FIRST, THE BACKGROUND INFORMATION
In late April, my husband and I met with an obstetrician by recommendation of my primary care provider (we’ll call this obstetrician “Dr. C”). My paps had come back abnormal two years in a row and this year, a biopsy uncovered that some of my cervical cells had progressed to be pre-cancerous. Long story short, we met with Dr. C and we all agreed to try and get pregnant for a few months and treat the abnormal cells after the pregnancy (if we were successful conceiving).
FEAR OF A MISCARRIAGE
We were obviously successful getting pregnant (yay!) and I went back to visit Dr. C at 13 weeks. He wanted to follow me closely throughout my pregnancy to make sure the pre-cancerous cells didn’t progress to cancer.
As expected, Dr. C was kind and patient and a calm presence throughout our visit. He made small talk and we began discussing my training plans. He first asked if I had still done the half ironman the week prior (even though I was pregnant) – I explained that I did, albeit slower, and really enjoyed it. He then asked if I was planning to complete Ironman (even though I was pregnant). I answered that I was playing it by ear and would see how I feel. I explained that I felt great and hoped the trend would continue through 20 weeks (at least).
Then he dropped the bomb: he shared a story about a patient of his who trained for and ran a marathon while pregnant and had a miscarriage. He acknowledged that there is not strong evidence to support that exercise increases a woman’s likelihood of a miscarriage, but also noted there isn’t evidence that proves there isn’t a correlation. I shook off his comments and assured him I was working with my midwife to ensure me and baby stayed safe and more importantly I was confident in my ability to listen to my body and respond appropriately. He seemed appeased and we ended the visit scheduling a follow-up at 28 weeks with a promise that lab results would be back within a week.
Dr. C’s story was striking fear in me and my husband too. I shared Dr. C’s concerns with my husband and after my Saturday long bike ride. My husband first apologized “I’m sorry to ask this…but it will make me feel better to know…did you push too hard today?” I responded with a confident “no”. The day was tough, the toughest yet that season, but it wasn’t anything worse or different than last year. Biking for 60 miles is hard and, at times, not fun. Hard doesn’t mean bad. I responded confidently, but a seed of doubt was planted.
MY FIRST PRENATAL VISIT: EMPOWERMENT FROM MY MIDWIFE
Thankfully, the following Monday I had my first prenatal appointment with my midwife, the primary provider I’m seeing for my prenatal through postnatal care. I shared the details of my visit with Dr. C – both the medically relevant details and the comments that were causing me to second guess my activity levels. My midwife is wonderful at not giving direct specific advice unless necessary (for an example, read her advice in Concerns for Ironman Training while Pregnant). Instead, she is great at armoring you with information so you can make informed decisions for yourself. A good portion of our appointment that day was spent on this topic and resulted in me feeling empowered and confident in my athletic endeavors.
“[I] STRONGLY DISCOURAGE YOU FROM DOING IRONMAN PREGNANT”
After my midwife’s visit, I was feeling great again and not the least bit worried. The next day, however, I received my lab results. A nurse from Dr. C’s office called to share that my lab results remained unchanged from last time (good news); she also shared “Dr. C had a note here he wanted me to share with you. Upon further consideration, while Dr. C encourages you to stay active, he strongly discourages you from doing Ironman pregnant. The risk is too high.” I responded with a direct “Thank you for sharing; I have another provider who is overseeing my pregnancy and we are both confident in my continued training.”
I was livid! I wasn’t presented with any evidence-based research; I wasn’t told that Dr. C had done further investigation into medical journals on the topic; instead, Dr. C felt the need to share his alarming thoughts about my decision to train for Ironman – his arbitrary feelings or thoughts about my body and my pregnancy are not of much value to me.
RELYING ON MYSELF AND EMPOWERMENT FROM WITHIN
I did a lot of talk therapy after hearing Dr. C’s shocking advice. I talked to my aunt, my coach, several friends, and even over-shared at my local prenatal yoga class. All of the talking was helping and I could tell I was getting to a better, more confident place.
Within a few days of hearing Dr. C’s point of view, I discovered that fetal monitor dopplers were available online for $50-60. I became increasingly interested in making the purchase and decided to think about it for a few days before splurging on it. It would be so fun to hear the baby’s heart rate whenever we wanted. I remembered that one of my dear friends, a midwife, likely has a spare one – maybe I could just borrow it.
The following weekend this friend stopped by for lunch at a nearby coffee shop and we caught-up. She broached the topic of the monitor explaining why she hadn’t brought it. She asked about my intentions for the monitor suggesting I may want it to serve as a source of external resolve that the baby is OK. Using a monitor in that capacity may become a crutch bringing attention and focus away from listening to my body and self-awareness. I may begin inappropriately relying on this device to reassure me. She asked me to reconsider why I wanted to use a monitor while letting me know that if I decided I still wanted it, I could come by any time and get it.
I’m so grateful for this friend and her intuitiveness. She was right – I was looking for additional verification that baby was OK. If I truly felt good about continuing my training, I should do so without fear and without the need to hear my baby’s heart beat. I mentally removed the option of using a monitor and reassessed my comfort with continuing my training. I have this friend to thank for my new found confidence and comfort with Ironman training.