chad Carlson, MD
Member AMSSM

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date: January 29, 2006