A new study shows that exercise is perfectly healthy and safe for pregnant women whose pregnancies are low risk.
The researchers tell of pregnant competitive athletes who significantly elevated their body temperature with strenuous exercise. Doctors often worry that heating a pregnant woman’s body may harm a fetus. But those women had normal babies. And a few small studies of pregnant women who deliberately exercised to raise their body temperature also found no effects on the babies.
The researchers add that questions about exercise and pregnancy remain, making it difficult for doctors to give advice. The problem is deciding what lines to draw, and why. If the risks of exercise were low, but real, case reports and small studies would not find them.
The best way to learn how much exercise is safe is with studies in which pregnant women are randomly assigned to exercise regimens. Such studies, though, “can’t be done,” said Dr. Mona Shangold, the director of the Center for Women’s Health and Sports Gynecology in Philadelphia. No researchers or women would want to take a chance that the exercise might injure the fetus.
But that doesn’t make it likely that doctors will stop discouraging exercising while pregnant:
As a result, said Dr. Shangold, an expert recommended by the American College of Obstetricians and Gynecologists, doctors tend to play it safe.
But the advice often varies by doctor and can be based more on hunches than science, she said. Dr. Shangold says she tells women to limit their exercise time to 30 minutes a session, which she said was arbitrary advice.
“The problem is that we don’t know yet what the safe limit is,” Dr. Shangold said. “We are probably more conservative than we need to be.”
In fact, as Dr. Pivarnik found, advice to pregnant women is all over the map. He and his colleagues asked athletes who were or recently had been pregnant what they had been told.
Some received specific advice, like keep your heart rate below 140 beats a minute. That pretty much guarantees you won’t be exerting yourself much. It was in 1985 guidelines set by the American College of Obstetricians and Gynecologists, but it makes little sense, Dr. Shangold said.
“Heart rate is not a useful parameter to monitor during pregnancy,” she said. “It varies widely during pregnancy and the heart rate response to exercise also varies widely.”
Other women reported vague advice like “listen to your body.” Others got very conservative advice, like stopping all but the mildest exercise until six weeks after the baby is born.
Having never been pregnant, I was completely unaware of how strongly pregnant women are discouraged from exercise. I would be interested in hearing some anecdotes from the moms out there, about what kind of advice they received.
I also thought that the article might be overstating the ways in which pregnant women are coddled and patronized with regards to exercise. After all, it does site a case where a pregnant woman swam the English Chanel — a completely awesome feat in its own right — as either extraordinary or insane. But she was only 11 weeks along, a stage where some women still don’t even know that they’re pregnant and many if not most aren’t even showing yet. We can’t possibly see any woman who is 11 weeks pregnant that differently from how we view other women, right?
Then I came across this article, on the same day, on the same topic, in Newsday. It seems to focus almost entirely on the risks of exercise while pregnant, and doesn’t even mention the good news from the study discussed in the Times.
So what the hell? Of course, women who develop medical problems during pregnancy should try to take it easy. Many women also get very tired during pregnancy, and so rest is probably a better option than exertion during those weary periods. And of course, playing tackle football, doing roller derby or street-lugging would be risky activities. Advising women to not do anything that causes pain or discomfort is also just good general advice. But running? Swimming? Not getting your heart rate over 140 beats per minute? Come on now.
The reason for the concern is also really disappointing. Nearly all of the worries involve potential damage to the fetus. Obviously women who have chosen to continue pregnancies to term are generally going to be looking out for the best interests of their fetuses, but this discussion is constantly frustrating.
It seems like every single piece of medical advice regarding pregnancy is about the fetus, the fetus, the fetus, until it starts to seem like the woman isn’t even there. But the woman is still there, and we really ought to be looking out for her, too. For one thing, I’m tired of hearing so much about what mothers-to-be should and shouldn’t eat. Sure, that’s important, but not changing your mind every two seconds about what is and isn’t healthy, not scaring the crap out of women and not making those who don’t follow the most up-to-date guidelines feel like bad women is important, too.
Instead, let’s talk some about postpartum depression, okay? Or, forget that: let’s talk about depression during pregnancy. A study was released on the same day as the study about exercise, showing that utterly huge percentages of pregnant women suffer from anxiety and/or depression. But doctors don’t want to give out anti-depressants, yet again, because it may harm the fetus. And maybe that’s fair enough — I’ll be the first to admit that I have no idea how grave those risks are, and maybe the risk would not indeed be worth it in most cases. I don’t know. I do know, though, that exercise releases endorphins, and has therefore been proven to help with mild to moderate depression. With this knowledge, and extremely little evidence that exercise is dangerous during low-risk pregnancies, it seems to me to be downright cruel to advise women against it.
I hate seeing pregnant women not treated as people, and it happens all of the time. All of this completely unfounded advice seems to me to be more about maintaining an image of women as frail because of their reproductive capacity, and an image of pregnant women as existing solely to be a temporary home for their future offspring. Even when doctors are just trying to do good, which I imagine that almost all of them are, they’re also not immune from this portrayal of pregnant women that has persisted in Western culture for many centuries now. Neither, for that matter, are the pregnant women themselves. Anti-choice and anti-feminist language regarding pregnancy is pervasive to the point where we don’t even always recognize it for what it is. I can’t help but feel like this has to be at least a partial explanation.