Emily Oster

8 min Read Emily Oster

Emily Oster

Staying Active, Starting Again

Exercise in pregnancy and postpartum

Emily Oster

8 min Read

Today on the podcast, I speak with Megan Roche, a doctor and researcher who specializes in female athlete health, an ultramarathoner, a running coach, and a mom. I wanted to talk to Megan because I get a lot of questions from you all about exercise in pregnancy and postpartum. What’s safe to do and what is not? How do I get back to what I was doing before? How do I know what is too much or too little? Megan works on this from a research angle, from a coach angle, and from a mom angle. I thought she’d be perfect. 

This conversation is about exercise — and we do nerd out a bit about the value of carbohydrates in running, why women’s health is understudied, and whether I should do an ultramarathon — but the ideas we discuss go beyond just sports. It’s really about how to think about returning to the things you love to do post-children, whether that involves 100-mile trail runs or learning to paint. I hope you enjoy it!  

Is exercise safe during pregnancy?

Emily Oster:

When I talk to people in this space, I think the science is very confusing, because you simultaneously get the “exercise is really important in pregnancy, it prevents gestational diabetes, it has all kinds of other [benefits]” and then the piece that’s like, “don’t lift anything or let your heart rate go above 140.” And people will often be like, “But that’s what happens when I exercise. Of course my heart rate is above 140.” So what do we know about this?

Megan Roche:

That’s a great question. Well, the 140 is a curious heart rate measurement that came back from 1985 from the American College of Obstetricians and Gynecologists. And it’s curious to me because I feel like whenever I hear a number, I’m like, where did that number come from? And 140 seemed awfully convenient. It was like this round number that we’re going to toss out there into the universe.

Emily:

It’s like everything in science where you’re just like, nothing in the world works like that. How could it be that exactly at 35 your fertility falls off a cliff? That seems wrong.

Megan:

Yes. Exactly.

Emily:

And it actually is wrong.

Megan:

It’s wrong. Plus, in pregnancy, heart rates are so variable. Resting heart rate goes up in pregnancy and maximal heart rate goes down. A pregnant athlete is totally different from a regular athlete. 

And so back in 1985, that 140 heart rate recommendation — which is this number out of the sky — they’re like, “Okay, this feels reasonable. Let’s start here.” And fortunately, the ACOG has backed off of that 140 recommendation now with the idea of, okay, let’s keep exercise feeling reasonable, let’s think about conversational efforts. Let’s go generally by effort more than heart rate. And it’s been refreshing to see that.

But I think there’s still a lot of work to be done and there’s a lot of confusion in this space of, okay, what is safe to do as an athlete? I think for me as a coach, I just want athletes to feel empowered to be in pregnancy and feel like they’re moving their body and enjoying it and not having it be an additional stressor, because there’s enough stressors as there is in pregnancy, and it’s like, let’s have exercise be this place of embracing mental health and embracing what we can do without all these additional vague stressors.

How can you prioritize exercise during pregnancy and postpartum, if it’s important to you?

Emily:

People ask me all the time about: how do I get back to exercising when my kids are little? They’re like, “Oh, you run so much.” I’m like, “Yeah, my kids are 12 and 8. I just leave.” I leave and it’s fine. They watch television. 

But there’s another piece, which is, if this is something that’s important to you, it’s something you should build in. And you should say, “This is something I need to prioritize because it’s something I want to do.” And that’s okay. It’s okay to say this thing is important to you.

Megan:

Running and endurance focus is my job, it’s my career, it’s my life. And I got so much pushback from family and friends. I even had, as I was leaving the hospital, a lactation consultant tell me that I should be in bed for three weeks after giving birth, which to me seemed very counter to general recommendations and guidelines. I like athletes to get up and get moving, within reason. I feel like there’s these societal pressures.

And each comment like that, it’s hard. It’s hard to endure when you care about something. And I think I’ve gotten better. It was hard to go through this, but as I’ve coached athletes, I’m like, no, this is important. I need to emphasize the importance to me and that it matters and it makes me a better mother and parent by getting out there and doing this. And I think it’s really helpful for me to have gone through this process and had to speak up for myself on it.

Emily:

Yeah. My first pregnancy I had an OB who I had a complicated relationship with. Then in my second pregnancy I had a midwife, and one of the things that was much better about that experience is she just listened much more to the things that were important to me. And so, actually, I was running the entire time and she’s the one who was like, “Hey, maybe you need a support belt and then you won’t have to pee quite as frequently.” I remember that so vividly. I was like, okay — I told the person this was important to me and then they’re helping me achieve that rather than telling me, well, stop running because it’s dumb.

Megan:

I love what you say about the belt. Because I feel like there’s also some little suggestions that go so far. And I think that the more that we have education on postpartum exercise and even exercise during pregnancy, those little suggestions might be the difference for someone to get out the door versus not to get out the door. And I think the more that we can have these different avenues of spreading information, the easier it will be. And we can raise the numbers — 40% of pregnant women are active. And I think it’s these little, small suggestions and people doing the good work to make it easier to get out the door that’s really going to be helpful.

Why don’t we have more data on women’s health, in general?

Emily:

I think this is everywhere in [women’s health research], and it comes up in this very extreme way in exercise. For example, people sometimes cite this idea that every extra pound of weight costs you two seconds a mile. It’s from some study in the 1970s. There are a lot of problems with that study, but it’s also just men. And it’s always just men. Every one of these things is just men. And why are we only studying men?

Megan:

It’s so hard. For a long time, [there was] the idea that women athletes obviously have the menstrual cycle, and the menstrual cycle can cause a host of confounding variables of things, like temperature and metabolism and cardiovascular changes, [so] that if you included a group of female athletes, you would have to control for the menstrual cycle to get good data. And sometimes it’s just hard to do that. So that makes a little bit of a sense, but it can’t be the reason that we exclude female athletes. 

If a researcher chooses not to study female athletes, I think they need to clearly state that in the abstract and clearly state that in the methodology and explain why they didn’t do that. Because it’s shocking the amount of research right now where we’re extrapolating from male athletes to female athletes, and it’s like, so many of these principles just don’t hold. It’s really challenging and it puts women athletes at a great disadvantage in terms of how they’re supported from a scientific standpoint.

Emily:

And I think it is in some ways the same class of reasons that we don’t include women in a lot of other studies, which is like, “Well, they might get pregnant. What if they’re breastfeeding? Their menstrual cycle is weird. They’re just not simple.” Men, it’s always the same. Just the same, same, same all the time. And women are interesting and complicated, and that’s hard to include. 

And actually there’s been a fair amount of change in this over time, but it’s still true when we ask about things like drug trials or vaccine trials, they almost always exclude women who are pregnant or breastfeeding. And I think the place we saw this in the most extreme way was in COVID, where they basically excluded pregnant women from the vaccine trials for some ethical reasons. But then it turned out that was probably the population that would benefit among the most from the vaccine, and then people were afraid to do it because they weren’t included in the trial. So there was a real human cost to that exclusion that I wish we had thought about more in advance.


Full transcript

This transcript was automatically generated and may contain small errors.

Emily Oster:

This is Parent Data. I’m Emily Oster.

I ran my first marathon earlier this year and someone asked how comparable that was to labor, and of course I had an answer, which was that labor is more physically painful, but you can’t stop, so you’re not forcing yourself to continue, whereas the marathon is really painful and you have to decide to continue. This is all to say I’m very interested in running, I’m interested in pregnancy, I’m interested in parenting, and I’m often interested in how they intersect. I get a lot of questions from people about how they can continue a movement practice, and that could be running, but it could be Orange Theory, or it could be walking, or it could be yoga. How they can continue that when they’re pregnant and afterwards. And it’s not just, and in fact, it’s almost never because people want to stay in shape or lose the baby weight.

It’s because people feel like themselves when they engage in these things. And it’s one of the many things that we can often feel like we lose when we have kids. My guest today, Megan Roche, is a researcher at the Stanford Center on Longevity. She has a focus on bone health and the genetic predisposition to injury. She also spends a lot of time thinking about what makes the female body different from the male body in athletics and how little we know about women’s bodies in sports and in general.

She’s also, I will say, just an absolute machine as a runner. She’s a five times trail running champion. She’s a six time member of Team USA. She’s a running coach. She hosts the Some Work All Play podcast, which I love. Megan and I are both athletes and we realize not everyone listening is, but I think that this conversation is universal for anyone who thinks about or has had the experience of having pregnancy just completely knock you sideways. You think you know what your body is, you think you know what it can do, and all of a sudden it’s different and you got to learn it again. And the good news is that often you come back and learn it, and it’s even better than it was before. We talk about bodies, our relationships with our bodies, some thoughts about getting active, and we hit Megan’s extra spicy take about running strollers. After the break, Megan Roche.

Megan Roche. So nice to have you. Thanks for joining me.

Megan Roche:

It is so amazing to be on here. Emily, I read the ParentData newsletter all the time and so it brings me great joy to be on here.

Emily Oster:

And I love you. I love your podcast. I want you to tell everybody here who you are.

Megan Roche:

Thanks. Thank you for listening. It’s such an honor. Oh my gosh. So yeah, my husband and I we host the Some Work All Play Podcast. It’s a lot of running and jokes and humor on there, but also some science and hopefully some strong data mixed in there. Emily, as you say you listen to it, I’m like, I hope it’s rigorous, I hope it’s strong.

Emily Oster:

It’s good. It’s good and full of science.

Megan Roche:

Perfect. But in addition, I’m actually a researcher at Stanford, so I work for Stanford’s Female Athlete Science and Translational research program, which is part of the Wu Tsai Human Performance Alliance. So I do research on female athletes. A lot of things related to bone health and menstruation and pregnancy and so this is a really fun topic for me today. And then I’m also an athlete and a coach myself. And so I work with athletes of all backgrounds, of all disciplines. Primarily track, road, ultra athletes, and then many pregnant athletes as well so this is a fun conversation.

Emily Oster:

I am excited. Okay. We’re going to talk today about science, data, women in sports and in movement in general. I have three areas that I want us to touch on so I want to talk about pregnancy and postpartum exercise activity. I want to talk about some of the research on under-fueling and RED-S, which I know is part of what you work on and I think people will be interested in. And then I want to talk about this general question of why isn’t there more research on ladies in sports and other areas.

Megan Roche:

That’s amazing. What a good combination of topics. That’s awesome.

Emily Oster:

It’s a good combination. And I will say I think that obviously I really like running. People who listen to this know about my love of running. But I actually think there are huge lessons here for people who aren’t trying to run trail ultras. Like you run because many of these issues of how do I return to whatever I was doing, movement-wise, postpartum, or how do I think about movement in pregnancy? These are just … Many people have these, even if they’re not trying to run 100 miles.

Megan Roche:

I love that point. I also too … I struggled. Actually in pregnancy I had myocarditis in my heart and so I went through several long periods of time where I couldn’t exercise or train. And coming back to exercise or training for the first time, it was so eye-opening to me how different it felt coming back for the first time. And I think it gave me the compassion empathy for anyone out there starting exercise and how amazing it is, but also simultaneously how challenging it is too. And so it’s fun to speak to all different audiences of women just starting exercising and athletes out there that are training for 100K, 50K races. It’s almost ubiquitous in terms of what we feel. And I think going through that, going through that return to run journey myself gave me so much compassion for that.

Emily Oster:

Totally. Okay. So let’s start with the pregnancy postpartum. So when I talk to people in this space, I think the science is very confusing because you simultaneously get the exercise is really important in pregnancy, it prevents gestational diabetes, it has all kinds of other things and then the piece that’s like don’t lift anything or let your heart rate go above 140. And people will often be like, “But that’s what happens when I exercise. Of course my heart rate is above 140.” And I want to think about what do we actually know about this? So what do we know about this?

Megan Roche:

That’s a great question. Well, the 140 is a curious heart rate measurement that came back from 1985 from the American College of Obstetrics and Gynecology. And it’s curious to me because I feel like whenever I hear a number, I’m like, where did that number come from? And 140 seemed awfully convenient. It was like this just round number that we’re going to toss out there into the universe.

Emily Oster:

It’s like everything in science of this where you’re just like, well, how could it possibly be exactly 1500 grams or exactly … Nothing in the world works like that. How could it be exactly at 35 your fertility falls off a cliff? That seems wrong.

Megan Roche:

Yes. Exactly.

Emily Oster:

And it actually is wrong.

Megan Roche:

It’s wrong. And plus in pregnancy, heart rates are so variable so resting heart rate goes up in pregnancy and maximal heart rate goes down. And so a pregnant athlete is also totally different than a regular athlete. And so back in 1985, that 140 heart rate recommendation, which is this number out of the sky … They’re like, “Okay. This feels reasonable. Let’s start here.” And fortunately, the ACOG has backed off of that 140 recommendation now with the idea of, okay, let’s keep exercise feeling reasonable, let’s think about conversational efforts. Let’s go by generally effort more than heart rate. And it’s been refreshing to see that back up in terms of let’s rewind from 140 beats per minute. But I think there’s still a lot of work to be done and there’s a lot of confusion in this space of, okay, what is safe to do as an athlete? And I think for me as a coach, I just want athletes to feel empowered to be in pregnancy and feel like they’re moving their body and enjoying it and not having it be an additional stressor because there’s enough stressors as there is in pregnancy and it’s like, let’s have exercise be this place of embracing mental health and embracing what we can do without all these additional vague stressors.

Emily Oster:

Yeah. And without stressors on either side. I think this is a thing which can be there in both directions. I know it’s really important to do I guess, but also somehow there’s no way to come to a happy medium except there is a way to come to a happy medium, which is to do what feels appropriate and think about not injuring yourself.

Megan Roche:

Exactly. Yeah. And so where I start with athletes is I think … So the current recommendations right now is if you can get 150 minutes of aerobic exercise in per week, that’s amazing. And when you break it down, that’s 30 minutes, five times a week. And I think for athletes that are just building into exercise, that can be something that can be attainable to work to during pregnancy so you can build up to that incrementally. And then for elite athletes, there often tends to be this more nuanced conversation of what is safe to do. And I think those individual conversations with coaches, with athletes, and with doctors are really important just to allow elite athletes to also feel empowered that this is not a nine-month shutdown of the body. That we can keep training and building and progressing forward. Because in reality, so many elite athletes go on to actually have really strong performances postpartum, and it can be a really beautiful time to build a foundation of strength and resilience within the body during pregnancy.

Emily Oster:

Again, it feels like all of these things during pregnancy where somehow we’re looking for an answer. We’re looking for a one size fits all. Like, okay, you can do this or you can’t do that with no nuance. And exactly what you just said was, if you are someone who never exercises, there’s going to be one answer. The answer isn’t going to be like, this is the best time to train for your first marathon because there are reasons why you might be more likely to get injured. Your ligaments are looser. You’re not going to want to run 100 miles a week if you’ve never done that before. But if you’re someone who does run a hundred miles a week, maybe you don’t have to cut down. You certainly don’t have to cut down to nothing. So it’s like somehow we’re looking for an exact answer and what we’re finding ourselves is there probably is no exact answer, but there also isn’t enough data to tell us what the answer is. This comes up every place.

Megan Roche:

Exactly.

Emily Oster:

Not just in exercise.

Megan Roche:

Yes. Plus it’s also really hard if you think about it. I actually extend a lot of compassion to researchers that have studied women in pregnancy or postpartum is most of these data that we have come from retrospective studies. So we’re looking back at what pregnant women have done. Very few of the studies have been done looking forward or evaluating athletes or people that are currently going through pregnancy. And so it also becomes very tricky to parse out what’s what.

And I think when I get down to it, I think these conversations need to be really unique and nuanced for each athlete, for each person that’s thinking about exercising. It’s hard because it’s like when we’re trying to ascribe data or recommendations or guidelines, we have to start somewhere. But I think going forward, I would love for there to be, okay, here is a guideline. And I think we’re at that spot of let’s think of reasonable exercise, let’s think of conversational pace. But I also think there needs to be wiggle room and more discussion surrounding elite athletes and surrounding other alternatives and provide just that nuance that every pregnancy is going to be different. And also every pregnancy within an individual is going to be different too. I’ve seen some athletes train beautifully through the first pregnancy and then the second pregnancy is so hard and it’s just impossible to predict, I think, until someone goes through it.

Emily Oster:

So there’s the pregnancy piece and then there’s this postpartum piece. And actually I would say in pregnancy, I get this one question which is, what about 140? 100% of the questions are what about 140? But the postpartum piece is a much richer set of questions because everyone effectively goes to zero. So whether you are an elite athlete or you’re someone who just occasionally gets out to walk or ride your bike or swim or whatever it is, you are going back to zero. And then people want to figure out how do they build back to something. And I also think we don’t know anything about this.

Megan Roche:

Oh, for sure. And I think we’re not really collecting data on this either, because if you think about the system … I remember going in … I have a 14-month-old. And I went in for my six-week postpartum check. And I was seeing a pelvic floor PT at the time, and she was so amazing doing rigorous checks, we’re going through the process, but not many people have access to that. Whereas at my six-week check, it was just like, hey, hi, I think you’re good. And it really wasn’t gathering the information or the data or even doing a heavy internal exam to know how things were in terms of my pelvic floor. And so I feel like we just need to collect more robust data for women postpartum to guide these recommendations. But for right now, I feel like it’s almost similar to pregnancy recommendations where it becomes just a very nuanced conversation based off of an athlete’s goals and how things are feeling. But I just wish individuals and athletes had more access to pelvic floor PTs where you can have more regular meetings and more regular check-ins. Or even if we could establish that within the classic gynecology check-ins. OBGYN check-ins. That would be amazing.

Emily Oster:

Yeah. One of my soap boxes. I have doulas, that’s a soap box. And then I have pelvic floor PTs because I think that this is something everyone … Even if you are never going to run ever, you didn’t run before, you’re not running, you’re never doing any sports, you should still see a pelvic floor PT because it’s not normal to pee on yourself and a lot of people do, and this should be part of the standard of care for everybody.

Megan Roche:

Actually for me, I’ve been an athlete my whole life and I feel like I’ve gone through rigorous training and I’ve gone through and done a bunch of mileage now as an endurance athlete. And when I went to the pelvic floor PT, I actually couldn’t activate my pelvic floor muscles. And to me it was so eye-opening that this is not just about postpartum health, but also think about things like back injuries and hip injuries and things like that. And I was like, oh, I wonder if there’s some connection here because I literally have no ability to activate my pelvic floor muscles. And it was a very eye-opening experience for me. I don’t think I quite realized the importance of pelvic floor PT until really even having gone through it.

Emily Oster:

Yeah. Totally. Everybody get a pelvic floor PT.

Megan Roche:

Oh, it’s amazing. And if you can, I think advocate for yourself at the OBGYN. And what I tell athletes too is I think sometimes athletes are afraid to speak up about what they’re passionate about. And if you’re passionate about exercise and passionate about returning back to sport, advocate for yourself. Treat yourself like an elite athlete because you are, because you’re exercising, because you’re putting yourself out there. And I think doctors will hopefully give you more compassion and more time and understanding if you advocate for yourself in that way.

Emily Oster:

Yeah. I think this is a place where I would draw such a strong connection between what I think people should do if they are thinking about sports and what they’re doing in general. That basically when we have a baby, it is so easy to just put everything that is you down at the … And you should in some ways. Of course when you have a little infant and you have kids, your kids are the most important thing, et cetera. But when we forget that there are also things that we cared about before that we would like to get back to, then we aren’t maybe serving even our kids as well as we could because we’ve forgotten that piece of ourselves. And a lot of times we’re not talking about those things and we’re not saying that they’re important and so then other people can’t help us achieve them.

Megan Roche:

I love that point.

Emily Oster:

It could be your OB. It could be your partner. People ask me all the time about how do I get back to exercising when my kids are little? The first thing I always say … They’re like, “Oh, you run so much.” I’m like, “Yeah, my kids are like 12 and eight. I just leave.” Leave and it’s fine. They watch television. But there’s another piece which is if this is something that’s important to you, it’s something you should build in and you should say, this is something I need to prioritize because it’s something I want to do. And that’s okay. It’s okay to say this thing is important to you.

Megan Roche:

Yeah. I love that. And it’s hard because I went through this and running and endurance focus is my job, it’s my career, it’s my life. And I got so much pushback from family and friends. And I think there’s almost the societal pressure of what are you doing? And I even actually had, as I was leaving the hospital, a lactation consultant tell me that I should be in bed for three weeks after giving birth, which to me seemed very counter to general recommendations and guidelines. I like athletes to get up and get moving within reason. And I just feel like there’s almost these societal pressures. And each comment like that, it’s hard. It’s hard to endure when you care about something. And I think I’ve gotten better. It was hard to go through this, but as I’ve coached athletes, I’m like, no, this is important is I need to emphasize the importance to me and that it matters and it makes me a better mother and parent by getting out there and doing this. And I think it’s really helpful for me to have gone through this process and had to speak up for myself on it.

Emily Oster:

Yeah. My first pregnancy I had an OB who I had a complicated relationship with. I wrote a whole book about it. Anyway. Then in my second pregnancy I had a midwife and one of the things that was much better about that experience is she just listened much more to the things that were important to me. And so actually I was running the entire time and she’s the one who was like, “Hey, maybe you need a support belt and then you won’t have to pee quite as frequently.” So it was just a little bit of someone. I remember that so vividly. I was like, okay. I told the person this was important to me and then they’re helping me achieve that rather than telling me, well, stop running because it’s dumb.

Megan Roche:

And it’s amazing too. I love what you say about the belt. Because I feel like there’s also some little suggestions that go so far. And I think that the more that we have education on postpartum exercise and even exercise during pregnancy, those little suggestions might be the difference for someone to get out the door versus not to get out the door. And I think the more that we can arm practitioners and arm coaches and even just societal messaging. Emily, you do such a great job of this. I’ve learned so much more about pregnancy and postpartum care from you than I have from any provider that I’ve ever seen. And I think the more that we can have these different avenues of spreading information, the easier it will be. And we can raise the numbers. 40% of women I’ve seen. The numbers vary based off where you see them, but 40% of pregnant women are active. And I think it’s these little small suggestions and people doing the good work to make it easier to get out the door that’s really going to be helpful.

Emily Oster:

Yeah. And also emphasizing to people getting out the door to take a brisk walk. When we talk about starting exercise, which I think can be an enormous challenge … It’s an enormous challenge in pregnancy, it’s an enormous challenge after to just give people little pieces of things that help them, that make it possible to do this and it’s worth a lot.

Megan Roche:

I love that. Yeah. I think for me, generally what I do for athletes is I have them return to a crash training usually two to three weeks postpartum, sometimes earlier depending on the athlete. And then six weeks is that gentle run, walk. And for every athlete it’s run, walk. And it’s really helpful I think just to ease back in so gradually. And then sometimes it varies too. Six weeks is the earliest I bring athletes back to run, walk. Sometimes it’s 12 weeks, sometimes it’s 18 weeks. And I feel like the more that people and athletes can have these individualized conversations about what does this return to look like? And it’s okay. If you’re 12 weeks and your friend is six weeks, that’s totally okay too because pelvises heal at different rates and different modes of delivery, so many different complications. And I think the more that these open conversations happen, the better.

Emily Oster:

Yeah. Yeah. Boy, the other thing is it’s very humbling when you come back after-

Megan Roche:

Oh, it’s so humbling. I have never felt worse exercising. I was simultaneously so excited to be back. And also this is heinous at the same time. I think there also needs to be this space too, because sometimes I feel like there’s this sensationalism when we talk about athletes that are returning to sport postpartum. And then it’s also there’s doomsday conversations. And I feel like there’s not always this middle of the road conversation about, yes, this is hard, this is daunting, this is challenging, this will be probably unlike anything that you’ve ever experienced before. But it’s also doable and amazing at the same time. And I think the more that we have those middle of the road conversations, the more fruitful it’s going to be.

Emily Oster:

Totally. All right. I want to actually back up or move into other parts of the lifestyle. Not lifestyle. In the lifecycle a little bit. Because you have worked a lot on these issues of RED-S or the female athlete triad. I would love to have you just talk a little bit about the history of how we think about fueling for women and its impact on health in part because I think it matters for people who listen to this, but in part because I think it’s something I think about a lot as a parent of a daughter and a daughter who engages in sport and the landscape of this has changed quite a lot in the last … Our understanding of this has changed quite a lot in the last several decades I think.

Megan Roche:

Yeah. I would say we’re in right now what we call fueling revolution. The idea that fueling our bodies is one of the most important things to unlock performance, to unlock mental health, to unlock so many different benefits that we’re going to get from athletic activity. And it’s exciting to be in research in this time because I feel like we’re seeing so much data and so many new papers coming out about different ways to fuel bodies. But I think first to bring it back actually to pregnancy and postpartum, something that’s not talked about enough is the idea that relative energy deficiency in sport or RED-S … So when an athlete or an individual is in a state of low energy availability. So essentially their energy expenditure is mismatched with their energy balance and they’re not getting in enough caloric intake. This is very common postpartum because athletes are breastfeeding, which is high demand on the body. There’s often weight loss that happens postpartum too and sometimes that weight loss trajectory just keeps going in potentially unhealthy ways. And so I think there also needs to be more conversation about RED-S and low energy availability in that postpartum period for women. Especially when too, it’s hard to fuel. You’re busy, you’re adjusting to breastfeeding demands. For me, I remember just trying to cram food in my face as I’m breastfeeding and getting into the door from a run.

Emily Oster:

I would tell my husband, when I am breastfeeding, you need to bring me cottage cheese.

Megan Roche:

Yes.

Emily Oster:

Maybe cottage cheese with pineapple next to my breastfeeding chair.

Megan Roche:

Yeah. Oh, it’s wild. I’m like, just please can you just give an ivy drip of pizza into me as I sit here and breastfeed. And even energy demands. I would have to fuel my exercise almost 1.5 times the amount that I was doing before in order to sustain breastfeeding and milk demands as well. So I think RED-S is also a really interesting conversation in the postpartum period. But in general, RED-S is also very common in athletes across the lifecycle.

Emily Oster:

For the casual viewer, listener, give us the rundown of the RED-S. What is this?

Megan Roche:

Yes. RED-S is common. There’s also the female athlete triad, which has started first and then RED-S came as an evolution of the female athlete triad. And so it’s the idea that there is this mismatch in energy balance. And so athletes or individuals are not meeting their energy demands and they’re left with an energy deficit at the end of the day that can have long-term impacts on many different bodily functions from things like the menstrual cycle to fertility to even cardiovascular health and bone health. And then the female athlete triad specifically talks about this low energy availability component and how that intersects with menstrual cycle dysfunction and then low bone health or low bone density. And so this can be a big concern for endurance athletes, athletes competing in aesthetic sports and then honestly athletes all throughout the lifecycle. Both genders male and female. And it’s been a passion of mine in terms of my research and work.

Emily Oster:

My sense of this is that there has really been this evolution of understanding that for women, for girls that when we see this loss of menstruation, this energy deficiency, we see it lead to injury and then we see it lead to basically a lack of ability to continue in sports over time. And that the change here is the idea that you actually do need to fuel. Basically you need to eat more. That’s the thing you. Got to eat more.

Megan Roche:

That’s the thing. And there’s actually been some fascinating research coming out that carbohydrates are often … So we basically need lots and lots of … The food revolution is let’s get all the macronutrients, let’s get protein, let’s get fat, let’s get carbohydrates. But there’s been some really interesting new studies looking at low carbohydrate intake as a predictor of relative energy deficiency in sport and the fact that carbs are super important for young athletes, for developing athletes, for all athletes training their body well and especially female athletes. And so carbohydrates have been a big focus in recent research. But I think the other thing that’s interesting is sometimes athletes can be in the state of low energy availability and everything can seem fine for a period of time. And some of the effects in terms of risk of stress fractures and risk of injuries and risk of negative performance take longer to happen. And so these conversations, these really open conversations are important because we really need to identify athletes at a younger age and start having these conversations for prevention at a really young age.

Emily Oster:

Yeah. We basically don’t want our girls to be eating so little that they perform great in high school and then never again and then they’re-

Megan Roche:

Exactly. Or not go through puberty. I think a big challenge is if you have low energy availability or RED-S around the time of puberty, you can either delay puberty or not experience the same magnitude or impact of puberty. And I think the more that we talk about the fact that puberty is a great thing. It might be hard to perform during the time of puberty, but if you go through puberty and sustain and fuel your body well, you are going to be … And these other words of Lauren Fleshman who’s an amazing endurance athlete. You’re going to be a grown ass woman. And that grown woman is going to do performances and compete stronger than you ever could. And so it’s like fuel is really the catalyst to get there. I’m so passionate about having these conversations.

Emily Oster:

This is slightly off-topic, but I think it is a topic I find very interesting, which is the question of carbohydrates versus the keto diet. And so I was listening to Andrew Huberman, whatever. There’s a whole space of the world that’s like carbohydrates are bad, and then there’s a space that I think is much more than one you and I live in, which is carbohydrates as performance fuel is incredibly important. Do you have a sense of how we bring those together?

Megan Roche:

Actually, I don’t think we bring them together. I think we keep them opposite. It’s probably the way I would approach it is I think in the longevity space, there are some discussions surrounding the keto diet. And I think for certain individuals it might make sense from a longevity perspective. But I would argue that athletes are in a totally different cohort of the population. That we are fueling our bodies and stressing our bodies in ways that if we add ketosis into that, it’s going to send our bodies into a state of haywire and excessive stress and excessive cortisol to the point where the longevity benefits that you would get from it are probably negligible anyways. Plus the performance benefits are terrible. And yes, I think a focus on low carbohydrate diets may work for a very small percentage of male athletes, but I think that’s really scratching at the margins. Whereas I would never recommend a female athlete to go on a low carbohydrate diet. It’s not worth the risk. It’s not worth the challenges associated with it. And part of the fueling revolution that I was talking about is the fact that we have seen bonkers performances recently in marathons and ultra marathons. And one big reason is a lot of athletes are consuming more than 90 grams of carbs per hour, and it’s providing those performance gains that we need to develop and to really progress as athletes.

Emily Oster:

I’ve thought a lot about the question of how we think about food and how we think about the idea of a healthy diet. And I actually think so much that question is asked. What is a healthy diet as if there’s a singular answer to that. And I think the answer is if you are trying to run an ultra marathon, that answer is going to be completely different than if you’re sedentary and trying to lose weight or trying to prevent diabetes or whatever that is. These are just totally different questions.

Megan Roche:

I love that point. It’s almost a very similar conversation to the pregnancy discussion is the recommendations have to be so nuanced to really capture the best health of pregnant women and athletes that we were looking for, and I think we really just have to have these nuanced conversations surrounding food and fuel. I think we’re getting better in that space, but there’s still a lot of work left to do.

Emily Oster:

Yeah. Totally. I had a conversation with my brother over the holidays who’s quite a good runner, and he explained to me that he does not fuel before his runs.

Megan Roche:

Oh, no.

Emily Oster:

No. It got so much worse. And that when he goes out for 20 miles, he doesn’t fuel before, he doesn’t fuel during, and he only brings water if it’s the summer.

Megan Roche:

Oh my gosh.

Emily Oster:

Isn’t that messed up? He’s so fast. I was like think about how fast you could be if you …

Megan Roche:

It pains my soul.

Okay. But it’s exciting though because when I work with an athlete like this, when I coach an athlete like this, I’m like, “Just think about the performance gains that you’re going to have ahead.” My husband and I on our podcast, we use the term food doping because honestly the performance impacts from adequately fueling your body are so strong that they could actually be categorized … If you think about the magnitude and the sheer percentage of it, it’s so much that it’s … You actually compare it to doping efforts, which obviously we don’t want to do. That’s not great for athletes.

Emily Oster:

Compare it to the shoes.

Megan Roche:

Yes.

Emily Oster:

You’re spending $400 on the AlphaFly V3. Get some graham crackers.

Megan Roche:

Yeah. And if those are 5%, fueling your body might even be 15%. And it’s like, let’s get those 15% gains.

Emily Oster:

Okay. My last topic is the paucity of data on women’s health. And I think this is everywhere in women and it comes up in this very extreme way in exercise. For example, people sometimes cite this idea that every extra pound of weight costs you two seconds a mile. It’s from some study in the 1970s. There are a lot of problems with that study, but it’s also just men. And it’s always just men. Every one of these things is just men. And why are we only studying men?

Megan Roche:

It’s so hard. For a long time and it makes a little bit of reasonable sense when you think about it, but this should not be the reason that challenges research for women athletes is the idea that women athletes obviously have the menstrual cycle and the menstrual cycle can cause a host of confounding variables of things like temperature and metabolism and cardiovascular changes throughout the menstrual cycle that if you included a group of female athletes, you would have to control for the menstrual cycle to get good data. And sometimes it’s just hard to do that. So that makes a little bit of a sense, but it can’t be the reason that we exclude female athletes. I think we need to … If a researcher chooses not to study female athletes, I think they need to clearly state that in the abstract and clearly state that in the methodology and explain why they didn’t do that. Because it’s shocking the amount of research right now where we’re extrapolating from male athletes to female athletes, and it’s like so many of these principles just don’t hold. It’s really challenging and it puts women athletes at a great disadvantage in terms of how they’re supported from a scientific standpoint.

Emily Oster:

Yeah. And I think it is in some ways the same reason. The same class of reasons that we don’t include women or pregnant … We don’t include women in a lot of other studies, which is like, well, they might get pregnant. What if they’re breastfeeding? They’re menstrual cycle is weird. They’re just not simple. Men it’s always the same. Just the same, same, same all the time. And women are interested and complicated, and that’s hard to include. And actually there’s been a fair amount of change in this over time, but it’s still true when we ask about things like drug trials or vaccine trials, they almost always exclude women who are pregnant or breastfeeding. And I think the place we saw this in the most extreme way was in COVID where they basically excluded pregnant women from the vaccine trials for some ethical reasons. But then it turned out that was probably the population that would benefit among the most from the vaccine, and then people were afraid to do it because they weren’t included in the trial. So there was a real human cost to that exclusion that I wish we had thought about more in advance.

Megan Roche:

It’s such a good point. And actually I think a parallel to that is actually just the conversation that we were having about low carbohydrate diets. So much of that research that was coming out that people were like, “Oh my gosh, this is the next fad that we have to glom onto,” were done in males or done in male athletes. And the dangers for female athletes are so much higher. It’s one area where literally it does not … The hypotheses and the conclusions that we draw from the research on male athletes just do not translate to female athletes. And in fact, that can be negative in terms of the consequences that it has on female athletes. And I can think of so many examples that also parallel that.

It’s challenging, and I think we are though … I think we’re in this area right now … There’s programs like Stanford FASTR. Boston Children’s has an amazing female athlete program, and there’s so much. I think companies and media are clamoring from more female athlete research that there’s almost been this explosion, which is amazing. We just have to make sure that that explosion of research and the explosion of how we talk about it is evidence-based and rigorous that way we’re not doing things for female athletes that might not actually be backed or supported by research.

Emily Oster:

Yeah. The idea of always having good evidence-based, causal research is … You’re not going to hear me argue with that.

Megan Roche:

Yeah. I think one place that we see this often is, I think there’s been almost a push to almost change the entire training philosophy based on the menstrual cycle. And for me, I researched the menstrual cycle. It’s so important. It’s so important to study. But it’s also one variable and a host of so many variables that feed into performance. And I think it’s one area where when we think about the explosion of female athlete focus, I think that’s an area where having a nuanced conversation makes sense. It’s like, let’s look at individual data points, individual responses to the menstrual cycle. But I don’t think we have to treat the menstrual cycle as this population level variable and adjust training just based off of that when there’s so many other variables that matter.

Emily Oster:

Love it. Okay. I have some rapid fire questions for you at the end.

Megan Roche:

I love it.

Emily Oster:

Before we get to that, tell me what’s next for you sports wise? What’s your next race? Just because I want to know.

Megan Roche:

Yeah. I’m so excited.

Emily Oster:

It’s a personal question.

Megan Roche:

I love it. I love doing ultra marathons. I have an autoimmune disease that causes myocarditis and pericarditis in my heart, so I’ve had to be very careful with ultra-running. It was actually interesting in navigating a high-risk pregnancy, being pregnant with that. But I’m back in a space where I’m hopefully going to be able to compete ahead. And there’s a race called the Lake Sonoma 50 Miler, which is in Sonoma, California, and it’s on trails and it’s beautiful, and I’m really excited to hopefully be able to return back to the ultra-distance.

Emily Oster:

That’s amazing. Okay. All right. Rapid fire. Someone says they want to return to relatively serious endurance exercise postpartum, what is the first thing you tell them to think about?

Megan Roche:

Oh, pelvic floor PT. I think it’s so important to loop in with a pelvic floor PT. I also think too, just listen to your body. I think listening to your body a very underrated … You will know. For me, I could feel my hips just weren’t ready. And so I think just take a good systems track on how things are feeling, and ideally work with professionals too.

Emily Oster:

I want to do better run fueling. What’s the best pre-run snack?

Megan Roche:

Ooh, this is a great one. There’s so many snacks to choose. I’m like, how do I choose just one? I want them all. Okay. I think for me … This is a Boulder, Colorado shout out. There’s a bar called Bobo’s Bars and they’re amazing. They’re pretty high carbohydrate bars. And the banana chocolate chip is amazing. It’s so good. So they’re a small company. Support them. They’re delicious.

Emily Oster:

Megan, you have to back up. You got too excited about snacks.

Megan Roche:

Yes. Snacks.

Emily Oster:

Okay. Ideas for gentle ways to stay active in the throes of the first trimester fatigue, nausea, or later as the center of gravity changes. How do I not give up exercising when I’m pregnant?

Megan Roche:

Oh, yes. This is a great question. Walking. I feel like walking for me … I personally love running. I embraced walking so much during pregnancy and I slowed down and saw things that I never saw before. I’d be on a trail and be like, “I didn’t know there was a house here. This is really cool.” To me, I experienced the wonders of walking through pregnancy. Great for aerobic activity, great thing for lower impact activity. And then also pool exercises. They’re great for reducing … It just feels great to get in there and you’re like, my body feels kind of normal again, especially for me in the third trimester. So pool running, pool aquatics, pool exercises and walking are fantastic.

Emily Oster:

Are running strollers worth the price?

Megan Roche:

Oh, this is a hot take. I like this. Honestly, I’m going to give a hot take answer. I don’t know if they are. We have a running stroller and we love it, but to be perfectly honest with you, it’s pretty heavy and clunky and we don’t use it a ton. We have run more with our Mesa stroller, which is not in an any way or sense a jogging stroller. And my husband will be doing loops of the neighborhood with this just regular conventional stroller. And so you know what? I’m going to go with a no on that. It’s going to be a hot take.

Emily Oster:

Yeah. I agree with that. We used ours like nine times.

Megan Roche:

Yeah. I had thought about it the other day. I’m like, we bought this $400 stroller and at this point, each mile in it is amounting to like $40. I’m like, what did we do?

Emily Oster:

It’s unfortunate. It’s unfortunate. Okay, last one. Give moms one un-ironic affirmation they can tell themselves in the morning when they’re putting on their maternity or postpartum stretchy pants and their sneakers to get out the door. What’s the affirmation?

Megan Roche:

I’m going to go with I love me some me. Because I think when I was pregnant, that self-love piece … I loved my baby growing inside me so much and I was like, this little creature is amazing. But I feel like that love for me in a changing body and changing hormones and I just didn’t feel like my same athletic self, even though I felt amazing to get out and exercise. I should have just looked in the mirror myself and been like, I love me some me. It would’ve helped a lot and I think it would’ve helped me just also enjoy the process too, and to be there for all the ups and downs of it.

Emily Oster:

Thank you. Thank you, Megan. Thank you so much for being here.

Megan Roche:

Emily, thank you. This was such a blast. I really appreciate it.


Speaker 1:

During pregnancy, I was kind of grieving the loss of knowing my body, and also how I’ve known me to be through movement.

Speaker 2:

I am 1 year-

Speaker 3:

11 months-

Speaker X:

8 weeks-

Speaker 4:

14 months-

Speaker 1:

4 months postpartum-

Speaker 5:

3 months postpartum with my second baby.

Speaker 6:

I absolutely thought I was going to be that super fit mom that was active.

Speaker 5:

I worked out until the day before my C-section.

Speaker 7:

I had the great fortune of being able to be active throughout the entirety of my pregnancy.

Speaker 5:

However-

Speaker 7:

But-

Speaker 5:

… recovering from pregnancy, it really felt like I was hit by a truck.

Speaker 7:

In some ways, it made me a little dismayed just to see how much society praised me for that.

Speaker 3:

I canceled my gym membership a couple months ago. I cannot get there, and that’s okay.

Speaker 6:

Honestly, when I wasn’t working out, I didn’t miss it because it just didn’t fit in this season, in this time.

Speaker 8:

I just really felt almost a form of guilt of, I really want to focus on getting back to feeling like myself-

Speaker X:

Feel like myself-

Speaker 6:

Feel like myself again-

Speaker 8:

And my friends are kind of telling me, “that’s silly or not important,”

Speaker 9:

It’s what I have to do to feel normal, to feel sane. I can’t tap into that part of my brain without playing volleyball.

Speaker 8:

It was so hard for me to wait and to be patient and to not just do too much, too soon.

Speaker 2:

It’s not necessarily pretty putting on those workout pants for the first time.

Speaker 10:

Running was hard. I began with a 1/10 of a mile at a time

Speaker 4:

And one day one of my friends convinced me to go for a run with her, and in the middle of the run she looked over at me and she just said, wow, it must be so hard to run with those huge breastfeeding boobs.

Speaker 12:

I got on my cute little leggings and headed out the door to trampoline class. I bounced three times. I peed three times, and I just walked off and was home like 15 minutes later.

Speaker 9:

Went out for a run and learned the hard way that doing some core and pelvic floor work to ease into it was definitely the right call.

Speaker 2:

My advice for anyone who’s trying to get back into working out would be if you can have a friend or two join you for a group exercise class, and then you can hopefully have that connection and community afterwards.

Speaker 8:

There’s a lot of different apps and programs out there, but I have to just say that I use this one called Expecting and Empowered.

Speaker X:

The Sculpt Society.

Speaker 1:

Couch to 5K.

Speaker 13:

Walks. I would aim for 5, 10, 20-minute walks.

Speaker 14:

The best thing I think you can do to support a partner is get them a subscription to Audible. It’s amazing.

Speaker 4:

After the birth of my daughter, I actually have a newfound respect for my body.

Speaker 8:

I think the whole thing has given me a deeper appreciation for what my body can do. It literally grew a baby, but then it also healed from that.

Speaker 11:

Most importantly, I gave myself a lot of grace and repeated to myself that anything was better than nothing. Be nice to yourself and be proud of where you are. It takes time.

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Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
...

The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you. 

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths. 

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths

The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you.

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths.

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths
...

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected. 

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected.

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips
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We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻

We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻 ...

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings
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Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone. 

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle

Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone.

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle
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Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
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I’m calling on you today to share your story. I know that many of you have experienced complications during pregnancy, birth, or postpartum. It’s not something we want to talk about, but it’s important that we do. Not just for awareness, but to help people going through it feel a little less alone.

That’s why I’m asking you to post a story, photo, or reel this week with #MyUnexpectedStory and tag me. I’ll re-share as many as I can to amplify. Let’s fill our feeds with these important stories and lift each other up. Our voices can create change. And your story matters. 💙

#theunexpected #emilyoster #pregnancycomplications #pregnancystory

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That’s why I’m asking you to post a story, photo, or reel this week with #MyUnexpectedStory and tag me. I’ll re-share as many as I can to amplify. Let’s fill our feeds with these important stories and lift each other up. Our voices can create change. And your story matters. 💙

#theunexpected #emilyoster #pregnancycomplications #pregnancystory
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OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76. 

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife
...

My new book, “The Unexpected: Navigating Pregnancy During and After Complications” is available for preorder at the link in my bio!

I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

The book lays out the data on recurrence and delves into treatment options shown to lower risk for these conditions in subsequent pregnancies. It also guides you through how to have productive conversations and make shared decisions with your doctor. I hope none of you need this book, but if you do, it’ll be here for you 💛

#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster

My new book, “The Unexpected: Navigating Pregnancy During and After Complications” is available for preorder at the link in my bio!

I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

The book lays out the data on recurrence and delves into treatment options shown to lower risk for these conditions in subsequent pregnancies. It also guides you through how to have productive conversations and make shared decisions with your doctor. I hope none of you need this book, but if you do, it’ll be here for you 💛

#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster
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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy. 

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙

We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy.

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙
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