30 years of the pregnant marathon – its history and safety

The first marathon run by a pregnant woman might have been in 1983. And, not surprisingly, it was unintentional. The Norwegian Ingrid Christiansen ran the Houston Marathon in 2:33:27 and was disappointed. It wasn’t until two months later her coach, Johan Kaggestad, suggested she take a pregnancy test. She was 5’6”, 106 lbs and used to infrequent periods. She called her coach crying. The test was positive. It wasn’t that she didn’t want to get pregnant; she did. But she also wanted to continue running.

Ingrid Chrstiansen ran around 200km/week the first 2 months of pregnancy.

Just to give a little historical perspective, in 1966, Roberta Gibb had her entry form for the Boston Marathon returned with a note that stated women were “not physically capable” of running a marathon. She ran anyway, thus disproving the theory of the author of the note.

Certainly there were women capable of running a marathon, though they were the exceptional few who had trained enough to be capable.

As early as the 1930′s, scientists and physicians discussed the safety of exercise during pregnancy. Smaller studies were done on animals and women, but by today’s rigorous research standards, nothing significant was deduced. In the 1980′s, evidence escalated that some degree of exercise and/or running was acceptable and was likely to be beneficial. This was reflected in the ACOG 1985 exercise in pregnancy guidelines. And today women are advised they can continue training at the same level they trained at prior to pregnancy. Even heart rate limits are no longer considered necessary by most health care practitioners.

In 2012 more than 200,000 women completed a marathon in the United States alone (Running USA). This does not take into account the number of women who completed long-distance triathlons or ultramarathons. These numbers would not be of much importance except many of these women are in their child-bearing years and will be interested to know if they can continue this type of racing and training while pregnant.

A careful reader might deduce: if a woman is currently allowed to continue training at her current level when she becomes pregnant and she is in the shape to run a marathon prior to pregnancy, then she can run one pregnant.

Is it indeed this simple?

Once the words pregnancy and marathon are combined, the general public disapproves. Of course, they view the marathon through the eyes of a person who is not in the condition to run a marathon, perhaps let alone a 5k, so it simply seems too dangerous. And women who are pregnant read the thoughts of these people and get discouraged.

But in March of 2013, the American Journal of Family Practice became part of an official movement of not discouraging women from running marathons pregnant.

 
Author pictured in the American Journal of Family Practice in 2013.

 The above article (http://www.aafp.org/afp/2013/0401/p471.html) states recreational athletes can continue to train at their current level in a uncomplicated pregnancy.

 The concerns about running a marathon pregnant are speculative and few.

- is there an increased risk of miscarriage?

- would the core body temperature of a marathoner rise to such a degree that it poses a risk to the fetus’ central nervous system? And if so, at what point in pregnancy?

- does the transient decreased heart rate observed in fetuses while a mother is running pose a risk? Or does it in fact make the baby’s cardiovascular system stronger and more resilient?

Studies with small populations and large epidemiological studies with multiple confounding variables have not been able to either confirm or debunk these concerns.

In the meantime women (many women) are running marathons pregnant. So why is it you may have only heard of Amber Miller and perhaps one or two others? Because actually, it’s not really big news for runners. At nearly every large city marathon, there are one or more women there running it pregnant. They may choose to announce it on a blog, Facebook or simply tell friends. But the press rarely gets word.

Tara Zimliki 2008 on her way to complete the ING NY Marathon 8 months pregnant.

I love looking a pictures of pregnant runners. Is there another point in a woman’s life when she simply glows? Some of the best running experiences I have had were when I was pregnant. The distance and speed you run at is up to you. Remember, there are so many health benefits for both you and your baby. Your own happiness is among the most important.

 When I became pregnant in 2007, I just kept running- some 13 miles a day. I wrote about it on my blog – and only because readers started voicing concerns, did I start researching it.  I soon learned that most of what you find online is women (and men) discouraging women from continuing to run because it is too selfish (this is a word that will break any pregnant woman’s heart). Even The Girlfriend’s Guide to Pregnancy by Vicki Iovine discourages women from engaging in any exercise whatsoever while pregnant.

The Girlfriends' Guide to Pregnancy
A humorous and entertaining take on pregnancy, published in 2007, which unfortunately discourages women from exercising.
 
These non-scientifically sound opinions are doing a true disservice to women athletes (and really all women), who are interested in having a healthy, happy pregnancy.
Subsequent to my pregnancy, I found a woman online who had run 7 marathons pregnant. Her website has now disappeared and I don’t remember her name (she likely had threats from her readers of contacting the police, as I did on my blog). Then I heard about a woman who had reportedly run a Midwest ultramarathon 9 months pregnant. I heard it from two different people who don’t know each other. Yet, I wonder if the legend created around her is larger than her belly got. This is just the nature of pregnant marathon “evidence”. Women don’t want to brag about running pregnant. They just want to do it and not cause any trouble.
By 2010, I had heard of or read about nearly 50 women who had run marathons pregnant. I never heard of complications. And I had read James F. Clapp III, MD’s book “Exercising through your pregnancy”
 
“The traditional approach to an unknown risk is avoidance….[Recreational exercise] does not increase the incidence of either smaller than average babies or premature labor; and it actually may decrease the incidence of both.”

 

which demonstrated through elegant research, not only described how safe running while pregnant was, but the myriad of benefits to the mother and baby that go along with running during your entire pregnancy. These include much lower rates of pregnancy complications and health benefits for the child including better self-calming, decreased chance of obesity, improved motor coordination and higher IQ. So one is led to wonder:

- would running A LOT result in an ideal pregnancy and a super child? Or is there a point where it gets risky?

That same year, I was contacted by a Ms. S, who had read my running blog. She had a few questions and wanted to know about my experience running while pregnant. She went on to set a personal record (PR) in the ½ marathon 4 months pregnant in and then another PR in the marathon 6 months pregnant in 3:27. I was floored. Not only did running a marathon pregnant now appear to be safe, but  running one at a higher speed than achieved pre-pregnancy was safe for at least this one woman. It should be pointed out, though, that she suffered a stress fracture late in pregnancy, and these are the types of issues that need to be further explored so women can avoid injury to their rapidly-changing bodies.

In the summer of 2010, I became pregnant again. I continued training at an intense level. I had a 50 mile race on my schedule when I was six weeks pregnant. I ran the race at a comfortable pace and felt surprisingly good the entire time. I had, though, run the race the year before an hour faster. The very next day, before I went to bed, I noticed pink in my underwear. By the next morning, I was bleeding so heavily that I knew it was a miscarriage. I blamed myself and the 50 mile race entirely. But I made the very wise decision to go to the hospital. They did an ultrasound there, which ended up making a lot more sense: the fetus had died 3 weeks earlier – it had nothing to do with the 50 mile race. Whether or not it had anything to do with a high level of training, I probably will never know.

But that fall, I got pregnant again. I ran 6 marathons during that pregnancy and gave birth to a healthy boy at 39 weeks. I ran the first marathon just 3 weeks pregnant (before the pregnancy test turned positive) and I was noticeably winded compared to my most recent marathon. My last pregnant marathon was the Copenhagen Marathon at 30 weeks pregnant, which I ran in 4:54. After that very strenuous effort, I had a long recovery and lots of Braxton Hicks contractions. I had to wonder how healthy such a fast marathon at 30 weeks was in retrospect.  But in the end, I have no doubt that running while pregnant was the right thing for me, as it is for many, many other women.

 

 photo 006_02_b.jpg
Elaine Cooper, 1996, 31k Dunhill Drive Cross Country Race

And what about Ingrid Christiansen? What happened to her after all of those kilometers and a world-class marathon time 2 months pregnant?

She had an uncomplicated pregnancy and gave birth to a healthy baby boy. Just six months later, she went on to set the women’s marathon world record in 2:24:26 in London in 1984. She lowered it again by 3 minutes a year later. 

Improved performance post-partum is a less discussed “benefit” of running while pregnant, but worth mentioning for moms-to-be who want to continue running. In the small amount of literature written about the doping effect of pregnancy, young women athletes in Eastern Germany during the 1970′s are mentioned  and it was termed “abortion doping”. Supposedly these women got pregnant simply to induce red blood cell production and then would abort the baby and get a boost in their training similar to what one would get with epopoeiten (imagine training such a malignant environment!). This effect should not last more than 3 months, given the life of a red blood cell.

But time and again, I have witnessed and heard of women who have gone on to set personal records in running of all sorts of distances after (an entire) pregnancy, though not within the first three months post-partum. So there must be a more long-lasting form of “doping” and I think the answer must lie in muscle memory. The body simply adjusts to all of that extra weight and when that weight is suddenly gone, the mother’s body is much more efficient at running. I do not know how long this lasts, but suspect it is between 1 and 2 years and is likely more pronounced the more you run while pregnant. And of course, if you continue to train, you can extend the benefits out for many years.

In the past, health care providers instructed women to wait six weeks after delivery to begin exercising. But in an uncomplicated, vaginal delivery, women may now begin running again within days of delivery – entirely up to their own level of comfort. If they can find the time…

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

I am hoping to create a database of women who have run ½ marathons, marathons and ultra marathons pregnant, including how far they were along, their time, their pregnancy outcomes and their experience. It may not give a definitive answer in terms of safety, but it would at least be a resource for pregnant women who are considering running a pregnant marathon. If you have experience running a marathon pregnant and would like to share it, contact me at sealegsgirlblog@gmail.com. Here it is in its nascent form:

http://sealegsgirl.blogspot.dk/p/another-test.html 

About Tracy Beth Høeg, MD

TracyTracy started running – for the sake of running – when she was 17 years old. It was her future husband who convinced her to start racing when she was 27. Up until that point she had never understood why someone would want to run fast. She is a bit obsessive, curious, hard-working, and continually wondering why she finds motherhood so difficult. Her passion is discovery – be it physical places, scientific phenomena, music, art, literature, etc., etc., (and discovery with a loved one is, well, the best). She loves questioning the norm when it comes to women’s running and women’s health. She runs to challenge herself and to treat her mind and body well. 

Blog: http://sealegsgirl.blogspot.com/

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11 thoughts on “30 years of the pregnant marathon – its history and safety

  1. Hey fellow runner!

    I stumbled across your blog doing some of my own research. My name is Tara, I’m a 30yr old Jersey girl and am just about 13 weeks pregnant and have not stopped running.

    I found out I was pregnant Mid April of this year and since time of conception I have ran 2 10ks, 3 Half Marathon’s, 1 Marathon and 1 UltraTrail 50K. I am due on December 21 2013 and have every intention of running the NYC Marathon (body willing). I will be just about 33 weeks at that point.

    The only thing I can say about running preggo is I am more thirsty! which in turn makes me have to use a portajohn more often. I will admit I haven’t cared too much on time (no garmin) but i end up pacing my normal pace anyway. I stopped wearing the pace’er bc if for whatever reason i physically cant run and need to slow down, i want to save myself the “disappointment’.

    I will be the first to admit, although I am happy being a mom-to-be, i was almost resentful about NYC Marathon bc it was going to be my PR and how now my chance to PR it is reduced. And there are definitely those who have claimed all my goals ‘wishful thinking’ and have even called me selfish, but I say, GO SCRATCH… I started researching preggo runners and have clearly gotten inspired and will run as long as my body allows me to.

    I train a lot in NYC and NJ and the only suggestion my midwife made for me what to get more of a stability shoe for balance, but not bc im going to fall on my belly, she said my balance will be slightly off and who wants a rolled ankle while preggo! (one of the many reasons i love her!)

    anyway, if you end up starting a preggo marathon group forum count me in! One of my best childhood friends is a preggo marathoner too (due 2 weeks before me) and is also registered for NYC. I know she would love to join!

    I look forward to hearing from you soon! If not, HAPPY RUNNING!!

    Have a great day!

    TaraLynn

    • Glad you found us, Tara! I had some mixed feelings when I became pregnant because it “wasn’t suppose to happen yet” for another year or so which completely sidetracked my ultrarunning ambitions. It’s so cliche but as soon as I had my little girl in my arms everything in my running life that had been temporarily sidetracked was unimportant anymore and I saw the big picture in what slowing down my running had allowed to happen. Slowing down so you and your child are healthy is of the utmost importance which I have no doubt you recognize! It seems most runners are highly in tune with their bodies though and quickly listen to any warning signs their body puts out to them. I am sure you will end up making all the right calls during your pregnancy.

      I will see how much interest there is in starting a PUMR (that’s Preggo Uber Mother Runner!) forum and get back to you on that if there is. Great idea!

      In the meantime, have a happy and healthy pregnancy!!

      In stride,

      Lacy

      P.S. One of our writers is building a database that I think you could help out with. You can find out about it and contact her through http://sealegsgirl.blogspot.com/p/another-test.html

    • Hi TaraLynn

      Wow. THANK YOU for commenting. I can’t figure out what that email problem is. I have tested the address twice just now and it is working. Hmmm. Anyway, thank you for persisting!

      First off, you sound like a super strong runner and you are honestly just the type of person I would love to get data on for the study – because you are going well beyond what is considered a normal amount of running in pregnany. (remember 10 years ago NO running was normal. The world is changing!).

      Next, great idea with the forum. I am not so technically advanced, but do you know how to set something like that up? I have thought of that before and never was able to get it going, but there are tons of women out there who would love something like that!! (better than my current database, which no one can read anyway!)

      Forget that whole PR thing for just one year because next year, post-partum, you will KILL your old PR simply because you have been doing so much pregnant running. You will not know what has gotten into you. :0)

      Those shoes with more support. Got to be honest, it makes no sense to me. Shoes with thick soles and more drop make it more likely for you to roll an ankle. Stick with the shoes you are used to running in. I ran my whole pregnancy in minimalist shoes and really think they spared my hips. I would say the last thing you want to do is buy something thicker – this will make you more likely to fall!

      Please stay in touch – here is another email address you can try. exophoria -at- gmail.com. I don’t want to write the @ sign to avoid emails from bots.

      Yay! All the best to you. Let’s keep talking. Would love to hear more about how things are going and I am always happy to offer advice from what I learned and waht I have heard from other ladies who ran during pregnancy.

      Tracy

      • Hi Tracy,

        I would love love love to write to you about my experience running thru my pregnancy! I will try and email you again later today and tell you about the Boston and NJ Marathon. I am so beyond excited to have found this blog! I am going to stick with my Mizuno Wave Riders too! I just ran both the Oakley Womens 10k and the Portugal Day 5M with out a garmin and just enjoyed the energy. Such an awesome experience to be in a race and have the chance to take it all in. Makes me remember why I LOVE running to begin with. I have been running about 4 times a week. One race per weekend, one 7-10 miles training run in NYC (59th street bridge, Central Park or the West Side), one 4-5m hill/ sprint work out near my apartment, and one 4-6 mile mile run on the treadmill at the gym. I also do crossfit workouts 2xs a week. i feel very good but I def pass out in less then a minute once i hit the bed. :-) I will talk to a computer junkie friend of mine about the forum! I t was so great to hear from you! I will be in touch!

        Tara

  2. You guys are such an inspiration and I’m so glad I found you! I’ve been a runner since I was 19, have competed in 5 and 10K’s but also mostly ran all these years because I loved it. I’m planning to complete a marathon next year and did a half marathon 2 years ago. Right now, I’m 20 weeks pregnant, researched and found you guys because I was tired of hearing about the “danger of exercise” from a lot of people around me. Now I know, I can do whatever I feel is right when it comes to exercise and running. And I will! :)

  3. I am 42 and just ran a full marathon yesterday at 14 weeks. My time was considerably slower than my 1st marathon in 2012 (5:03 compared to 4:26). Might have had something to do with the 5 bathroom breaks I needed….. Did lots of walking, too, as it was an extremely hilly course and my hamstrings were angry about it. Still, feeling ok today – no issues with cramping or spotting – and proud of baby’s first 26.2.
    I did a half back in September at 5 weeks (about 10 mins off my PR pace-2:04 compared to 1:54 in 2012) and was extremely winded much of the time.

    • Congrats on your pregnant marathon, Kathy!! I would love for you to join our support group and share your experience with other PUMR’s. Click the “Pregnant Running Support Group” tab above to find out how to join.

  4. I just found out I am pregnant I have been running for a year have ran half marathons and now I am training for a full marathon inpuerto rico in 3 months I am probably at the earliest part of the pregnancy do you think it is wise for me to continue running. I will run at my own comfortable pace I am just a little nervous and excited.

  5. Pingback: » Week in Review: Slow & Steady

  6. Pingback: Resources for Pregnant Runners Part 1 | Feebabble

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