I was winded and nauseated, and I walked across the finish line of my 20th marathon about an hour slower than my recent time of 3:27. Something wasn't quite right. What a relief (and thrill!) when my pregnancy test came back positive. I ran five more marathons during that pregnancy, slowly, among friends. They were some of the happiest moments of those nine months.

When I was 30 weeks pregnant, my midwife agreed I could run the Copenhagen Marathon. Spectators screamed from street corners and hung out of windows to catch a glimpse of my belly. Around mile 16, I started getting Braxton Hicks contractions. They eventually became less pronounced, and I made it across the finish line in 4:54. My recovery from that marathon was long, but I was glowing for weeks. I received overwhelmingly positive feedback from women who had already run or went on to run their own marathons while pregnant.

After 39 weeks, our beautiful son was born. Even today, 10 months later, I can't help looking at him and thinking, “You were there with me all those wonderful miles.”—TRACY HØEG, MD, NÆSTVED, Denmark

COMMENTARY

Healthy pregnant women should be encouraged to get 30 minutes of moderate aerobic exercise, such as brisk walking, on most days of the week to achieve an average of at least two and a half hours per week of exercise.^1,2 Studies have demonstrated that moderate exercise is safe during a normal pregnancy.^3,4 Recreational athletes can maintain their usual exercise regimen as long as they are not at increased risk of pregnancy complications, such as second or third trimester vaginal bleeding, preterm labor, intrauterine growth restriction, or preeclampsia. Guidelines support the continuation of vigorous aerobic exercise in healthy pregnant women who were already engaged in such a program before pregnancy, but recommend that patients discuss the program with their maternity care clinicians.¹ Women who are sedentary when they become pregnant are encouraged to choose moderate rather than vigorous aerobic exercise.