Here’s how you can keep running through a few common pregnancy woes before and after your baby is born.

pregnancy running
Illustration: Chris Pyle

My 10-year-old son is not impressed when his father tells his birth story: “Your mom ran 7 miles the day before you were born.” Secretly, I’m proud. Then it wasn’t nearly as common as it is today to see baby bellies on the road or in the gym.

This acceptance of running during pregnancy had been percolating for some 25 years. “In the early 1980s, pregnancy was still perceived as a state of confinement and indulgence,” says Dr. Raul Artal, professor and chair emeritus at Saint Louis University’s Department of Obstetrics, Gynecology and Women’s Health. Physicians almost never recommended exercise during pregnancy—certainly not running. Now the vast majority of obstetricians have changed their attitude. Most often they will encourage running during pregnancy with this caution: “Heed your body’s cues for adjusting your activity,” according to Fit & Healthy Pregnancy: How to Stay Strong and in Shape for You and Your Baby by Kristina Pinto (VeloPress, 2013), a Boston-based running coach.

Your body goes through a zillion changes, from conception through your baby’s first year, that will no doubt affect your fitness plan. Here are five common issues and how you can run your way through them.

Dehydration
You feel: Lightheaded, nauseous, dizzy, dry mouth, headache
Why? We all know it’s important to get enough fluids before, during and after exercise. But hydration is extra important for expecting moms, especially in the first trimester and when nursing. Blood volume and cardiac output increase about 40 percent during pregnancy, says Pinto.
Manage it: Individual hydration needs vary due to activity levels, physiology and the environment, but Pinto recommends starting by getting 64 ounces daily and carrying a water bottle to remind you to hydrate. Check the color of your urine during one of many pee breaks—the clearer the better! If you feel lightheaded or nauseous, or if your urine is dark yellow, drink more fluids.

Related: The Scoop On Running Through Pregnancy

Nausea
You feel: Like ugh, meh.
Why? Thank first trimester extra hormones and “reconstruction.” According to Pinto, “Everything is growing, your circulation isn’t keeping up with growth, so your hormones and blood circulation are out of whack. In the second trimester, women start to feel better.”
Manage it: “Women tell me one of the best ways to deal with morning sickness or nausea is to go outside for a run or walk,” says Pinto. The combination of fresh air and movement makes a difference.

Loose Ligaments
You feel: Dull aches or sharp pain in hips, knees or ankles, plus a change in gait. Instability, back pain and increased risk of falls are additional possibilities.
Why? During the second trimester and a few weeks before delivery, the hormones relaxin and estrogen are released to loosen joints and ligaments, especially the hips, to accommodate your baby’s growth and birth. These extra hormones affect “performance and the ability to stop, start and change direction during pregnancy,” says Artal.
Manage it: “You can stick to your workout program, but listen to your body,” says Dr. Rachel Kramer of Lankenau Hospital in Philadelphia. Be mindful of overstretching—it can lead to ligament strains. To reduce extra pressure on your pelvis, Kramer recommends using a foam roller to stretch, because it encourages you to use gravity. For yogis, avoid forcing poses, recommends Pinto.

Related: First Trimester Running Lessons

Overuse Injuries
You feel: Post-pregnancy foot, knee and hip pain
Why? Often runners want to get back on the trails as soon as possible. But if you do so before your body has fully recovered, you may end up with an overuse injury like plantar fasciitis, iliotibial band syndrome or runner’s knee.
Manage it: Take care of your feet, because they change a lot during pregnancy, says Dr. Melissa Goist of Ohio State University Wexner Medical Center. Wider hips, weight gain and changes in your center of gravity and gait all affect your footing and footfall. Visit a specialty running store to get fitted for shoes during pregnancy and re-fitted afterward to avoid injury. A maternity band can alleviate back and hip pain by reducing pressure on the sciatic nerve as your body shifts its center of gravity.

Related: Post-Pregnancy Running—Don’t Rush It

Incontinence/Pelvic Floor Weakness
You feel: Urine squeaking out during a run, cough or laugh, or a strong urge to pee before going to the bathroom
Why? The bladder sits on top of the uterus, and as the uterus grows, it puts extra pressure on the bladder, causing increased bathroom urges. In vaginal births, there may damage to the nerves or muscles that help you hold and release urine—this takes time to heal.
Manage it: Empty your bladder before a workout, or Kramer suggests taking your workout to the gym, where you can use the bathroom anytime. She doesn’t recommend wearing Depends or pads, because they can cause chafing and irritate the vulva. Instead, wear black capri pants that won’t show a little leak. You can also practice Kegel exercises when urinating: Stop the flow of urine a few times and hold for five seconds, and work up to 10 seconds.