By Andrea Parkinson
Personal Trainer

Having a baby is an endurance event that starts at conception.  Moms need strong and flexible bodies to nurture their babies during the forty or so weeks of the pregnancy and beyond.  Simply put, the benefits of exercise for a woman during a typical pregnancy include but are not limited to:

• Decreased risk of gestational diabetes.
• Decreased risk of hypertension/ preeclampsia.
• Decreased loss of bladder function.
• Decreased severity of pregnancy related muscular skeletal discomforts.
• Decreased loss of bone mass during lactation.
• Decrease in maternal weight gain.
• Decrease in time between birth and returning to pre pregnancy weight.

There are also indications that a fitter mom has an easier delivery with less chance of needing medical intervention (forceps, vacuum extraction, or caesarian section). However, I do not advocate exercise during pregnancy for these reasons as strongly as I would the ones listed above. Since I intend to get a bit more personal with this post, I’ll say this now: However any woman is able to get through childbirth is the “right” way. The most important result of the birth is being able to celebrate a healthy baby alongside a healthy mom. Being physically fit is may or may not assist in an easier labor, but it certainly has many other attributes.

Once Mom is ready to go home, she will need the strength and flexibility to maneuver a small helpless being with zero neck strength into and out of seats, harnesses, and cribs, all ostensibly designed to challenge adult dexterity and patience.  She will need to be able to bounce and coo and cajole for hours at a time with no sleep whatsoever.  The job of mom also demands the ability to bend and crane and lift the most important and squirmy little being ever held without allowing him or her to fall.  As the child becomes a mobile toddler, mom must be able sprint from a dead halt repeatedly. Once the tyke is on a bike, Mom needs to be able to trot alongside at a steady state pace for however long the vehicle privileges are granted for that day. Prior to my own pregnancy, I likened having a baby to running a marathon.  Now that I am a Mommy, I would say having a baby is more like a “Tough Mudder” event that lasts a minimum of three years.

So far, I have been careful to specify the benefits of a “typical” pregnancy. “Typical” generally means that one fetus is growing inside a receptive uterus, with a healthy placenta, managed by a relatively healthy woman.  Before I share a bit of my atypical or “high risk” pregnancy story, let it be noted that while my anecdote is a happy one, I am NOT advocating any sort of exercise program for anyone without the consent of a qualified obstetrician.  When I begin working with an expecting client,  I demand a note from a doctor before I give so much as a pelvic tilt.

When I found out I was pregnant with twins, I hyperventilated as quietly as possible as my doctor pointed out the two separate heartbeats on the ultrasound screen.  My husband kept squeezing my hand and saying “Wow” then holding his middle and index finger up and mouthing “two!”  We spent the rest of that morning assessing the magnitude of our good fortune (aka, freaking the hell out). We were not simply expecting a baby,  we were getting plural.  A small litter of kids was gestating inside me.  Our life together was not just going to change, it was going to be completely leveled and rebuilt.

In logical fashion, my husband immediately focused on real estate and public school ratings.  My concerns were pinned to wondering how my petite frame would manage two critters at once,  how big I was going to get, and would my babies be able to make it inside me full term?

Any multiple order pregnancy has an increased risk of low fetal growth rate, pre eclampsia, gestational diabetes, and premature labor.  Medical assistance might be needed.  I might require muscle relaxants via IV.  Maybe I would need a procedure called cerclage, which stitches the cervix to keep it from dilating too early.  If my delivery needed to occur before a certain milestone, I  might need medication to stimulate the babies’ lung maturation before they were whisked into a Natal Intensive Care Unit (NICU) to assist with the development an early birth halted.  The worry I had for what I could not control for duration of the pregnancy was nearly crippling.

The potential disaster of endangering my babies via my lifestyle was an excruciating reminder of how ill prepared I felt towards motherhood.  My chosen “on the go” routine of training, dancing and generally racing about the city at all hours now felt completely inappropriate, yet it was how I defined myself.  How long would I be able to keep working?  How big would I get, and could I stay active on some level?

The weeks went by and somehow, the babies continued to thrive inside me.  My husband opened two separate college funds.  Meanwhile, I progressed from morning sickness to heartburn. My clothes grew uncomfortable and walking required considerable effort. At twenty three weeks, my husband and I went on a “babymoon” where I got to don a third trimester tankini that was too small for my second trimester twin bump. The typical challenges most of us face in New York City became more profound as subway stairs became a significant commuting issue. Sleep was fleeting, yet held more importance to me than eating. My stomach was pushed up into my throat, so it seemed, while my bladder was being compressed by what I am guessing was my son’s huge skull. Intake of both food and fluids was very uncomfortable.

During this time I maneuvered cautiously between what I thought would be best for my babies, and what I felt I needed to do for me. The two concerns often felt like opposing forces.  I was barely out of my first trimester when I got my first wave of guilt for wanting to, NEEDING  to continue to exercise in some capacity every day.  After all, I’d been highly active for most of my life.  How could I just “cool it?”  Anecdotes from other twin moms I knew suggested that I just hunker down, keep off my feet, and eat for three.  I was told to expect a weight gain of 45 to 70 lbs for the well being of the babies.  Mothering forums online also leaned towards extreme caution when it came to activity with any pregnancy, multiple or otherwise.  The implied and not so implied message was don’t be vain.  Don’t be selfish.  It’s not about YOU anymore!   Even the literature I had collected on raising twins admonished exercise if I wanted to nurse (I did).  One author speculated that our bodies could not produce enough milk if we exercised, or that the lactic acid created by activity would be present in the breast milk, and who knows what that could do to your babies (?!).

I took everything I read to heart, but I simply could not believe that attempting ballet class or moderate weight training was going to undo my bump.  If anything, working out kept me more focused on the extraordinary sensations of pregnancy.  I was out of breath very easily because I was breathing for the three of us, but it still felt good.  My abdomen was immense, yet I still felt a connection to my deepest pelvic muscles and imagined that every time I contracted my core, I was hugging the little ones.  I was also on a tight schedule with my Ob’s office, where I had my cervix checked for dilation once, then twice a week once I hit the 3rd trimester.  I even asked the exalted Dr. if I should stop exercising or working at a specific point.  He looked at me wearily and said, “Whatever you’ve been doing seems ok.  If you want to exercise, fine.  You can go to work as long as you can get up out of bed.”  So I carried on.  I lumbered from one place to another and sat as much as possible.  I drank water constantly, and also got up to go to the bathroom a minimum of four times hourly.  I wore support hose that took me twenty minutes to get into and a belly band to prop my massive tummy up.

I also made sure to move in some capacity everyday.  By 33 weeks, working out was more comfortable to me than rest in any position.  At 36 weeks, I was so miserable most of the time, that I began to lift heavier just to get the labor ball rolling.  By nearly 38 weeks, my body had had enough.  My Ob was also clearly tired of my unhappy looking mound of a profile in his office every other day, so off I went to be induced.

I was prepared to attempt 2 natural deliveries, but twin A’s head was too big to get through, and Twin B was trying to push him out of the way, causing a birth canal gridlock that could have lasted another week.  For nearly 9 months, I had lived in fear that I was inches away from a terrifying loss, when the reality was that my body did not want to let my babies go too early.  In fact, their own rush to make an exit only delayed the grand entrance (this behavior never really stopped, by the way).

My beautiful babies were born at 37.5 weeks via C section.  They weighed 6.5 and 5.5 lbs. and did not need the level 4 NICU I had researched.  We were all home within 4 days.  After about 8 weeks, I cautiously added exercise back into my schedule.  If my breast milk was different due to an accumulation of lactic acid, my babies did not seem to care.  They grew rapidly as my body lost more than the 40 lbs I had gained within a few weeks.

So there I was, two healthy infants and a body that was proving itself to be far more elastic than I could have hoped.  As I nursed and pumped and spent many wakeful hours shushing my babies in front of my computer,  I began noticing more literature on how maternal exercise benefits infants.  Simply put, some of the perks look like this:

• Decreased risk of insulin resistance.
• Decreased risk of overly high birth weight and the ensuing complications.
• Increased heart and brain health.

There is even a slight correlation towards better athletic ability in children whose moms were active during pregnancy.

Did my twins find the taste of my breast milk repellant after a quick run? I can’t speak for them, but I had a tough time weaning.  They were three when I finally closed up my blouse and said “no more.”  At the age of 5, they still  recall the good old days of mommy’s milk and enjoy letting me know how delicious it was (tmi, kids!).  I am guessing that any accumulated lactic acid might have gone undetected and we three were all the better for it.