Pregnancy Running - I'm Done Thinking, Now for Some Conclusions

I appreciate everyone who has put up with my analyzing and overanalyzing (to some) of my current and future physical condition, the safety of the baby, and my mental/emotional health in relation to staying active and exercising during pregnancy.  I know I am a weird mix sometimes of extremely emotional and yet critically analytical - and it creates a giant cluster of thoughts and feelings.  I was surprised how many read all my musings on pregnancy running and this whole situation - I had about 150 unique visitors to this blog over the last week!

So here is an update on my more recent workout and heart rate testing (test #3), research and anecdotes everyone has provided or I've found on my own in the last few days, and conclusions on my workout and total body-and-baby health plan moving forward!  I know it's long but necessary to be to get all this out and done and move on with staying as healthy as possible through the rest of this pregnancy!

Update on Latest Workout
I can tell that I feel amazing.  After a 30 minute elliptical workout of 3.5 miles yesterday morning, I also accompanied my friend Sarah to our first 1 hour Zumba class last night.  It's kinda like step aerobics without the step, then shake your hips, booty, and chest the whole time - oh, and throw in some basic salsa moves.  Kinda fun, definitely not as hard as running for an hour.  I wore the heart rate monitor and most of the class my heart rate hovered around 130, had some jump-ins for short times to 140-155, but it would bounce back down super quick.  There's a 10-20 second break every couple minutes between songs so that bit of recovery was quite noticeable on the heart rate monitor.

Research and Anecdotes from Others
A load of googling and reading articles I've found and that others have been so kind to send me has been very helpful.  I understand that my doctor appears to be using very conservative rules for exercise during pregnancy - I can't really blame her, she's just the type to want to guarantee the safest pregnancy possible for her patient.  And, while some suggested I consider changing doctors over this, that's not the best choice overall for me.  This doctor is an amazing Type A woman who is a great fit with my personality and who has already gone through a pregnancy and delivery with me - overall, I really enjoy having her as my doctor.

After reading articles, including going directly to sources like the American College of Obstetrics and Gynecology, I feel much more comfortable now knowing that there are less strict, more fluid guidelines available with ranges of safe percentages of max heart rate and a more subjective test of using perceived exertion, which can actually help a pregnant woman, by staying body aware, carefully limit her activity more over time as she feels the exertion required for the same exercises is higher.

And here's a sampling of the personal anecdotes:

• Lisa W.: "My Dr said the 140 was out of date and to run at conversation pace. As long as I could keep up a conversation without huffing and puffing I thought that was an ok pace. That did mean about 1-2 min slower per mile than my non pregnant pace though."
• Elizabeth M.: "I could not keep my heart rate below 140 when running while pregnant, which is why my doctor came to the compromise (after he did research as I was going to keep running) that as long as my heart rate went back down within 2 minutes of stopping, I was okay. There is a big difference between pregnant fit women and unfit women when it comes to heart rates."
• Abigail H.: "I read your blog and feel your pain! I ran through the first 20 weeks of this pregnancy and used the elliptical after that, up until the day I delivered last week. I used 'perceived exertion' as my guide, and my heart rate usually was between 150 and 160. Lillian was born healthy and happy with no damage. I don't want to disagree with your doctor, but that was my experience."
• Lena H. (a newly certified personal trainer): "The general consensus tends to be that it is safe to run during pregnancy if you ran before you are pregnant, are generally healthy, take some precautions, and check with your doctor (which you did). The 140 heart rate rule is considered "old school" by many, and obviously didn't work very well in your case. Rating of perceived exertion (RPE) may be a better estimate of effort. You need to work out at a moderate level, where you can talk (which means you are working aerobically). Also, your joints get looser during pregnancy, which means you are more prone to injury and have to be VERY gentle if you are stretching. Finally, a disclaimer: I'm not a doctor, just a personal trainer, and cannot tell you for sure when it is safe to run. Maybe a second doctors opinion is in order."
• Jonathan P. (medical student): "For what its worth, what I've heard both in class and in my reading is that in addition to the heart rate rule there are two other rules. 1. You should be able to hold a conversation while you are running, and 2. If you were running a lot before pregnancy (which obviously you were) then maintaining that level of activity, perhaps slightly decreased, should be fine. So if while your heart rate is around 160 you can still carry on a conversation, seems like you could be good to go. Hope you are able to come to a conclusion that both you and your doctor are happy with!"
• Jennifer K. (head training coordinator for a large Dallas running training program): "Ok- a few thoughts. I certainly don't want to disagree with your doctor- he/she knows best....but it is my understanding that the 140 HR is kind of "old school". Here's a quote from an article:
  
  
  “One of the keys is whether a woman exercised before her pregnancy,” says Burke. “If she exercised at 70 percent of her maximum heart rate (age subtracted from 220 times .70) before she became pregnant, she might be able to continue at that rate even if that number is above the 140 beats per minute (bpm) benchmark that has been established for pregnancy. Otherwise, she should keep her heart rate below 140 bpm at all times during her pregnancy. The Polar monitor will help her follow her doctors recommendation.” http://www.howtobefit.com/heart-rate-during-pregnancy.htm
  
  That being said- I think the effects of the heat are what you need to be concerned about...your core body temperature is already elevated because of the baby, you may tend to be a bit dehydrated....so consider doing the test inside on a treadmill or at a cooler time of day. Stay hydrated and cool because those things cause everyones HR to be elevated. Runner's World has a pretty good book about Running in Pregnancy- you might want to check it out.  If it continues to stay higher- you might even consider water running (although in my opinion it is about as fun as watching grass grow). Try it inside and see what happens."
• Lisa: "The 140 heart rate is very old school. New recommendations use 'perceived exertion'. 140 is very arbitrary and feels different to each person. You might want to get a second opinion. I have been through training with experts on prenatal fitness and there is no reason why you shouldn't be able to run with a healthy pregnancy. I have some articles that I can send you when I get home...  Don't get discouraged."

Additionally, some comments were more along the lines of encouraging cross-training of swimming or biking (neither sport I've ever done, including the fact I can't swim, so now's not really the best time to start out of the blue), treadmill running, taking it completely easy, that it would have been good to have a baseline heart rate before pregnancy (yeah, I know that NOW. Hindsight is 20/20), etc.

Current Conclusions on Workouts
There are currently three things I feel I need to watch out for...

1) Stressing my heart and therefore, the baby's heart:

Zumba and elliptical have proved to be clearly safe.  For running, more detailed testing on run/walk intervals and paces and different times of day still need to be performed.  But more and more, I'm willing to just TRUST HOW I FEEL.  So far, while my heartbeat may seem high to my conservative doctor, I'm at conversational pace, I'm feeling good, I'm not feeling overheated, etc.  I'm going to stick with not too many miles, work in these other types of cross-training workouts that are more heart-rate friendly, and "run happy, not hard".

2) Thermoregulation (overheating my core body temperature which stresses the baby):

Again, Zumba and elliptical will help as indoor workouts.  I'll also be especially cognizant of the weather forecast, both temperature and humidity, and adjust when and how often I run around that!  This will probably include a lot of evening runs.

Major hydration will continue to help throughout this!

3) Caloric Intake

This is an issue not previously discussed in my blogs but one I've been thinking about.  I'm not great about consistent calories throughout the day and day by day.  I wouldn't say I've increased my calories more than pre-pregnancy, and I had read that a 30% increase to daily caloric intake is good during pregnancy to provide the baby the needed "fuel".  So if I additionally burning calories by the hundreds multiple days a week, I will really need to commit to eating more often.  I've already been making changes the last couple weeks of consistently getting in a breakfast now (used to be really bad about that!).

So with a plan in hand, I'm ready to move on to the next thing to stress about - ha ha! Kinda kidding, kinda not. Those that know me well will completely understand.