Recurrent Pregnancy Loss

We just came back from a relaxing and fun week down south at the beach and I was settling back into the daily routine when my husband, Priyan, came back from walking the dog, Tyson, and asked me how I was feeling. I thought for a minute and realised how I was feeling in limbo. Not just because of the readjustment from the holiday vibe back to normal life, but because this is the first month we decided to try to conceive again after a 6 month break following two very emotionally and physically difficult miscarriages starting this time last year. Not being spring chickens (I turned 40 last year) we agreed we would give it one last shot.

Anyone who has actively tried to conceive might be familiar with the ups and downs of the two week ‘limbo’ window that falls just after ovulation and before the start of the menstrual cycle comes around again. Every twinge in your lower abdomen, a slightly stuffy nose, the tiniest wave of nausea or some sensitivity in your breasts might by a symptom of pregnancy, and the closer you get to the expected start day of your next period the more convinced you get. Then comes the disappointment when your period starts and you’re feeling a bit silly about the way you swore your body ‘just felt different’. Those two waiting weeks after ovulation are also paired with some major hormonal shifts leading to mood swings. Motivation and energy ebbs and flows. 

After such a difficult year of COVID, unexpectedly relocating to a tropical country half way across the world with a toddler in tow, and recurrent pregnancy loss, the idea of getting pregnant is scary. It has an impact on everything I do; dietary habits, sleep prioritisation etc, but mostly it has an impact on how I train. There is no reason why I shouldn’t train the way I always have (I love deadlifts and chin-ups), aside from perhaps de-loading during the last week of the menstrual cycle to account for the hormonal shifts making me feel tired and sluggish. But now, after ovulation, I’m scared to lift heavy; scared that too much pressure on my lower abdomen might cause a potentially implanted egg to come away from the uterine lining. There is absolutely NO EVIDENCE to support the idea that exercise – even high impact movements – is related to miscarriage, but I’m taking a risk/reward approach and tone down to intensity for those two weeks – just in case. Emotions play a huge part in making your desires and beliefs come true*. I would not advise someone I am coaching that lifting weights poses any kind of risk when you are trying to conceive, because I know it’s not correct, BUT I would listen to her concerns and programme according to what she feels comfortable with. She really doesn’t have to be setting PBs at this stage in her life if she’s even questioning it.

So when you hear me say ‘it depends’ in response to a question on how to train after recurrent pregnancy loss when trying to conceive; that’s why. It’s not simply a case of there being no evidence that exercise can cause miscarriage. It’s unhelpful to be told that you can ‘do what you’ve always done’, or ‘listen to your body’. It’s goes far deeper than that; it’s facing the demons and listening to them and saying ‘OK, cool, you’re scared, let’s work around that and not give up doing what you love’.

If you have experienced/or are experiencing pregnancy loss, I’m so sorry – and please reach out to me if you would like some personal support. If you are looking to return to exercise, I can coach you in a 1-1 environment if being around pregnant ladies and babies is too difficult for you right now.

Here are some resources that have really helped me deal with the grief and recovery: 

Websites:

www.twopeaswellness.com/resources

Instagram:

@Psychedmama_

Maryam Refai , Psychologist BSC (Hons). MPhil (Clin Psych), CPD

Mama’s Mental Health Evidence Based Approach to empower and support Mama’s

@isiktlabar

Isik Tlabar, Empowerment Coach

1:1 Coaching & Breathwork

Books:

*Breaking the Habit of Being Yourself by Dr Joe Dispenza.

Training While You’re Trying

It can be confusing to know what to do about diet and exercise when you are trying to conceive or have experienced recurrent miscarriage.

When you are trying to conceive (TTC), it is an ideal time to prepare your body to be strong and healthy for the demands of pregnancy and motherhood. Pregnancy places extra stresses on your body as you become heavier and your body is learning to adapt to all of the physical and physiological changes. Then at the end of the pregnancy you may be in for some endurance training throughout the labour and birth process too!

TTC is the time do away with any notions of exercising to burn calories. It’s time to consider exercise as part of your overall self-care programme. A self-care programme in itself is an excellent habit to get into and one you can learn to commit to through out pregnancy and perhaps more importantly once you become a mother because you may find yourself needing that space at times! The earlier it becomes part of your routine, the better placed you will be be to come back to it after birth with all the new demands that being a new mother brings and later to role model the importance of self-love to your child.

We are told that we should exercise because it is healthy for both the mother-to-be and the baby but we are not given any real guidance on what kind of exercise is safe or how hard we can – or should not – push ourselves. We do know that increasing levels of lean, metabolically active muscle mass encourages healthy body fat levels and insulin responses and may reduce the risk of both infertility and gestational diabetes. Research has shown that overweight women are less likely to ovulate or spontaneously conceive, and upon conception, have an increased risk of miscarriage. However, excessive exercise and calorie restriction can also lead to a reduction in frequency of ovulation, poor endometrial development, amenorrhea and sub fertility (https://journals.physiology.org/doi/full/10.1152/physrev.00023.2015)

Exercise burns calories which is beneficial if you are looking to maintain good body composition (healthy levels of body fat and lean muscle mass), but on the other hand you want your body to be a safe and healthy, welcoming environment to grow a tiny human being. Therefore you will want to avoid being in any kind of calorie deficit, as this can negatively impact your hormones when it comes to fertility. While TTC is not the time to be pushing yourself in HIIT (High Intensity Interval Training), there is still a huge benefit in increasing your cardiovascular fitness and strength to be able to meet the added psychological and physiological stress that comes with TTC and pregnancy as well as the demands that pregnancy and labour place on your body! 

Aerobic activity also helps get a better night’s sleep (http://www.sciencedirect.com/science/article/pii/S1755296611000317 ). Regularly scheduling rest and recovery sessions for eliciting the parasympathetic nervous system is a great way to relive everyday stresses. High bio markers of stress have been linked with a longer time to pregnancy and increased risk of infertility (https://academic.oup.com/humrep/article/29/5/1067/2913997)

So what can you do?

Depending on your training history, you can do some high intensity cardio (HIT) if you are used to doing it and you can also integrate some medium intensity cardio (MIC). Previously the recommendations for pregnancy cardio were not to allow your heart rate to go above 140BPM but this is outdated advice and now the general rule during pregnancy is breathy but not breathless (to ensure adequate flow of oxygenated blood to the uterus).

Much of the focus can be on building lean muscle and maintaining healthy levels of body fat. Specifically through movement patterns such as the hip hinge, lunge, squat for the lower body (protect the lower back when picking up/putting down the baby, get up from and down to the floor), press and pull for the upper body (push the buggy, strengthen the back to mange the weight of the breasts and abdomen) walking and rotation (carry baby, groceries etc)

  • Reduce the pressure on your lower back, for example by learning how to disassociate the spine from the hips through movements such as the ‘hip hinge’. Lower back pain is very common during pregnancy, as the weight of the uterus can increase the lordotic curve in the spine, compressing the vertebrae and nerves within the spine.
  • Strengthen the core. The muscles of the core stretch and weaken as the abdomen expands to accommodate the growing embryo. By staying connected to the transversus abdominis (TA) muscles, you will maintain strength in the core and reconnect more easily with them after birth. We train the core in such a way that does not restrict us from enjoying our work out (i.e. we do more then lying on our backs doing kegels) but is mindful of not putting pressure on the Linea Alba, which is the connective tissue between the rectus abdominis (6 pack muscles), and can impact the shape of the tummy after birth. 
  • Strengthen -and relax! – the pelvic floor muscles. Much like the the stomach muscles, the pelvic floor gets weakened by the weight of the uterus which sits on a ‘sling’ of muscles in the pelvis. It’s important to maintain strength in these muscles for urinary continence and to avoid issues such as pelvic organ prolapse. It’s also important for the birthing process that we learn how to relax these muscles too.
  • Reduce the effect that pregnancy can have on the upper back. Our bodies become out of balance with the weight and changes to the anterior -or front – of the body (increase in breasts and abdomen) so often we risk having more rounded shoulders. So we work on strengthening the back to help prevent pain which could result from poor posture.

The main thing to keep in mind is that your body is the environment in which your baby will grow. That includes activity, nutrition and stress. In addition to promoting healthy body composition (body fat and lean muscle mass). Your exercise programme is designed to improve posture and alignment, increase strength and prepare the core and pelvic floor for pregnancy. It also promotes a positive body image and releases feel good hormones to level out all those other psychological changes. Exercising and staying active when trying to conceive can help ease stress and improve sleep which is essential for keeping hormone levels where they should be.

Losing your identity after becoming a mother

I loved becoming a new mother. I was all consumed by the newborn, the new skills, the new mum friends asking advice and keeping each other sane during the sleep deprived days. 

Life literally revolved around motherhood 24/7 for months – no – years. 

But as the novelty of the role of new mother wore off, I was gearing up to carry on the role of mother and have more babies but that has led to experiencing 3 devastating miscarriages in the past year. So after staying in Sri Lanka due to COVID, taking time to grieve and settling into a new life here, I find myself with nagging questions at the back of my head asking who am I? What am I going to do with my life? Look at all these people I know who have amazing careers as well as being wonderful mums. 

Now that my baby is no longer a baby, there’s a kind of identity crisis. I gave up my job to become a full time mum. Should I go back to working as a women’s coach (my dream)? …in these strange social distancing times… in a new country where I am immersing myself in a different culture. 

Caring for my little one was the easy part …now caring for myself is the difficult part!

I figure that there must be many mums out there who go through an identity crisis because we have forgotten how to prioritise ourselves and live our dreams and aspirations. I did a quick Google search on mums losing identity and found plenty of suggestions on self-care and finding new hobbies but it all sounds like distractions from the real question underlying it all.

Who am I? 

I am not just a role I played at a company working to build someone else’s dream; I am more than just someone who can keep a house clean and cook meals. I am someone who loves to feel the exhilaration of waterskiing or learning to surf. I am someone who wants my little boy to be a happy and free soul. I am someone who wants to work with women to help them feel more connected with themselves and their strength in both body and mind.

So whoever I am. Coach. Mother. Wife. Daughter. Friend. 
In the end, identity is just another label which limits the perception of ourselves or any other person as a whole being.

Pre- & Postnatal Coaching at Kinetic

We’re super excited to inform you that we have taken on pre and postnatal specialist from the UK, @jen_de_mel, to join our @kineticfitmove teaching team. It’s so important to stay fit during and after your pregnancy, especially because it fights a number of issues including depression.

Jen will be conducting semi-private group sessions in both prenatal and postnatal categories– slide into our DMs for further information. 🤰✨

Connecting the breath in Cat/Cow

I’ve been working with mums to align the breath with movement particularly when activating the core, to strengthen the connection between the pelvic floor, lower back and abdominals. 
Here’s how to to align the breath in the Cat/Cow exercise:

COW 
In table top position, with toes tucked under, place your hands under your shoulders, place your knees and feet hip distance apart, press your hands into the ground and imagine you are lifting your knees away from the ground.

INHALE: soften the belly and let it relax out. Keep your shoulders away from your ears as you pull your chest forward and up. Lift the head to look forwards.

CAT 
EXHALE: Use the exhale to initiate the contraction, squeezing the pelvic floor muscles and start to bring the navel towards the back of the spine, keep curling the pelvis to round your lower back. Allow the movement to continue doming the whole back as you push the floor away and allow the head to drop, forcing all of the air out with a deep contraction of the abdominal muscles.

5-10 rounds at the start of a workout or even just to start the day with a little movement and breathing.