Running a marathon when pregnant

The fact that Amber Miller did not fall or faint or develop complications while running in the Chicago Marathon is nothing short of a miracle. An ounce of prevention is worth a pound of cure. What on earth was her physician thinking when she was given the green light to half-run half-walk a 26.2 mile marathon? Miller was not your usual runner; she was approximately 39 weeks pregnant.

Although pregnant women are encouraged to maintain an active, healthy lifestyle that includes aerobic exercise, moderation is the order of the day. A woman’s body changes when she becomes pregnant. She has more fluid circulating in her body; hormones from the pregnancy make her ligaments more relaxed, thus she waddles. As the baby enlarges, the diaphragm (aka muscle of respiration) gets pushed up making it difficult for pregnant women to breathe. The heart rate increases and the center of gravity changes as the uterus becomes larger thus, increasing her risk of falling.

Miller participated in 8 previous marathons including one when she was pregnant with her first child. At that time she was 18 weeks. She says that she’s “crazy about running.” As the mother of two sons who were Junior Olympic Track and Field participants, I can relate.  However, where is the voice of reason? Prolonged exercise means an increase in heat production which may or may not affect the fetus. Years ago, pregnant women were discouraged from running or performing any exercise that would increase their core temperature for fear it would adversely affect the fetus. Unborn babies cannot regulate temperature because their brains are not fully developed and it is a special part of the brain that controls temperature.

In recent years, this rule has been relaxed because the medical studies are inconclusive. However, it is not recommended that pregnant women perform more than 45 minutes of continuous exercise and it should be in a temperature controlled environment. This was not the case with Miller. Although she ate frequently and drank water, she ran and walked for over 6 hours, developed contractions and subsequently went into labor. If her physician gave her permission to run at 39 weeks, then perhaps he or she should have accompanied Miller to monitor the process.

26.2 miles at 39 weeks is not a benign act and I certainly hope this will not become a trend among pregnant women.  Can you imagine delivering a baby in the middle of a marathon? It would not be a pretty sight.

Linda Burke-Galloway is an obstetrician-gynecologist and author of The Smart Mother’s Guide to a Better Pregnancy. She blogs at her self-titled site, Dr. Linda Burke-Galloway.

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  • Henry Ehrlich

    It’s all about the mom.  She’s so cool.  She will be the center of attention for weeks.  She might get her own reality TV program and endorsement contracts from a sports nursing bra company.  Maybe she will get to jog with Sarah Palin.

  • Elizabeth Abraham

    If pregnant women shouldn’t engage in more than forty-five minutes of sustained activity, no pregnant woman should work on a farm, or in a daycare or a factory.  Pregnant women shouldn’t wait tables.  They shouldn’t run after toddlers.  And yet, pregnant women do all of these things.

    I know that, years ago, pregnant women were advised not to exercise, lest they harm their babies – but isn’t that an outmoded recommendation?  Don’t we know better now?  My doctor was certainly unconcerned about me walking, jogging, gardening, taking dance or yoga classes, or hiking while pregnant.  I felt incredibly restless in late pregnancy.  I walked two miles the evening I went into labor.

    I don’t think that marathon running in late pregnancy is likely to become a trend – there aren’t that many women who are capable of running a marathon at all.  I wouldn’t tackle this one myself.  However, there were certain safety factors  unique to marathons in place, including aid stations along the course, and EMTs and ambulance transport on site.  Had she fallen, fainted, had other medical problems, or gone into active labor, she could have been removed from the course and taken to a hospital in less time than it takes most women to get to the L&D unit from their homes.

    Miller took nearly six and a half hours to complete a marathon that began at 7:30 in the morning.  According to the linked article, she gave birth around 10:30 in the evening, more than eight hours after she finished the race.  Is it possible that she started having contractions, and then delivered her baby, because she was thirty-nine weeks pregnant, and not because she overexerted herself?  Could we maybe trust pregnant women to listen to their bodies and stop exercising when they feel overheated, out of breath, or unwell?

  • Erika Krumbeck

    I think this is a bit overblown.  Women are not the fragile creatures our society expects them to be – I’m sure walking 10-20 miles or performing hard manual labor at 39 weeks is normal in many cultures.  As long as she was paying attention to her body, not “pushing through the pain,” was in good shape and seen by a physician, then it is her decision to make, and not ours to judge. 

  • Adam Falik

    I think it’s interesting that this author’s last name is Galloway (the runners out there will know what I’m referring to).

  • Linda Galloway

    I have traveled to Africa (both West and East) . . . twice . . . and I can say with authority that pregnant women at 39 weeks are not running 26.2 miles so let us not compare American women with women in “many cultures.” The maternal mortality rate is also extremely high in “other cultures.” I am not making a judgment call, I’m stating the standards of obstetrical care as dictated by the American Congress of Obstetricians and Gynecologists. An ounce of prevention is worth a pound of cure. Miller was not in her second or early 3rd trimester. She was 39 weeks in latent phase labor as evidenced by the fact that she delivered 8 hours after completing the marathon. I have had the unfortunate experience of witnessing a maternal death in residency. I have also seen every horrific obstetrical complication imaginable having trained at Harlem Hospital in New York City and then worked on a Native American Reservation and in the bayous of Louisiana. Pregnancy is a specialty of the unexpected. It is far easier to prevent a catastrophe then to try to treat one after the fact. Miller was very lucky. 

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