Friday, July 20, 2007

Labor and marathons

Disclaimer: In case anyone feels inclined to post a huffy comment about how childbirth and marathon running are NOT the same in every respect, please read this. Of course they are not identical. Of course the analogy breaks down at a certain point. I think the biggest difference between birth and marathons is that birth is something within every woman's capability, while marathon running is admittedly an extreme endurance sport.

I’ve often wondered why we don’t approach pregnancy, labor, and birth like we do marathon running. Pregnant women encounter so much negativity and fear: your baby might be too big or too small. You might develop toxemia. You are gaining too much or too little weight. You might hemorrhage and die. Your pelvis might be too small. Your baby’s head might become trapped. Your baby might go into distress. You probably won’t be able to handle the pain so you should consider an epidural. You don’t get a medal for having an unmedicated birth. All that matters is a healthy baby anyway.

What if we were as pessimistic about marathon running as we are about childbirth? Here’s my imagined scenario for a hopeful marathon runner, Ann:

Ann was in reasonably good shape and could run several miles, although at a fairly slow pace. She ran cross-country in high school and enjoyed it, even though she was usually one of the last to finish. She was inspired by several friends who had recently run marathons and decided she’d prepare for one.

Ann started researching how to run a successful marathon. She wanted to find training schedules, nutritional requirements for runners, and advice on good running shoes. She went to her local public library, which had a shelf of books that focused on the risks of marathons. Most discussed in great detail the various injuries common to marathon runners and only included short segments about success stories. They warned that although marathons can be empowering, most people cannot successfully train for or complete them. The books also emphasized the tremendous amount of pain that marathon runners experience. Ann knew that certain injuries were possible and although she appreciated the information, she preferred to have more information about how to prevent the injuries in the first place through proper training, stretching, and nutrition. She also wanted to read books that motivated her and assumed success rather than failure.

She knew that there must be more useful information out there, so she pulled up a chair to the library’s computer. She waded through pages of results, but she finally stumbled upon a small but vocal community of marathon runners who had successfully completed the race and who raved about the experience. Their stories were generally ones of triumph, confidence, and exhilaration. They talked about the hours of mental and physical preparation, the extensive research they did into ensuring they were in top physical condition, and the ways to prevent common injuries such as shin splints or knee problems. They supported each other when a runner didn’t reach her desired time, or when physical problems forced her to drop out of the race. They cheered each other on as race day grew nearer.

Ann posted her training schedule around the house so she would see it every day. She decided to maintain a positive outlook, knowing that top athletes considered mental preparation as important as their physical training. She dedicated time every day to meditation and visualization. She imagined what it would feel like to line up, waiting for the gun to signal the beginning of the race. She visualized her heart beating strongly, her blood supplying oxygen to her muscles, her breath even and steady. She repeated positive affirmations to herself, such as “It will be exciting and hard at times but I know I can do it.”

A few weeks later, Ann’s training was going well. She had missed a few days, but usually accomplished her daily goals. While the running itself was sometimes tedious and uncomfortable, she loved how she felt afterwards. Ann mentioned to a friend that she was training for a marathon and was surprised when her friend told several horror stories of marathon runners who suffered lifelong injuries—even one about a runner who drank so much water that he died during the race. Ann replied that she had carefully researched both common and rare injuries and that she was sure that she could either prevent them, treat them herself, or seek help if something serious arose. Her friend said, “But how can you be sure? You might die of a heart attack while you are running—you’d have no way to know it’s going to happen until it is too late. It’s just not worth the risk.”

Ann’s family thought she was crazy. Shouldn’t she be doing something more useful with her time? What if something went wrong? What if during the race she is in too much pain and can’t finish—then how would she feel? Anne told her family that she had done her research and that it was an important goal. She asked that they either speak positively about her upcoming race, or that they refrain from saying anything at all.

Ann noticed that the media always focused on the sensational stories of marathon running turned ugly. When TV crews covered races, they showed runners limping along, looking like death warmed over. They usually interviewed runners who had to drop out, giving them several minutes to tell their stories. Then, almost as an afterthought, they would give 30 seconds to a successful runner who looked exhilarated, if a bit tired and sweaty. Of course, after that runner was done speaking, the TV host would remind the audience that most people cannot complete marathons and that it was best not to get your hopes up. Good grief, Ann thought. I know plenty of people who have completed the race without dying or breaking a leg or permanently injuring themselves.

Somehow—maybe it was when she ordered a few pairs of her favorite running shoes—marathon support companies got hold of Ann’s address. Almost every day her mailbox had a new glossy ad for “pain-free, effortless marathons.” One company’s slogan was: We do all the work—you just come along for the ridetm. Inside the brochure, Ann learned that:
Marathons are a lot of work. The pain is excruciating. The risks of running so many miles are numerous. Why suffer when you can do it the Pain-Fretm way? For only 12 monthly installments of $199 each, you can finish your marathon in comfort and style in our patented Pain-Fre(tm) motorized vehicle. Our chauffeur will personally pick you up as soon as you feel too much pain. Once you are settled in your EZE-Ridetm seat, you will enjoy the view in comfort and luxury as you are driven to the finish line. You will receive a complimentary photo of you crossing the finish line on foot. Beverages not included. Runners will be assessed a $10/mile fee for any miles they run themselves. The fee is waived if you take the EZE-Ridetm in the first 5 miles. Due to liability concerns, rides are not available the first 4 miles or after mile 23.

Ann stacked these fliers beside her fireplace. After her long runs on Saturday, she’d run a hot bath, start a fire, and toss the fliers into the flames, watching the edges curl and twist. She imagined all of her fears melting away with those glossy advertisements.

Ann’s training continued. She enjoyed her changing body—seeing her leg muscles become more toned, noticing the articulations of each muscle group. Preparing for the race also gave Ann a heightened appreciation for good, nutritious food. Her body craved proteins, fresh fruits and vegetables, and complex carbohydrates. She ate sweets every once in a while but no longer enjoyed them.

Several months into her training, Ann heard of a disturbing new trend in marathon running: elective bone breaking or EBB. She knew that stress fractures were a common injury among runners, not to mention the rare but drastic broken bones from accidental falls. Apparently some people were advocating a new “preventive treatment,” which consisted of wearing bone fracture monitors while running. The monitors were touted for being able to predict bone fractures. Using information from the monitors, surgeons could then carefully finish breaking the bone (to ensure a clean, even break) and repair it in a controlled setting. The monitors were quite heavy and occasionally caused runners to fall and suffer extensive injuries. However, they were the hot new thing in running, touted as “every runner’s safety net.” One surgeon promoted the new technology as making the leg bones “better than new.” Has the world gone mad? Ann wondered. Why anyone would choose to have their bones broken before a serious problem even developed was beyond her. Fliers started arriving in her mailbox describing EBB. Ann had to smile when one company named itself EBB—Even Better Bones.

As race day grew near, Ann experienced a mixture of confidence and trepidation. She knew she had prepared thoroughly for the race, but she had never run 26 miles before. She decided that if something “went wrong” during the race and kept her from finishing, she would accept it calmly, knowing that she had done everything to ensure success. She continued her daily visualizations, imagining how empowering it would be to finish. The race would end in a beautiful river valley. Ann often swam in the river and knew that the cool water would feel incredible after the race. She kept this image in her mind: lying on her back floating in the clear water, her body suspended between water and sky.

On race day, Ann was surprised how crowded it was around the registration tents. There were almost as many marathon support companies as there were runners. She talked to a seasoned runner who warned her that it was just as bad even when the running began. Motorcyclists would drive alongside runners, asking them how much pain they were in, if they would like to drop out. Bystanders would hold signs saying “It’s never too late to give up.” “Drop out or drop dead.” “You don’t get a medal for finishing.”

One of Ann’s running partners, who had finished her first marathon a year ago, handed Ann a package while they were standing in line to register. It was a t-shirt with the slogan Drug-Free Zone. “You’ll need it,” her friend said, “especially around mile 22 where the race’s sponsors are handing out morphine pills. They know better to stay away from people with these shirts on, otherwise they’ll get an earful and the occasional well-aimed punch.” Ann grinned.

While she stretched, she turned inward, visualizing the stages of the race and repeating her affirmations. I can do it. I am strong. I am ready.


  1. hi, beautiful mama! I have selected you for the Bloggers for Positive Global Change awards...just so you know. Check out today's blog entry on my blog for more info.


  2. I think it is an AWESOME analogy and have thought of it often throughout my pregnancy. I ran a marathon in 2004, as someone who always wanted to and never saw myself as 'athletic'. It is an amazing physical and mental feat, but I truly believe anyone who really wants to, can do it. When I got pregnant, I knew I wanted a natural birth and the more I learned the more I realized the marathon was such a great analogy. I can do it-- if I educate myself, surround myself with supportive people and messages, "train" mentally and physically, and most of all, if I can stay mentally positive or have others play that role for me when I falter. I could go on and on, but you know what I mean. Thanks for the great blog. Your daughter is SO CUTE.

  3. Rixa,
    This is probably my favorite post of yours so far. The analogy was fantastic. I'm glad you brought out the importance of the mental preparation in both birth and marathon-training. I've trained for a marathon, and the thing that kept me from running it was that I did not mentally train myself to succeed. I know that the next time I do it, I will make sure that my mental preparation matches or exceeds my physical preparation. How true that this is exactly what you need to do to be able to birth a baby successfully.

    Great job!

  4. That really is a thought provoking analogy, Rixa. Keep going! I hope Ann's story will soon continue beyond the day of the big race!

    As it happens, I've just been informed by a friend that in medical school they told her that water birth is a 'theoretical drowning hazard' because babies take their first breath after the head is out. Dang, I didn't think of that! Boy did we get lucky! LOL

    Why research and teach facts, when they have handy dandy theories?

  5. Loved this analogy! Keep up the great blog!

  6. Haha, this is brilliant! Very well done, Rixa. I think I disagree with your disclaimer...the analogy is almost perfect! :)


  7. I think, from what I can tell, that the analogy is right on.
    But, let's remember that not every woman is capable of birth. Some of us will never get the chance to do what so many of you have the opportunity to experience.

    Many women I know can run marathons--but will never be able to birth.

  8. Thanks for all the comments so far--I've often tossed around the labor-as-marathon analogy in my head and finally got around to writing something. I still feel like my story about Ann is unfinished but I can't figure out how to end it. Writing about the actual race would seem too I decided to stop right before she began running. I wanted the story to end with multiple possibilities rather than one narrative.

    I've often thought about training for a marathon or even a half-marathon myself. Much like Ann, I ran cross-country in high school and was always one of the slowest runners but I didn't mind. Most of my runs are a couple miles; I haven't done any serious distance running since I was 20. I would love to be able to work up to a half-marathon. I keep saying that, though, and never quite get around to it. Anyone have a good, and realistic training schedule for that?

  9. I like the beginner training schedules at :)

  10. This story really got me thinking... And it's just so painfuly true... But the "negativity" does not only show up when it comes to labor or maraton. Try dieting without everyone around telling you you are gonna die, lose you health, get an ED, etc.

  11. YES! Thank you! And you are right!

    A friend of mine referred me to your blog b/c she knows that I have used the same analogy of birth = marathon. As a woman who has run a marathon AND who has given birth naturally with no pain mediciation, I can attest that the analogy is spot on accurate.

    Thank you for this beautiful, supportive, thoughtful post.

  12. What a GREAT idea to show up to the hospital with a shirt on that says "I do not consent" or "no drugs for me".

    Love the analogy.

  13. I made myself a maternity shirt that said "Drug-Free Zone" and wore it proudly while I was pregnant. (Can you tell I'm writing myself into the story? LOL)

    Off to check out the marathon training schedule...

  14. Having run a marathon AND given birth, birth was harder, the recovery especially. I pushed for two hours and had to have a c-section as my pelvis was too small. Natural birth is not always an option, not every woman CAN have a child even, and not everyone CAN do a marathon. Don't take these things for granted or generalize for all of us. I'm just grateful to have a healthy child, no matter how the delivery went.

  15. I don't recall reading in the post that every woman CAN give birth naturally or that everyone CAN run a marathon. However, most of us can do both.

    Excellent post! Thanks for this.

  16. Anonymous, did you have a pelvic exam during your pregnancy? If you did, did the midwife/OBGYN point out any concerns with size? I ask this because I, too, was C-sectioned under the pretenses of a small/abnormal pelvis, yet after my pelvic exam several months beforehand, my midwife assured me that everything was shipshape.


  17. Rixa, there is a great book called "The Non-Runner's Marathon Trainer" that my sister and I used as we trained for our marathon. Very do-able. As a matter of fact, when the time comes that I decide to train for another one, I will use that book. I highly recommend it.

  18. I really enjoyed this post, Rixa. I have thought about both marathons and drug-free childbirth, but haven't yet committed to either one. I will do some more thinking.

  19. Hey Mrs. M--didn't know you had a blog! I'll have to bookmark it.

    I'd suggest reading Sarah Buckley's book "Gentle Birth Gentle Mothering." It has several chapters devoted to the hormonal physiology of unmedicated (and undisturbed) birth. I think one of the key aspects to planning an unmedicated birth is to also plan to be in the right setting--one that will enhance the hormones that make birth easier, more pleasurable, and more efficient. In other words, being in a highly technological hospital environment with a care provider who is used to medicated or induced labors would make the attempt much more difficult than if you were, for example, in a birth center in which all of the staff were used to non-medicated labors and familiar with non-pharmaceutical mains of pain relief (birth tubs, massage, birth balls, etc). Having an unmedicated labor in a standard hospital environment is probably the most challenging way to do it.

    To see an example of a very supportive hospital setting with an awesome OB, see this post (contains close-ups of the birth, FYI):

  20. I have been researching midwifery & homebirth for a few years but just now stumbled upon your blog. And I am so grateful! I am pregnant with my first and just decided (aloud to my parents, though I knew it in my heart all along) that we will have a homebirth. In trying to explain to my mom with the running analogy, I've said similar things--I'm a runner and I know I will not win a medal for my races and I could avoid running and thus the pain, but.... Anyway, my mom's response: "yeah, but when you're running you're in charge of your own body. When you've having a baby, you don't know how your baby's doing." Thanks so much for the cogent arguments about this bad-mom-for-caring-about-the-process idea. I've truly felt guilty about that but your posts capture my feelings so well. I've been reading your blog for a few hours now and will be reading your articles and dissertation soon. Thank you, thank you.

  21. This is fantastic, I have started reading and trying to prepare myself really early this time, I'm not even pregnant, I'm like a marathon runner that hasn't even signed up yet but is starting training. I have just started a blog of my own to record all of the useful things I find to help me when we decide to have another baby as I want my next experience to be the opposite of last time, thank you, your site is very helpful to people like me who don't know where to start

  22. This is an old story, I know, but funny how you compare childbirth with marathon running. That is EXACTLY how I approached it. I am a runner and triathlete, and I basically tried to equate labour to a long event (a marathon or ironman triathlon perhaps). When I stood at the start of the ironman, I did not know how I was going to get through, I knew it was going to be hard work, I knew it might hurt, but that the best thing to do was just take it one step at a time - every swim stroke, every bike pedal and every step was in the right direction - towards my goal, that finish line. And, oh though I ached at the finish, it was the sweetest thing imaginable. I thought labour was very similar - every contraction was like a hill I had to run up and over - hard work getting up, then I got to the top and could recover down the other side. Every "hill" was a step towards my goal - that of holding my baby. Sure, labour hurt, but it was not an "I want to die" hurt, it was a very similar "hurt" to what I get when I am running really hard - its hurts but in a good way. Fantastic analogy!

  23. This is a wonderful post! As a Bradley Method educator I use the marathon vs labor and birth analogy all the time!

  24. I just finished my first marathon and I was comparing it to my labors and delivery a lot while I ran. I didn't know there was an analogy. I was thinking of the race itself. The mental aspect. Being positive and tuning into the mind over body. I also kept thinking of all the energy that went into my children's labor. If my body could handle that for hours on end then I could run 26.2 miles.

    Anyway. This is a very interesting post. I ran my marathon 'naturally.' :o) I researched alternative foods for energy boosts instead of those gross GU packets. Fig newtons, almonds, etc... they worked just fine.


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