Pro Triathlete Sarah Piampiano: Pregnancy as an Elite Athlete

Last week we shared part one of pro triathlete Sarah Piampiano's pregnancy journey. You can read about her first trimester, the changes that have happened so far, and what she has observed on her Ember device here.

Trimester Two - Week 13 through Week 26

Training:

Goal - Stay active and healthy

Hours Per Week:

Planned - 13-15 hours per week

Actual Training - 17-19 hours per week

Starting around week 11 (so towards the end of the first trimester) I began feeling MUCH better. My nausea was more manageable, and the fatigue that was just zapping my energy and motivation was returning. Mike and I returned from our trip across country at the latest possible moment, so the first week home was filled with doctor appointments as well as genetic testing. As soon as we got the OK that the baby was healthy and things looked good, Matt and I agreed we could ramp up my “training” a bit and also start weaving in some intensity. Like the first trimester though, we agreed to leave things fluid and open. It felt great to have the energy to actually follow a structured plan again!

As I began to ramp up my training there were a few things that I immediately noticed. First - my body seemed to have a natural limitor, meaning that it felt like there was an intensity/ effort level across swim, bike and run where my body just wasn’t willing to cross. Throughout the second trimester I have found this to be the case, and that limit-needle has continued to move as my pregnancy has progressed.

For example, pre-pregnancy I would typically hold 360+ watts for 1 minute hard efforts on the bike. When I returned to training at week 12, the same effort was more like 280 watts, and as I have continued along in my pregnancy, that number has shifted down closer to 240 or 250 watts. Similarly, pre-pregnancy I could hold 280 watts for a hard 20-minute effort, versus now I MIGHT be able to hold 210 watts on a good day. My endurance rides, which normally average 160-180 watts, are now between 130-140 watts. I have found this to be true on the run as well. During the early stages of pregnancy my body would let me run much faster than a 6:00 mile pace, which felt like a strong tempo effort. Soon that creeped down to 6:15, then 6:30, and now it is around 6:45. My endurance runs have declined from 7-7:15 pace to 7:45-8:15 pace. And while I don’t love the feeling of getting slower, I actually have taken a lot of comfort in the fact that my body will stop me from doing anything stupid or pushing too far.

I also have also noticed that as the second trimester has gone on, I have more and more days where my body just doesn’t want to give a whole lot. On these days running a 8:30 or 9’ mile is a struggle, or riding at 100 watts is all I can muster. I remember a day a few weeks ago when I averaged 79 watts on my ride and that was ALL I COULD DO. I could not have ridden any harder. These days are hard mentally because you feel awful and it is not that fun to be out exercising. Yet I frequently remind myself that the best thing I can do for my body and mind is to keep moving. It is not about performance and more about creating a healthy body and mind.

Given these limitations, it has been easy for me to “go with the flow”. I’ve been able to stick to my structured plan, but some days are better than others. Some runs call for tempo but my body just says run easy. Some days are a hard bike session, but they turn into a spin. The key for me is movement, even if the scope and structure of the session changes.

Before I was pregnant I always thought it was funny how other pregnant athletes would be training 15 or 20 hours per week and say they were not training, just “exercising”. I didn’t get it. I thought “how can you workout 20 hours per week and say you are ‘just exercising’?” I was too quick to judge!! Now that I AM pregnant, I understand this idea so much more. I really DO feel like I am just exercising. My effort levels, paces and outputs pale in comparison to when I am training full on, and my committed hours and intensity are much lower. Although 18 or 20 hours seems like a lot, it feels natural for what my body is accustomed to, and I really do feel like I am just moving vs. “training”.

On average I have been training/exercising/moving about 17-19 hours per week. This includes about 8-10 hours of biking, 2-3 hours of swimming, 6-8 hours of running, and 2-3 hours of gym work each week. I know this will decline as my pregnancy progresses, but for now this feels about right. During the second trimester I actually completed my longest single run ever (30 miles), and have done 1x 85 mile ride, with the goal of completing 1x 100 mile ride in the coming weeks. Riding 100 miles wasn’t that hard for me a few months ago, but now it feels like a true accomplishment. This is one fo the ways I’ve been trying to challenge myself. It may not be fast, and there are a lot more stops involved, but I like doing things demonstrate how amazing the human body is.

Diet:

My diet largely returned to normal once the first trimester was over. I’d say between weeks 12-14 food slowly started to sound good to me again. I also work with a company called Ixcela Wellness, which monitors gut health, and they were able to offer me some great suggestions of ways to improve my diet based on my first trimester gut health scores. I have become very conscientious about eating at least 100 -120 grams of protein per day to support both my growing nugget and the exercise I am doing. I have added in more fermented foods like greek yogurt, cottage cheese, Saurkraut and some plant-based yogurts. I limit my sugar intake almost exclusively to foods containing natural sugars (so no added sugar). I had read a number of research studies showing the impact of added sugar on brain development. The recommendation is eat no more than 30 grams of added sugar per day, but I generally try to stay far below that. In some ways I think it is the only thing that keeps my ice-cream addiction under control! I still eat ice cream for dessert 1-2 times per week. I usually have a square of chocolate per day, and in training I haven’t eaten a single processed/packaged food product since June. When out on the bike I often pack gluten free cream-cheese and mashed fruit sandwiches, or make my rice bars, which do contain maple syrup, but in limited quantities. I also carry bananas and use fresh squeezed pineapple juice as an electrolyte in my water bottles in place of powdered electrolyte formula.

I have very few food aversions now and can eat most things. Nut butters still don’t sound great to me, but I’ve been able to incorporate them into my oatmeal some days. Similarly carrots, which are a typical go-to snack for me, just don’t sound appetizing. Yet when I include them in salad or grill them up, I can eat them without problem. I still haven’t touched a rice cake since I became pregnant (and I usually eat about 6 per day!).

One thing that I have been very conscious of is water intake. One of the not so pleasant side effects of pregnancy is constipation (sorry for the TMI!), but I’ve found that drinking at least 10 large glasses of fluids per day (not counting what is consumed in training) helps keep that in check. Exercise, too, is vital to keeping things regular.

On average I’ve been eating 1,800 - 2,500 calories per day, depending on hunger levels and how much I’m exercising.

Weight:

Between weeks 12 and 20 my weight went down to 126, and then very slowly crept up. At week 20 I was at 128.5 lbs, but then between week 20 and 21, my stomach popped, and my weight shot up 3 pounds to 131.5 lbs, and between week 21 and 22, which is where I am now, I’ve gained another pound. My doctor says that weight gain comes in fits and starts and often corresponds to the baby’s growth spurts, but the goal from here on out is 1/2-1 lb per week of weight gain. Right now, at almost 22 weeks, I weigh 132.5 lbs, which is a 10-12 pound gain from my normal weight.

Energy:

On the whole I would say that I feel great and my energy is very good in day to day life. I often get more tired at night. I’m worthless after 7 pm, but during the day I am usually productive and feel great.

The biggest change I have noticed is my energy levels in training, which I talked about above. Some days I feel great, and others, just the simple task of moving is an accomplishment. I laugh because on the tougher days I think “I’m never going to last all the way through this pregnancy!!!”, and then the next day I might feel great and my mindset shifts to “oh, ok. - I’ve got this!”.

Main Pregnancy Symptoms:

Headaches

VERY broken and restless sleep

Low back aches

Slower digestion, so I’ve needed to eat more frequent, smaller meals (starting around week 19)

Dry eyes

LOTS and LOTS of pee stops

Higher hunger levels at night before bed (which means a regular pre-bed snack)

I will say that one thing I’ve really struggled with throughout my second trimester is sleep. On average, 1-2 times per week I wake up at sometime between 1 AM and 2:30 AM and cannot go back to sleep. That is it. I’m done sleeping for the night. Occasionally I’ll be able to get back to sleep for an hour or two at 5 in the morning, but typically I don’t, and I just get up and start my day. But, the lack of sleep really kills my energy for a few days and so that has been hard for me. I feel like in the grand scheme of pregnancy symptoms, this isn’t so bad, but its been hard for me to adapt to this nonetheless.

Cercacor Ember Device:

You can see some big changes in the trends of my Ember data between the first and second trimester:

Declining Hemoglobin - This is consistent with expectation during pregnancy. As blood volume increases (and eventually doubles), the amount of iron available in the body stays the same, causing hemoglobin to be less concentrated relative to blood volume and then falls. A common symptom of pregnancy is anemia, and so while hemoglobin values are expected to drop, women are encouraged to eat iron-rich foods and even supplement iron to mitigate this. I have not started taking any iron supplementation, but have increased foods rich in iron, including beef liver.
Drop in Resting Pulse Rate and a Cooresponding Increase in PRV - After week 12, I quickly felt my energy levels return, I was able to exercise with regularity and my diet improved. I think these changes relieved stress on my body and the adaptations to the pregnancy helped bring my resting pulse rate down and my PRV levels up. HOWEVER, you can see from the last chart, that in the last few weeks, as the baby’s growth rate has rapidly increased and more changes are taking place in my body, my resting pulse rate has started to creep back up, and my PRV levels have started to fall again, showing that my body is doing more work.
Steadily increasing Respiratory Rate - My resting respiratory rate has continued to steadily increase throughout pregnancy. This to expected as your oxygen uptake increases by 50% during pregnancy. To take up more oxygen, you need to breathe more frequently!

I’m really looking forward to seeing how the next 18 weeks go. Between weeks 21 and 25 the baby nearly doubles in size, and as the baby grows your lungs, bladder and stomach all become crowded. I think watching the trends will be fascinating as well as monitoring the changes in my body, diet, and training. I’ll be sure to keep you posted!