Running for two: the controversy and the facts

These days everyone is running a marathon. From the unofficial kickoff of the fall marathon season in Chicago in early October, to the ING New York City Marathon this coming weekend, almost a quarter of a million people will complete the 26.2 mile distance. With so many people conquering this once formidable distance, why should the youngest runner to finish yet, a 39 week baby in utero – draw so much attention? If you haven’t already heard, Amber Miller, aka “The Marathon Mom”, ran the Bank of America Chicago Marathon at 38 weeks 5 days pregnant and then delivered her baby girl just hours following the race. This mom and, by all accounts, her very healthy baby have generated a lot of attention, and not all positive.

Despite abundant evidence that exercise during pregnancy is not harmful for mother or baby, Amber Miller was openly criticized and attacked for putting her unborn child at risk by running a marathon. A veteran of eight marathons, three of them while pregnant, Amber’s actions were called “reckless,” “stupid,” “selfish,” “unfair,” and “ridiculous” in online reader comments to the news story. Some said she should be locked up. Others compared her to a crack addict, an alcoholic, or a smoker endangering her child for her own selfish wants. Even elite and experienced runners are not immune from the criticism. Paula Radcliffe, mother of two and current world record holder in the women’s marathon, won the 2007 ING New York City Marathon only 10 months after the birth of her daughter Isla. She has said of running through her pregnancies: “You feel like saying, I'm not sick. There's nothing wrong with me. I'm just pregnant. Even people I know really well will come up and say, "Are you still able to run a bit?" And then they'll see me on the track and say, "Should you be doing that?" 
There is a longstanding debate on the safety of pregnancy and exercise. However, extensive research demonstrates no adverse outcomes for mother or baby, no adverse effects on fetal growth or size, and no increase in early pregnancy loss or late pregnancy complications as a result of moderate regular exercise during pregnancy. Rather, the untold story is that numerous benefits of regular exercise exist for both mother and baby. Maternal benefits include increased fitness and decreased pregnancy weight gain, reduced muscle cramps and swelling, overall improvement in mood, and reduction of gestational diabetes and hypertension. The exercise benefits for baby include decreased fat mass and improved stress tolerance.

Perhaps the most compelling reason for women to stay active during pregnancy - new research shows that women who voluntarily maintain their exercise regimen during pregnancy continue to exercise over time at a higher level than those that stop. Over time they also gain less weight (7.5 pounds vs. 21.8 pounds), deposit less fat (4.8 pounds vs. 14.7 pounds), have increased fitness and a lower risk for cardiovascular disease than those who stop exercising during pregnancy.
Not a marathon, but a 5K race
one week before Charlie was born
In an era when more and more overweight and obese women are becoming pregnant, limiting pregnancy weight gain and losing the weight post-pregnancy are critical health priorities. Scientists are just beginning to understand how maternal health can impact not only fetal health, but also disease risk throughout adulthood for both mother and baby. For example, research shows that gestational diabetes puts both mother and baby at greater risk for developing type 2 diabetes later in life. With this dire evidence of the negative consequences poor health can have on future generations, greater emphasis should be placed on positive lifestyle change during pregnancy.
Running a marathon while pregnant is not for everyone. Even running while pregnant is not feasible for many women due to other risk factors, increasing size, or levels of discomfort. But the extreme example of Amber Miller completing a marathon at 39 weeks pregnant brings this important issue to light and will hopefully encourage people to start viewing pregnancy differenty - as a period to enact positive lifestyle changes that could benefit both mom and baby in a big way. And maybe then, a pregnant woman accomplishing a remarkable physical endeavor like a 26.2 mile race could be cheered rather than jeered.

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