The Art and Science of Fitness | Of pregnancies and active lifestyles

Like most Indians, I belong to a family with a background in farming. And as is common in the farming community, women are out on the field, active day in and day out, with no holidays or breaks. Often, they aren’t allowed to complain about illnesses or even fatigue.

When it comes to pregnancy, it doesn’t matter until she is in labor. An unwritten doctrine guided by the patriarchy kept them working and active throughout the day, from the kitchen and other household chores to the farms, even when they were pregnant. Soon after the delivery, they are back to work again. This coupled with the fact that until recently, having about 6-7 children in rural India was the norm, and this norm did not give women the agency to choose whether they wanted to have children. This continues today, as back-breaking work continues in the fields, but they’re assisted by the technology of various kinds.

However, this isn’t true in present-day urban India, which has seen a paradigm shift in the lifestyles of both men and women. However, with pregnant women in metropolitan cities, the rules of the game have changed drastically. Furthermore, young girls in schools are often made to feel ashamed of their bodies as they grow older, forcing them off the fields and discouraging them from active lifestyles because of society’s most infamous — appalling — question: “What will people think?”

This question begins in middle school, and slowly but surely pushes women into believing that the outside world — from the schoolground to office spaces — that they’re meant to remain in the household, thereby reducing their activities one by one, often leaving them quite inactive. Any physical activity is “un-lady-like”. As they grow older, these women are forced into an inactive lifestyle in their marriages as well. So when they get pregnant, often with external help such as IVF assistance, the cycle of inactivity continues. Ironically, this is driven by the need to “protect” the unborn child from issues that were caused by forcing the mother into an idle life. This is wrong.

However, this is not the only cause. As our lifestyles are increasingly being determined by technology and fast food, we are no longer as active as we used to be. And this paradigm shift in the way we live and work is worrying, especially for women who want to have children. This is further exacerbated by the fact that women are now choosing to get pregnant in their mid-30s and mid-40s even, despite the risk. Here’s why:

There is consensus in the global medical fraternity that physical activity during pregnancy is good for pregnant women, for the unborn child and their health post-delivery, and the physical and mental well-being of both mother and child.

A study published in the British Journal of Sports Medicine in November 2022, Public health guidelines for physical activity during pregnancy from around the world, delved into what’s happening at the grassroots. Dr. Melanie Hayman and her colleagues looked at such public health guidelines in 194 countries. Unfortunately, India was not one of the 30 that have such guidelines promoting physical activity in pregnant women. Gender equality and equity start from here. How does Indian society want to empower women, if they don’t actively encourage them to move?

Here’s the journey of two formidable women I know.

Dr. Erika Patel, a mother of a 2-year-old, is a gynecologist and fertility specialist at ART Fertility clinics, in Chennai, and a runner for the last seven years. Dr. Patel ran until the day before her delivery and then after a year, decided to train for the prestigious 89 km Comrades Marathon in South Africa. Last year, she got to the finish line. Dr. Patel has been into fitness since school. From joining Chennai Runners in 2016, last week, as an official pacer at the Tata Mumbai Marathon 2023, she helped other runners to the finish line in their targeted time of 4hr 45min.

Here is what she had to say: “Running is my passion. And so, I always knew that I would be running when I got pregnant. I was training for a triathlon when I found out I was pregnant. After getting all my checkups and scans and clearance from my gynecologist, I decided to continue running and swimming. I sought professional help for training during pregnancy — a coach who has expertise in training pregnant athletes (coach Lindsey Parry). Most of my runs would be walk-runs, very slow with utmost importance given to my heart rate. I learned to listen to my body and would take days off. Thankfully the pregnancy went through uncomplicated and I ran until the day I delivered. I did a few 10k races in my second trimester and ran a 6k at 39 weeks as my last run. I had a 32-hour labor and I believe the strength to endure that came from being active during my pregnancy. I was back on my feet on day three, post-delivery. I worked on my core and pelvic muscles for the next 6 weeks and got back on the road post-clearance from my physiotherapist and coach. Running during pregnancy made me stronger both physically and mentally.”

“Running during pregnancy was once considered a taboo in India. Indian women were often advised to be in bed throughout their pregnancy by their families. However, this is changing. More women are understanding the importance of exercise and movement during pregnancy. It can prevent pregnancy complications like gestational diabetes and pre-eclampsia. Exercise in pregnancy is safe provided it is an uncomplicated pregnancy and provided one has been fairly active and exercising before pregnancy. In the field of fertility, there is this huge misconception about being in bed for hours after an embryo transfer. I make my patients get up and walk around in the hospital. I am working hard to break this misconception.”

Dr. Tvisha Parikh

Dr Tvisha Parikh, a mother, trekker, adventure enthusiast and an exercise and sports medicine consultant at Sir HN Reliance Foundation Hospital, Mumbai, was the medical director at the 2019 edition of La Ultra – The High.

Here’s what she had to say.

“Pregnancy is a physiological state, and unless there are contraindications, all women should be encouraged to exercise during pregnancy and remain physically active. Medical guidance in education about the safety of exercise and scientific exercise prescription could go a long way in this endeavour. Goals could vary from building fitness levels to sustaining the period of pregnancy and post-pregnancy by remaining fit, preventing excessive weight gain, and maintaining euglycemia. Here, baseline fitness levels or prenatal exercise habits are important determinants of exercise prescriptions during pregnancy.”

“In addition to the routine exercises focusing on aerobic capacity, muscle strength and flexibility, pelvic floor exercises need to be added to antenatal exercise routines. Finally, mental well-being is crucial.”

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Pregnancy is life-changing for women. As India expands its ideas on defined gender roles, it must make sure that it ensures that, from a young age that it instills the importance of an active lifestyle for all women. This is so that, one day, if they decide to have children, their bodies and their minds are ready for it.

Keep smiling and smiling.

Dr. Rajat Chauhan is the author of The Pain Handbook: A non-surgical way to manage back, neck and knee pain; MoveMint Medicine: Your Journey to Peak Health and La Ultra: cOuch to 5, 11 & 22 kms in 100 days

He writes a weekly column, exclusively for HT Premium readers, that breaks down the science of movement and exercise.

The views expressed are personal

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