24 October 2008

Fit Pregnancy & Childbirth


Fit pregnancy and childbirth are the topics for this week.  The letter is likely to end up fairly long but it should make an interesting change from politics and the economy!

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Couple of announcements before we kick off.

Tucson -- we have ten slots left for our Spring Camp in Tucson.  Dates are March 29th to April 5th.  Six days of training, $2,350 includes everything but your airfares.  The camp is appropriate for sub-13 hour IMers (and sub-6 hours Half IMers).  For more info drop me a line.

Over on Endurance Corner Radio you will find three new podcasts -- Greg Bennett; Going Fast in Kona; and Chris Baldwin.  If you want then you can subscribe to the podcasts through iTunes -- we are listed under Endurance Corner Radio.  Jonas Colting will be live on Monday!

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Fit Pregnancy

On October 14th, Monica gave birth to our daughter Alexandra (she's the one in the photo above).  Seeing as I'm the writer in the family, I will share some observations across the last ten months.

We have all heard stories about massive weight gain during pregnancy.  I've heard stories of women gaining up to 80 pounds across their pregnancies.  Listening to these tales, many women must wonder if large amounts of baby weight are the norm.  Do I have to become huge, to have a healthy baby?  Monica's experience might be relevant to you.

Before we start with the pregnancy, I want to mention a little bit about the year before the pregnancy.  When you look at the athletes racing in Kona, or ITU Worlds, you will see that most participants are optimized for performance, rather than personal health.  In fact, I'd guess that many very fast elite athletes (male and female) would have trouble conceiving when they are peak athletic condition.  

So my first recommendation for athletes seeking to conceive is to get a medical check-up and shift the basis of your athletics from performance, to health.  That is something that Monica and I did across last winter.  Although I continued to ride my bike, my overall training stress was low enough that I had sufficient energy to devote to fatherly duties...

Monica didn't ride and focused her training on swimming, running and yoga.  She was in excellent health and physical condition.  While we were trying to conceive, she kept both the volume, and intensity, of her program.  She didn't do much fast running but she would swim fast three times per week.

Monica's main worries prior to getting pregnant: 
  • I will lose my body
  • I will lose fitness
  • I won't be able to do anything
  • I will get slow and never recover
I can relate to those concerns -- I share many of them every October and November!

The good news is you can maintain your body, your health and, most surprisingly, your fitness.  Here's how she did it.

No Zeros -- Monica did some form of physical activity every single day, for her entire pregnancy - even the day her water broke.  This performance was a lot better than Dad's record!

While our medical advice was not to commence a fitness program when you get pregnant, all our doctors said that it was OK to maintain a fitness program through pregnancy.  Monica's doc also noted that there isn't much practical knowledge about pregnancy and the endurance athlete.  

The warnings boiled down to:
  • Don't let your body overheat;
  • Stay well hydrated;
  • Don't get out of breath (steady effort, or lower); and
  • Listen to your body.
Monica read the blogs of athletic moms like Bree Wee and Paula Radcliffe -- seeking to learn from their experience.  She also consulted with coaches of elite female triathletes to learn from their experience.  Something that came out of that research is the risk of stress fractures that result when moms come back too quickly.  We received a lot of warnings about late term and postpartum running.

While most people talk about trimesters, looking from the outside, I noticed shifts closer to ten week blocks within M's 40-week pregnancy.

First ten weeks -- hormonal changes, mainly impacted mood and appetite.  Monica was lucky in that her cravings were fresh fruit (rather than sugar/starch) related.

Second ten weeks -- feeling much better, moderated volume and intensity with attitude of baby-comes-first.

Third ten weeks -- pregnancy starts to show, pubic bone discomfort at 26 weeks, stopped running at 30 weeks, shifted to the elliptical trainer 2x per week.

Final ten weeks -- months of high frequency swimming left her very economical in the water, some high volume swim weeks, hiking started around 34 weeks, elliptical reduced to 1x per week.

Here's a great stat... total swim distance across the pregnancy... 908,600 meters.   Average weekly volume was 14 hours and 45 minutes (includes yoga & cross training but not mellow walks with me).  That average volume was down from 19-23 hours per week before conception.

The most surprising thing for me was that across her third trimester, Monica had returned to a level of aerobic swim economy that was on-par with where she was preconception.

To sum up Monica's focus:
  • Pre-pregnancy -- health, not race fitness
  • During pregnancy -- baby comes first, no zeros
The biggest mental challenges Monica faced were:
  • not stopping; 
  • coping with weight gain; 
  • coping with her body changing; and
  • coping with peer group response.
There will be days where you feel like everyone wants you to get huge, slow down and be uncomfortable.  Those feelings are normal and it helps to know that all pregnant ladies are dealing with them.

If she had to give you one piece of advice with your pregnancy then she would encourage you to remain active, moderately, every day.  Also remember that if you plan on breast feeding you'll burn off your baby weight safely and gradually.

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The birth experience was intense and nothing like either of us expected.  We went to "baby school" this summer but nothing can prepare you for the real thing.  

All you experienced moms out there... you certainly downplayed the extreme nature of childbirth!

6:45pm Sunday (Zero Hour) -- water breaks, contractions start shortly thereafter

+6 hrs -- at the hospital, told cervix is 1-2 cm dilated

+15 hrs -- Monica's OB/Gyn gives an exam and notes that cervix is 1 cm dilated -- previous exam was incorrect; drug inserted to help cervix along

+18 hrs -- full blown labour gets going, strong contractions happening up to 2:30 min apart

+23 hrs -- another exam; disappointing news; uterus is ahead of cervix; only 2cm dilated; facing another 12 hrs of labour M opts for epidural

+24 hrs -- epidural kicks in with three hours of pain relief and relative comfort

+29 hrs -- pain relief gone; M feeling pretty strung out and ragged; doctor recommends sleeping pill to enable M to sleep; doesn't force it but strongly recommends

+30 hrs -- M waives off sleeping pill; gets anaesthetist to refresh the epidural;

+31 hrs -- another three hours of pain relief; a couple of short naps; makes a huge difference

+34 hrs -- pain relief wanes; good news that M is 8.5 cm dilated (one needs to get to 10 cm) 

+35 hrs -- pretty extreme pain through transition; M starts pushing; has to pause because she nearly pushes the baby out before the doctor can get to the room

+35:30 hrs -- childbirth!

Things that surprised us:

The extreme amounts of pain -- likely magnified by duration of labour and lack of sleep.   Picture the most despair your have ever seen in an athlete... this didn't even come close!  I'm guessing that you'd only see close having to watch young people die or see people broken via torture.  It's a good thing that babies are so cute!

The main thing that surprised me (M didn't see) was the large amount of blood that came out after the birth -- between the placenta and the blood, there was a bucket full of post-baby-bits. Didn't freak me out but it certainly got my attention.

Tips for the guys:

Being in the room, and supportive, provides a HUGE opportunity to strengthen your marriage. In life, we only get a few opportunities to demonstrate character. Child-birth is a total-body experience for your wife, being able to share that can create a deep bond. She will always remember if you were there for her.

Besides, after you watch, you'll spend the rest of your life grateful that your wife is handling the birthing part of the relationship. Blew my mind!

Back next week,
gordo

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