Having a baby is like 
running a marathon because...

A version of this article was originally published in 
The Practising Midwife, July 2001. 
Reprinted with permission.

I was introduced to  this analogy by Andrea Robinson in her book  Empowering Women – Active Birth in the 1990’s, where she advocated  using parallels between events in peoples lives and childbirth / parenting  experiences, as an activity in preparation for childbirth sessions.   I later heard Michel Odent denounce the notion of comparing marathon preparation  to preparing for the day of labour, reviling the idea of ‘coaching’  pregnant women  for an event that in reality requires the relinquishing of conscious control.

 In April this year, I ran the London Marathon and now, having completed  both of these events, I feel that  I am in a position of authority to pass comment  and opinion on the similarities and differences of these two momentous   occasions in life.  It could be suggested that the memory of the marathon  still looms larger than that  of childbirth, the former completed only weeks ago,  and the latter seven years ago.  But as many who have given birth will agree,  the years may pass but the experience retains an exceptional clarity.

In my particular case, the decision to undertake a marathon was given  notably more deliberation than that of having a baby, and was made   with a greater degree of informed choice. Nonetheless, I did have the  full support of my partner on both occasions. It seemed however, that he, as a  ‘been there, run it, got the tee shirt’ marathon competitor,  was able to support  me to a greater extent  in my marathon endeavour. There was a sense of  empathy which had been less obvious in labour. I always suspected that during  my pregnancies that he harboured a degree of uterus envy! He certainly appeared  to be more sympathetic of my needs after the marathon, and informed  everyone how proud he was of my achievement. After the birth of my first child,  he told everyone that it was ‘a   piece of cake’ the proverbial ‘pea out of a pod’.

 The role of supporter would appear to me to  be of equal importance in each event.   The focus on the encouragement of those around you becomes increasingly  significant as the toil continues, and the complete trust and belief in that  support is invaluable.  I remember clearly my third birth, a VBAC following a  section for the second.  Although my belief in my own body to achieve a normal  spontaneous birth was resolute, the knowledge that those who were with me  felt the same, spurred me on through labour. Likewise, after hitting the 
’wall’ at eighteen or so miles during the marathon, the momentum of  the crowd calling my name (emblazoned across my chest as advocated by  seasoned marathon vets) and willing me to complete, became my raison d’etre.

  The point at which the support of the crowd became so significant can be  compared to transition in labour.  The enormity of the task in hand was  almost too much to bear. If my partner had deigned to run with me, I  probably would have been blaming him for the ills of the world at this point,  from my aching thighs, to the cultural destruction  of global capitalism. A friend  of  mine has suggested that offering a woman an epidural at this stage in  her labour is akin to offering a marathon runner a lift in a car when they  hit the wall.  Such temptation, I have to say, would have been great for me  at that time in the event. However, early recognition of  “the wall” brought  with it the acknowledgment that my endocrine system would kick in and  help me out. I was positively relishing   the thought of the  forthcoming  endorphin rush, and embraced its pain nullifying  effect when it arrived.  My euphoric  expression, complete with extremely dilated pupils   in the post event photographs bear witness to this phenomena. I feel that  this is a status sometimes  witnessed during the early post-partum  period, when the mother has been blessed with an active  birth, where  those around her believed in her ability to birth her baby, and didn’t  interfere with the process.  It is the look that proclaims “We did it ourselves”

 The nutritional requirements  for marathon running and labouring women  is an interesting association. I feel that here there are again, similarities.   The carbo loading encouraged in the weeks running up to the marathon  prepares the runner to store quantities of carbohydrate to utilise when  the glycogen stores deplete at around the 17-20 mile stage of the event.  The average marathon runner will have used somewhere between  2000-3500 calories during the race by this stage. It is believed  that the average woman may use up to 700-1000 calories per hour whilst  labouring. (Swift 1991) I spent the early part of labour feeling ravenous  and wanting to eat for England, and then having to ask the midwife  to kindly “pass the sick bag Alice” in the latter part of first stage.  I could no more have eaten once in established labour than I  could have abseiled down the wall of the maternity unit. Like wise, I had  made arrangements for a “chocolate stop” at fourteen miles during  the marathon, but on arrival at the rendezvous, found I really didn’t really want it.   However,  the offer of  ‘Liquid Power’ (a high calorie, isotonic drink) at  3-4 mile intervals was essential, and I felt made the difference between  completing and not completing. There may be a lesson to be learnt here.   The solution prevented me from becoming too ketotic and provided me  with essential minerals, which ensured adequate hydration.  Sounds  familiar as a preferred state for a labouring woman, doesn’t it?

  Crossing the finishing line and pushing my babies out also brings to  mind a range of  parallel encounters.  The tears, the triumph, the sense  of relief, the exhaustion, the pain!  I was able to share this glory with  partner and friends after my babies had been born. Sadly, because  of the organisational arrangements, I was unable to share the immediate  post marathon experience with anyone other than the official photographer.  As I staggered along The Mall clutching my medal, I became aware that if  I sat down I would never get up again.  I needed my supporters and  finding them and being greeted with warmth and admiration made me  feel very special in a way that I don’t really feel that I have rarely  experienced since birth.  Sara, who was looking after my children  during the event stated that I took on the semblance of a new mother  to such an extent that she felt the need to midwife me there and then.  She helped me out of my sweaty apparel, into clean fresh clothes,  simultaneously providing me with nourishment, though in the form of  sandwiches and mineral water, not tea and toast.

Having associated with female runners over the course of the past  few years, I am aware of their extensive knowledge of the physiological effects    of running on their bodies and systems. By being so attuned they are able  to utilise coping strategies to deal with the hurdles along the way.  They recognise the value of preparing for running events by ensuring  that their bodies are in an optimally nourished state.  They recognise the value  of  preparing physically for the task of long gruelling runs,  thus minimising the risk of injury.

How many of our labouring women really understand the physiology of birth?   Do we really offer them the opportunity to discuss the physiological peaks  and troughs in labour and how to adopt coping strategies that enable  them to carry on?  They frequently appear to have an awesome knowledge of  the choices on the ‘pain relief  menu’ yet have little faith in their own bodies  resources to cope. How often do we remind the mother that nature rarely  deals more than we can bear, and of the powerful effect of our own  hormonal systems?  Do we inform them that pain in labour has purposes,  about the benefits of experiencing the power and strength of contractions?   How much value do we place on nutrition during pregnancy?  Most antenatal education sessions begin at 30+ weeks when the opportunity  to discuss the benefits of good nutrition have been lost.

The experience of running the marathon has given me the opportunity  to reflect on what made it achievable for me, a woman with a very full life,  and as described, I feel that  many of those factors can be applied to  the needs of a woman in labour.  Would I do it again?  Sara reminded  me recently that my first comment on greeting her at the end of the race  was “Never again, no-one told me it was going to be so hard.”   Yet now, several weeks down the line, I am seriously contemplating  my entry for next year, because I’m sure I could be quicker next time round!

In conclusion,  I think the maxim which sums up both experiences  for me, when I look at both my children, and of course my marathon medal,  was extolled on the tee shirt of a runner at about the 22 mile point:-

  “The pain will subside – but the pride lasts forever!”