When it comes to running, you could say pregnancy and postpartum is The Great Equalizer. Behind Instagram feeds and Strava records, elite and everyday runners alike tend to meet at the same crossroads: where running intersects with motherhood. And the setting, while wonderful, isn’t always so scenic. Women’s Running consulted with doctors and physical therapists and Olympians and moms all over the country to share what you can truly expect from the sport you love in pregnancy and postpartum.

 

Section divider

What to (Really) Expect from Pregnant Running

Knowledge is power. These physiological changes show up long before you have a bump.

Fatigue

Besides growing a baby during your first trimester, you’re also growing your placenta, the organ your body creates to sustain your baby. This means your energy levels aren’t going to be where they used to be, says Sara Tanza, a pelvic floor physical therapist in Aptos, California. But fatigue isn’t permanent. The bigger you get, the more energized you might feel, because you don’t have that demand of kick-starting growth of both the placenta and your baby.

Sore Boobs

Breasts go through a lot of changes as hormones increase to prep for milk production, says Celeste Goodson, a pre- and post-natal trainer and founder of ReCORE Fitness. “This often causes sensitivity the first trimester and heaviness or fullness in the last half as they increase in size.”

Nausea

Blame the hormones. Usually, nausea settles after the first trimester (vitamin B6 can help). Some people actually feel better after they’ve exercised.

If nausea is getting in the way of your day-to-day, you’re not able to keep any food or water down, or you’re losing weight, call your doctor. Hyperemesis gravidarum (HG) is an extreme form of vomiting and nausea in pregnancy. Prescription meds can be helpful.

Out of Breath

File this under the-female-body-is-amazing: “Because of increased progesterone in first trimester, the body takes in 10 to 20 percent more oxygen per breath,” says Goodson. As pregnancy continues, blood volume also increases at least 50 percent, so your heart has to work harder to pump all of that blood. Plus, in the third trimester, your belly may push against your diaphragm.

The result of all of this? You feel winded. Sometimes, really winded. Like, “Where did all my fitness go?” winded. The good news is that, when you’re pregnant, easier workouts can have a similar physiological effect as harder ones because your body is working overtime, says Tanza.

Watch out! Anemia, aka low levels of red blood cells, can also cause shortness of breath and fatigue, so have your levels checked if you’re worried.

Musculoskeletal Issues

Due to hormonal changes, ligaments in your pelvis can loosen, even early in pregnancy, to prepare your body for birth, Tanza explains. You might experience joint pain because of it.

As your pelvis and hips widen, making room for baby and to take on more load, you might notice other muscular and physiological imbalances, too. Stabilization training, which includes hip, core, glute, and pelvic floor work (think: clamshells and squats) will help build muscle and control in key areas and lower your risk of pelvic injury.

Form tip! Focus on picking up your knees and feet when running during pregnancy. As your belly grows, your body struggles to flex your hips as much, which can lead to weak hip flexors. Sending the knee through its full range of motion helps you maintain strength and (hopefully) avoid pain, says Tanza.

Did you know? Walking uphill doesn’t put as much stress on your pelvic floor and pubic bones, says Tanza. Pregnancy hill walks, anyone?

Section divider

Own Your Run

Feel your best mentally and physically in any trimester (including the fourth).

Have One-Liners for the Opinionated

Assuming you’ve been given the A-OK by your doctor, exercise is healthy and recommended in pregnancy. But that doesn’t always stop the unsolicited advice. These one-liners should quiet the haters commenting on your workouts.

What to say: “The best I feel all day is when I run.” It’s what two-time Olympic medalist and mom Dawn Harper-Nelson used to tell people about running during her pregnancy.
Why it works: People really can’t argue with your lived experience, says Dr. Erica Burger, an integrative psychiatrist in Northeast Iowa. Plus, it’s empowering to speak your mind. Think about other people’s comments like sunlight, she suggests: You can either absorb it or shield it.

What to say: “I appreciate your concern, but I’ve discussed this with my medical provider.”
Why it works: It quickly signals that it’s none. of. anyone’s. business.

Find the Bright Side

Whether it’s your mile times getting progressively slower or a painful one-step-forward, two-steps-back recovery, there’s no way around it: Running while pregnant or postpartum will likely, at times, be frustrating. Seeking out in-the-moment joy and giving your body some love can help.

“Running in pregnancy, I realized that I was doing the best thing I could possibly do for myself and my daughter. I remember thinking, ‘These are the things I dreamed of and I’m doing them both at the same time,’” says Harper-Nelson.

Go with the Flow

“Every pregnant person who wants to stay active will benefit from a really flexible mindset,” says Tanza. “It doesn’t matter what your experience is going into it.” She’s seen amateur runners run their whole pregnancy and professional runners not be able to. Pregnancy and motherhood teach us that you can’t always be in control of the outcome.

That certainly was the case for Harper-Nelson. “I was terrified to get stretch marks—terrified, not nervous. I thought that if I got them my tummy would never be beautiful again and when I saw one, I cried so hard. I even set my phone up to record myself because in my mind I felt that it made no sense that I was getting that sad about stretch marks.”

Fuel Accordingly

Breastfeeding? Aim to eat about 500 (or more) additional calories a day of easy-to-digest, nutrient-dense foods. You’ll need the extra calories to support yourself, your baby, your milk supply, and your workouts (phew, that’s a lot).

Pro tip: Pumping or feeding right before you run gives you the biggest window of time—and helps you sidestep any uncomfortable issues such as engorgement on the go.

Be Patient—Then a Little More Patient

When Harper-Nelson’s body needed more time to heal postpartum and she was getting frustrated, she reminded herself: “It’s OK.” (A line her husband gave her.) “There’s this mindset of it’s enough time, but it’s not always enough time. When I became ‘mommy Dawn,’ my body needed more time and that was OK. I just wasn’t letting myself feel that it was OK.”

Feeling bummed? Life happens in seasons and it’s going to be lopsided at times, especially as a mother. Use the time to work on something else—flexibility, mobility, or your pelvic floor. After all, a return to running isn’t about coming back fast, it’s about coming back strong. “It’s like the tomatoes in my garden,” says Tanza. “I want there to be tomatoes, but there can’t be tomatoes right now. I have to water them, prune them, take care of them, then in August there will be tomatoes.”

Section divider

Avoid the Comparison Game

We get it: It’s never an easy pressure to fight against, but it can be even more challenging during pregnancy and postpartum. When but-she’s-doing-this-already thoughts start creeping in, these tips will help you feel your best.

Home In on Your Purpose

“Running isn’t about being the best. It is about enjoying your body and what it can do,” says Danielle Cotter, a perinatal therapist, mom, and runner based in Bloomington, Indiana. Thinking about why you run (and that “why” might be different now) helps you avoid comparing, because it gives movement a deeper meaning in your life—not someone else’s.

Pinpoint Perfectionist Tendencies

Feel like everything has to be a certain way in order to feel “successful?” Take note of when these thoughts come out and when you start comparing yourself (to yourself in other pregnancies or to others), suggests Dr. Burger, who’s also an avid runner. Doing this can help you find triggers (someone else’s times) and solutions (running without your watch).

Clean Up Your Feed

“Your identity is going to change once you’re a mother. Find women in real life, on podcasts, in books, or on social media who speak honestly and candidly about what motherhood is really like,” suggests Dr. Burger. Here are some positive mom influences we can totally get behind:

• Book: What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood
• Podcast: Ali on the Run
• Social media: @alysiamontano (Instagram)
• Social media: @dearsundaymotherhood (Instagram and Facebook)

Is It the Baby Blues?

It’s common to notice mental health changes on the journey to motherhood (about 80 percent of moms experience what’s called the “baby blues,” feelings of sadness, worry, and fatigue in the two to three weeks after birth). But around 15 percent of women develop a perinatal mood and anxiety disorder (PMAD) such as postpartum depression or anxiety. If your symptoms get in the way of your day to day and last beyond the first few weeks after delivery (or crop up in pregnancy), check in with a mental health provider. Postpartum Support International has a directory of trained professionals at psidirectory.com.

Section divider

Your Return-to-Running Checklist

In 2019, researchers out of Ireland and the U.K. published some of the first recommendations for postpartum running. To allow the body to heal, those guidelines suggest waiting 12 weeks before lacing up.

“It’s a guideline, not a set rule,” says Goodson. If you’re working with a women’s health professional, you might be able to start earlier. Once you’ve confirmed you don’t have a diastasis recti (a separation of the abdominal muscles that’s normal in pregnancy but can linger postpartum) and that your pelvic floor functioning is normal, consider this at-home postpartum readiness exam from Tanza. If you notice any “red flags” hold off and connect with a pelvic floor physical therapist.

• You can stand up from the ground without using your hands
• You can do a full pelvic floor contraction and relaxation
• You can walk for double the amount of time you want to run
• You can jog in place for one minute
• You can jump on one leg 20 times per leg
• You can do 20 side-to-side jumps
• You can do 10 single-leg squats on each leg
• You can do A-skips and ankle dribbles for 30 seconds each

Running Red Flags

Here are the symptoms and signs that it’s time to put the breaks on running.

• You leak urine or feces while running, which could be a sign of pelvic floor weakness.
• You feel heaviness or “poofiness” in your vagina or rectum, a potential signal of prolapse (when your pelvic organs descend down). Remember: Common does not equal normal. Research suggests prolapse impacts 50% of people who have had a vaginal birth. “In my experience, that number is higher,” says Tanza.
• You have pain in your pubis symphysis (a joint in the middle of your pelvis), SI joint, or tailbone, potential signs of pelvic floor dysfunction. (Quick anatomy lesson: The tailbone, pubic bones, and “sitz” bones are all major sites of attachment for pelvic floor muscles. Pain in these areas can be signs of pelvic floor dysfunction as muscles might be yanking those areas, says Tanza.)
• You notice “coning” or “bulging” between your ab muscles when you sit up postpartum, a potential sign of diastasis recti, a separation of the abdominal muscles that’s normal in pregnancy but may not heal on its own postpartum.

Let It Go

Postpartum, many moms need to strengthen their pelvic floor (that’s where Kegels come in). But with some pelvic floor issues (pubic symphysis or tailbone pain), relaxing your muscles (imagine your vagina or anus opening and let go of your low abs) is key. “Think of your pelvic floor like your quad. It needs to relax and be strong,” says Tanza. Putting a (clean!) finger inside your vagina or around your anal opening can help you feel whether or not you can inhale and feel the muscles relax and exhale and feel them contract. Manual treatment and biofeedback with a pelvic floor physical therapist can help you re-learn this skill.

Butt wait. Managing constipation is super important and helpful postpartum (especially if you’re breastfeeding, which is dehydrating and can put you at an increased risk for poop problems). “When you have harder stools, that puts more weight on the pelvic floor,” says Tanza. Straining due to constipation can also contribute to hemorrhoids (a common and sometimes debilitating PP reality). Making sure you’re bearing down properly (think about relaxing and opening) can help get you back on track.

Section divider

Ensure a Smooth Maiden Voyage with the Run Stroller

More pushing? Here’s how Amanda Nurse, an elite marathoner, run coach, and mom of two in Boston sets up clients for success when jogging with baby.

• Wait for full head control (around 6 months).
• Feed before you go.
• Time your run around a nap or play time.
• Set reasonable expectations (to simply be able to get out and move with your baby, for example, instead of setting a specific distance).
• Plan a flat route close to home.
• Pack accordingly (diapers, wipes, water, sound machine).
• Perfect your form. Staying upright or slightly leaning forward allows you to push from your glutes and core instead of your arms. Maintain a loose grip on the stroller or alternate hands.

Section divider

“What My First Postpartum Run Was Really Like…”

Repeat after us: Every. Body. Is. Different.

I felt so proud. I had low expectations and far exceeded them.

—Sarah Chapin, a mom in Boston

Halfway through my run it felt like my insides were about to fall out, which was extremely unsettling. An ob-gyn discovered I had prolapse. It took several months before everything felt normal and before I felt really comfortable working out again.

—Stacey W., a mom in Winston-Salem, North Carolina

I felt free. It was great to run again and have some me time.

—Kyndal Michel Marks, a mom in Cincinnati

I felt 100% discouraged as a former ultrarunner who ran 13.1-mile distances in pregnancy. I had complications, including fourth-degree internal tearing. After a year postpartum, I still cannot sneeze without peeing. I would have gotten more pelvic floor help by now if my insurance had covered it. I’m looking forward to any paths forward that are best for me athletically. It’s an ongoing journey between myself and my relationship with my new body.

—Pamela Huff, a mom in Boulder, Colorado

“When I tried to take off sprinting, it just felt like I was dragging. There was no ‘pop.’ Normally, when I say ‘go,’ my body goes—there’s not a question, I’m a sprinter. But I remember looking at my husband afterward and just crying.

—Dawn Harper-Nelson

Glorious. My cardio wasn’t what it was pre-pregnancy, but I was expecting the worst so I was pleasantly surprised. Leaked milk everywhere the second I stepped into the shower, though.

—Kiera Carter, a runner and mom in New York