- Christine Sterling, MD, FACOG, obstétricienne-gynécologue certifiée, fondatrice de Sterling Parents et membre du conseil consultatif médical d’Oura
Mais au cours de ma propre grossesse, j’ai découvert qu’« écouter mon corps » lorsque je m’entraîne ne me permet pas toujours de me sentir mieux. Parfois, lorsque je laisse mon corps guider mon exercice, je finis toujours par me sentir fatigué ou sous-stimulé, gazé de manière totalement inédite, et même souffrant ou légèrement blessé. Ces moments m’ont laissé un sentiment d’éloignement de moi-même, de frustration, de blessure et de bouleversement, mais ils m’ont également obligé à faire preuve de plus de compassion que jamais auparavant.
Écouter son corps pendant la grossesse : l’approche recommandée en matière d’exercice
L’American College of Gynecology and Obstetrics (ACOG) recommande aux femmes enceintes de pratiquer 150 minutes d’activité physique modérée par semaine, ce qui est la même recommandation que celle que les Centers for Disease Control and Prevention (CDC) donnent à tous les Américains. Selon l’ACOG, l’exercice est associé à de multiples résultats positifs en matière de santé pendant la grossesse, tels qu’un risque réduit de problèmes de tension artérielle, une meilleure santé mentale, des taux plus élevés d’accouchements par voie vaginale, etc.
Personnellement, en plus de ces bienfaits, je voulais continuer à faire de l’exercice pendant ma grossesse car la marche et la randonnée, la musculation, la course et le yoga ne représentent franchement qu’une grande partie de ma vie. Le mouvement m’aide à m’endormir et réduit mon anxiété liée au sommeil, me vide la tête, me fait me sentir accompli, positif et plein d’énergie. Avec tant de changements dans mon corps et dans ma vie, il me semble important de garder cette partie de moi.
Les médecins soutiennent cette approche de la condition physique pendant la grossesse. « [For] Pour quelqu’un qui participe à un programme d’exercice régulier, nous constatons qu’il est sécuritaire pour lui de poursuivre ce programme d’exercice », déclare Christine Sterling, MD, obstétricienne-gynécologue et membre du conseil consultatif médical d’Oura. « Si vous vous sentez à l’aise et que vous sentez que vous ne faites pas trop d’efforts et que vous ne ressentez pas de douleur, nous n’allons pas vous dire : ‘Oh, vous ne pouvez pas faire ce genre d’exercice.' » Grâce à ces conseils, les offres de remise en forme destinées aux femmes enceintes se sont multipliées.
« Pendant la grossesse, notre relation avec notre corps doit changer, et c’est vraiment difficile. » —Christine Sterling, MD
Mes niveaux d’énergie fluctuants signifient que je fais définitivement plus de marche que de course ces jours-ci ; Je veux toujours faire de l’exercice, mais pas autant ni aussi intensément qu’avant la grossesse. Cela a été un ajustement, mais pas énorme, pour modifier mon effort et mes objectifs.
« Beaucoup d’exercice, c’est comme : ok, je vais atteindre l’autre côté de l’euphorie du coureur, je vais surmonter cette difficulté », explique le Dr Sterling. «Mais nous voulons vraiment que les gens écoutent leur corps pendant la grossesse et ne repoussent pas la douleur. Votre volume sanguin augmente, votre fréquence cardiaque (le volume systolique réel) augmente, votre cœur fait plus de travail, votre système cardiovasculaire est déjà stressé et [in] votre système respiratoire, vous n’avez pas la même réserve respiratoire. Cela fonctionne déjà à son maximum. Nous ne voulons donc pas que quelqu’un s’exerce au point d’avoir un impact sur la capacité de son corps à fonctionner.
Un conseil assez facile à suivre, non ? Si quelque chose vous fait mal ou est difficile, arrêtez-vous. Si vous êtes essoufflé, faites une pause. (Le Dr Sterling recommande d’utiliser le test de conversation : vous devriez toujours pouvoir avoir une conversation pendant l’exercice que vous faites.)
Where the train has come off the tracks for me is when I’ve thought I was following advice about listening to your body during pregnancy, and my body still reacted in unpredictable ways.
When listening to my body wasn’t enough
Take a recent Saturday afternoon doubles pickleball match I played during the end of my second trimester. It’s not something I do regularly, but doubles pickleball (a beloved pastime of senior citizens) is not the most strenuous of sports. I also instituted pregnancy rules: I was allowed to hit off of a double bounce, no one was allowed to serve too hard to me (or the point was mine), if I hit near the line, my ball was in. It felt great to slice, compete, talk trash, and spend an afternoon outside being active. When I was starting to feel tired, I told the group it was my last game. Way to set limits and listen to my body, right?
One hour later I was on the couch, depleted and horizontal. I was brain dead and exhausted from head to toe. Most troublingly, my hip joints felt like jelly. I could barely hoist myself off the couch let alone stand upright because I felt I couldn’t put pressure on the joints, like they were about to collapse underneath me. Recovery took days.
Pregnancy, of course, played a role. Dr. Sterling explains that lactic acid takes longer to clear during pregnancy, so your muscles might feel sore for a longer amount of time. Higher amounts of the hormones progesterone and relaxin make your joints and ligaments looser, so “they’re going to ache more because there’s more movement in them.” Running around for an hour until I got tired felt fine—fun!—in the moment, but it turned out to be more than my muscles, joints, and cardiovascular system could handle after the fact.
Pickleball wasn’t the only time I’ve felt let down by my limits: In month six of my pregnancy, I set out for a walk-run, which I had done multiple times. At around the 30-minute mark, pain exploded on my right side, and I had to stay off my feet for a week. Apparently, my stomach had gotten big enough that one of the ligaments around my uterus was simply not up to the task of supporting the bouncing load for half an hour anymore. Once I was recovered a few weeks later, I tried again, intending to stop well before the point where my side had started hurting. The pain came after just 10 minutes that time, and I had to limp my way home.
Then there’s the way I sometimes have to choose between having the energy to get exercise or get my work done, the pain in my feet that blooms when I’m wearing what are normally my most comfortable pair of walking shoes, the energy crash that happens at the farthest point of my favorite walking route despite feeling totally up for a walk of that length at the outset. In these instances, “listening to my body” has simply not been enough guidance.
My body and I have had over 30 years to develop our vernacular. I’ve learned how to tune in to the signals and feedback that tell me what kind of movement I’m in the mood for and for how long, whether I want to push through fatigue or give myself a rest, when I’ve had enough of an activity or when I’ve got another mile, another game, another set in me. But now, my body doesn’t always have the language to express what it needs. How is it supposed to say, “Hey, my joints are loose, my muscles take longer to recover,” when my joints and muscles haven’t behaved that way for the last 30 years?
Ideally, we’d be able to work with our doctors to keep us informed and feeling tip-top day in and day out, but Dr. Sterling says the fact that most OBs have just 10 minutes to see patients each appointment means “one size fits all” advice about what to do or not do is the most common type dispensed.
“We’re in an imperfect situation of how to really guide people,” Dr. Sterling says. “We have a paucity of data because back in the very paternalistic white male days of OB/GYN, the advice was, ‘Oh no, pregnant women, don’t exert yourselves.’ We were overly protective, I think. And so there were many, many years where no studies were done looking at this issue.”
Which leaves us with little more advice than listening to your body during pregnancy.
How to be a better ‘listener’
I’ve been surprised at how emotional I become in the moments where listening to my body hasn’t been enough. It feels like my body has betrayed me by giving out, or that I’m losing touch with my sturdy and spirited identity, my capability and my strength. It also feels like a personal failing, like I have been negligent in taking good enough care of myself and my growing baby in pursuit of, what, a temporary endorphin rush? How could I be so irresponsible?
« In pregnancy, our relationship with our body has to change, and this is really difficult, » Dr. Sterling says.
Though this period is temporary, how do we bridge the gap? I don’t have the ultimate answer, but I’ve instituted a few things in recent weeks that are helping me to stay active without beating myself up.
1. Be prepared for changes
The first thing I’ve learned is to roll with the punches and internalize the idea that pregnancy is an individual experience where the rules of the game are under a constant renegotiation. When I walked home at the end of that second failed walk-run, I felt dejected. But I also felt more resigned than the first time I got hurt, because it was simply time to face the fact that my belly was now too big to run with. Sure, Charlotte York could keep running in the Sex and the City movie when she was pregnant. But it no longer worked for me and my ligaments. Change: noted.
2. Notice how your body reacts, and reassess
I’ve learned to take stock of my body’s reactions. For instance, I stopped playing pickleball soon after I got tired. That’s the time frame I’d always used pre-pregnancy to know when to end a workout: When you feel tired, go a little bit more, then you’re done. Now, I know that formula is too much for me. I have to stop before the point where I get tired, and not wait until I’m waning. Taking lessons when things don’t go 100 percent to plan can help guide me for next time.
3. Get curious
Learning more about what’s happening « under the hood » has helped me have more compassion for my limits. I’m not just a delicate baby-making vessel who can’t do what I used to. I’m pumping more blood at a higher stroke rate in order to send nutrients to the placenta (which is a a whole new organ I grew, by the way), my joints are loosening to prepare me for the task of labor, my three centimeter–long cervix is having to withstand pounds and pounds of pressure it’s never had to support before. Increasing my knowledge about why my body might react differently than it used to is helping me become a more understanding and proactive listener.
4. Know you’ll be okay
Lastly, I’ve started to have faith in my resilience. When I strained my ligament, turned my hip joints to jelly, or found myself on the couch, I eventually got better. It’s never the goal to end up wrecked and in pain. But if you’re already making an effort to listen to your body, it’s not usually the end of the world, either. I’m lucky to be strong and healthy, and in this time where the ground is shifting under my feet, I’m not always going to feel great. But I’ll be okay.
