During what was classified as a high-risk pregnancy, a Utah mom received some advice she didn’t expect.
Just three weeks earlier, Isabelle Fisher had been ordered to stop working and placed on complete bed rest while doctors closely monitored her unborn daughter’s growth and blood flow.
But when her midwife asked her about the exercise routine she followed before pregnancy, the plan changed.
Isabelle Fisher holding her newborn.
“Honestly, I had the best midwife on the planet,” Fisher said. News week. “I had heavy bleeding during the first trimester and she was with me every step of the way as well, so I had complete trust in her in the decisions she recommended to me.”
Before the pregnancy, the mom-to-be mostly did powerlifting and was even considering participating in a powerlifting competition.
At 35 weeks, her midwife suggested she return to the gym, focusing primarily on upper body exercises while avoiding excessive strain on her pelvic floor.
The hope, she said, was that the movement might improve blood circulation in the umbilical cord.
Although exercise is not typically prescribed as a treatment for fetal growth restriction, Dr. Jeffrey Chapa, national medical director of maternal-fetal medicine at Obtelecare, said staying active is no longer discouraged in many pregnancies.
“Exercise can improve blood flow in some cases, primarily by improving vascular endothelial function,” Chapa said. News week. “For high-risk patients, its main benefit is to prevent complications by improving the metabolic profile, maintaining blood flow to the uterus and reducing the risk of diseases such as gestational diabetes and preeclampsia.”
When Fisher’s midwife cleared her to return to weightlifting, the main priority was making sure she wasn’t putting too much pressure on her pelvic floor and risking triggering early labor.
“The most important thing from my midwife was making sure I listened to my body,” Fisher said. “So I did occasional pelvic floor exercises to help strengthen it, but nothing that wore me out too much.”
Due to her high-risk pregnancy, Fisher was placed on bed rest at 32 weeks.
Her daughter was about four to five weeks overdue due to intrauterine growth restriction (IUGR), which she said was linked to a calcified placenta and poor blood flow through the umbilical cord.
She began twice-weekly monitoring, including non-stress tests and ultrasounds to assess blood flow.
Even though the baby continued to pass tests, she said concerns about blood flow and nutrient supply persisted.
She received steroid injections to help prepare the baby’s lungs for a possible early delivery, but at 35 weeks there was no improvement.
When she was put to bed, Fisher said her blood flow “decreased exponentially.”
“When I started lifting again, they saw a much stronger flow through the cord than they expected,” she said. “It came down to a race to see how quickly my placenta would calcify. Every ultrasound I had, they noted that everything was better.”
Chapa explained that Doppler measurements can vary from test to test and that improvement after resuming exercise does not necessarily mean that the exercise itself caused the change.
“Improved measurement after resuming exercise does not show that exercise is the cause,” he said. “This variability is exactly why high-risk pregnancies require constant and ongoing monitoring by experienced specialists.”
However, at 36 weeks, Fisher’s daughter failed a non-stress test for the first time, after passing nearly 15 before.
An ultrasound showed blood flow in the umbilical cord was the best doctors had seen, but the baby was moving less than usual.
Concerned that the placenta could no longer adequately support her despite the improved blood flow, Fisher’s care team recommended delivery. She was admitted to the hospital and induction began with Cervidil, followed by Pitocin.
“I labored for about 20 hours while my midwife checked on me regularly,” Fisher said. “But I wasn’t dilating well and my daughter wasn’t handling my contractions well either.”
After an emergency C-section, the family spent three weeks in the neonatal intensive care unit (NICU), with the baby requiring oxygen for two months.
During her six-week check-up, her midwife told her something she would never forget.
She believed that returning to the gym and lifting weights helped improve blood circulation and gave her baby what he needed in these final weeks.
Although she was born weighing 4 pounds, 5 ounces, Fisher said her daughter is now incredibly healthy.
“You couldn’t even tell she had a hard time coming into the world with how much she talks and runs,” she said.
Chapa said recommendations for exercise during pregnancy should always be individualized.
Women who exercised regularly before pregnancy can often continue with modifications, he said, but vigorous activity may not be appropriate when blood flow to the baby is already compromised.
Determining the cause of fetal growth restriction, whether it’s placental problems, an underlying condition, or simply a constitutionally small baby, requires a specialized evaluation.
Fisher hopes her story nonetheless challenges assumptions that pregnant women must automatically give up activities they enjoyed before pregnancy.
“I think we have lost the knowledge that women are capable of incredible things while becoming human,” she said.
Contact Newsweek editors about this story: Kara Dolman, Gray R.Thomas
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