This month we have a case study of one woman, Casee Sumter, her pregnancy, the birthing process and con¬current CrossFit training. The mystery and awe of preg¬nancy are enough to make this an interesting and fun endeavor for all concerned, but we had the added bo¬nus of helping an already healthy mom get healthier, thus facilitating the birth of an amazing new baby boy. What more could one possibly ask for?

Before we get to the story, however, let’s look at some¬thing that has been talked about a bit, but for which no quantifiable numbers have been run. CrossFit seems to get people pregnant. Brian Mulvaney astutely com¬mented on this observation and offered a fantastic free market solution to the infertility crises that seems to strike well-to-do mid-30s couples. Seemingly healthy, these couples find it near-impossible to conceive a child, and find themselves in one of the highest mark-up businesses in the world. The problem? Insulin. Elevated insulin levels in one’s youth lead to a state of hyperfer¬tility caused by decreased production of Sex Hormone Binding Protein. A decrease in SHBP results in more free estrogen and testosterone. This means increased youth fertility, acne, PMS and a slew of other problems. This is the very situation that caused the massive population explosion our species encountered when we switched to starchy foodstuffs as the basis of our diet. Neither the crushing levels of activity inherent in early agriculture nor even breastfeeding could stop this process that normally matched our population exactly to our food supply. Hyperfertility is the short term result of elevated insulin. The long-term result is premature sterility due to an ever more deranged metabolism that becomes deaf to its signal of high sex hormones and insulin.

In a normal menstrual cycle, estrogen and progesterone play a game of tag. Estrogen climbs to a peak in response to the maturation and release of an egg within the ova¬ries with progesterone following quickly behind. At a crucial point, progesterone passes estrogen in concen¬tration and estrogen levels then drop to a low baseline for 10-14 days, during which estrogen begins climbing in concentration again in a continuous cyclical manner. If a fertilized egg is in the proper location, progesterone encourages implantation of the egg and growth. If no egg is present the uterine lining is shed.

If one is insulin resistant, this scenario can shift from the hyperfertility of youth to a form of sterility amid remarkably high estrogen levels. With high insulin comes a higher fat mass. This fat mass plays a role in aromatizing testosterone to estrogen. This feeds into even higher levels of estrogen due to decreased SHBP which eventually leads to estrogen receptor burnout. This means ever higher levels of estrogen and an eventual inability of progesterone to surpass estrogen and fa¬cilitate either egg implantation or shedding of the uterine lining. This is the hormonal environment in which we find uterine fibroids, poly¬cystic ovarian syndrome, polycystic breast disease and endometriosis to name but a few conditions.

These mechanisms are quite well known and hyperinsulinism is obvi¬ously understood to be a player in these events as insulin lowering drugs are the first intervention for infertility. Call me cynical, but it ap¬pears we have a situation of extreme laziness on the parts of both medical professionals and our populace—we appear incapable of adopting the recommendation of nutrition and exercise that is con¬sistent with health. Metformin (an insulin lowering drug with the brand name Glucophage) will reduce insulin levels for a time, but it is not a long term solution to problems that go far beyond infertility.

In very simple terms, the adoption of sound nutritional practices and a short duration, high intensity exercise program will set right the condition of hyperinsulinemia and make the numbers a bit more fa¬vorable for not only conception but lifelong health.

If you have a female in your life whose health and well being you value (you know… wife, daughter, mother… yourself), buy the book Sex Lies and Menopause. Read it and strongly consider its message. Be warned! If you have strong political leaning to either the right or left you will likely be enraged by some aspects of the book. If you are middle of the road, you may simply shake your head in disbelief at some of the implications raised by the book.

OK, enough of the intro on pregnancy! Here is the story of one mom and her experience doing CrossFit while pregnant. Casee had been training with us for approximately one month prior to becoming pregnant. We have had three women become pregnant within the first month of training with us in the past year.

FIRST TRIMESTER

During the first trimester, I was really tired, so the toughest part about working out was dragging my butt out of bed at 5:45 am to get to CrossFit. Sometimes I had great energy during my workouts and during others I could feel a lag, but all in all I think I held my own with all of the workouts.

SECOND TRIMESTER

Fourteen Weeks
Although I had only gained about six pounds, immediately into the second trimester I found out the hard way that I needed to curb the weight I was lifting. I think it was a workout that con¬tained three rounds of deadlifts at 35 pounds. That wreaked havoc with my back. I was out of commission for about a week. After that, I resolved to keep the lifting under 20 pounds. Robb and Nicki were great and they worked with me to adjust the routines in a way that wouldn’t take me out. They showed me stretches for my lower back and I started spending more time cooling down and stretching after workouts. [As one gains weight during pregnancy, the abdominal wall distends for¬ward, which can both weaken the abdominal wall and tends to put the low back into a state of hyperlordosis. This condi¬tion can lead to back pain and certainly destabilizes the core and can make lifting dangerous. Stretching the hip flexors and hamstrings with generous helpings of “sit-to-stands” keeps this problem at a minimum.]

Eighteen Weeks
No more back issues. Yeah! My morning energy is rockin’ and I’m loving the workouts. I feel really strong at squats right now. [We only perform sit-to-stands with our expectant moms as it would obviously be madness to have them squat] My upper body is becoming stronger and running and rowing seem to be agreeing with me too.

With the growth of the baby, my stomach is starting to pull and stretch. All of a sudden hanging from the rings to do knee ups doesn’t feel so great. No worries—doing knee ups on the paral¬lel bars is the solution.

Twenty Weeks
The workouts are becoming more challenging. My times are longer, but I’m able to complete the workouts, and my recovery is slower. My running is slow and steady. Just need to breathe and take it easy.

Twenty-two Weeks
I have gained about 14 pounds and am feeling it in my pel¬vis and left hip and leg. Lifts involving squats are tougher than they were a few weeks ago, but I will keep persevering because these will help with labor and delivery.

Robb and Nicki say my negative pull-ups are getting strong enough to start kipping. I’m game! [Casee was VERY close to a pull-up at this point. Her weight outstripped her performance, however, and we will have to wait for the first one.]

Twenty-six Weeks
Over the last two weeks I’ve experienced Braxton-Hicks con¬tractions with regularity, so I’m stepping the intensity down yet another notch. This week, no running, rowing, jumping rope or weight. I will monitor how I feel and adjust as I go. I still get a pretty darn good workout from the things I can still do. Yester¬day I did five rounds of wall ball (20 reps with a 6-lb ball) with OHS (15 reps with PVC pipe only). Kicked my butt!

Twenty-Seven Weeks
Instead of the 200 meter run, Robb and Nicki had me do a 200 meter farmer’s walk. This felt a lot more comfortable and was a great workout for me. [Tthe farmers walk can be a great al¬ternative for anyone who can not run. However, in the case of an expectant mom, keep the loading very moderate and make sure they do not have to death grip the weight. Extreme contraction of the hands can dramatically increase the mom’s blood pressure.]

THIRD TRIMESTER

Twenty-eight Weeks
I’ve gained 20 pounds. Only got to CrossFit twice this week. Had a good upper body workout doing three rounds of a 200 meter run, 10 dips and one rope climb. [Casee climbed approx five feet up our fifteen-foot rope three times to count for a full ascent. She is a VERY good rope climber, but this seemed a pru¬dent modification. Two layers of crash mats were also provided “just in case”.]

Twenty-nine Weeks
I felt pretty strong today. Did Fran with rowing (800 m, 400 m, 200 m) instead of thrusters. My negative pull-ups were OK but took some time because my belly tends to tighten up. I also practiced kipping.

Looks like I’m back to being able to do the runs—they’re more of a powerwalk-run combo, though. Kickboxing Friday with Robb got my cardio going pretty well, and then I practiced kipping. [Casee has a wicked right cross. Upper body is feeling stronger each week.]

Thirty-two Weeks
Due to family schedule changes, I am only able to go to Cross¬Fit one day a week. I can already feel a difference in my body. I am so bummed!

Did the “Carry.” Nicki and Greg had us carry a variety of weighted whatevers to the back fence and back. I did the Farmer’s Walk, Waiter’s Walk, Suitcase Walk, pulled the sled, negative pull-ups and some kipping. [Dan John would have been proud.]

Thirty-Three Weeks
The baby is in an uncomfortable position that makes it painful to even walk at times. I have decided to begin my temporary leave of absence from CrossFit. I look forward to resuming in two months!

Thirty-six to Forty Weeks
(10 days past due date) Thankfully my temporary leave of ab¬sence was short-lived. The baby shifted and I am on maternity leave so I look forward to my mornings at CrossFit. I basically come in to waddle around, stretch out and talk to everyone about how big I’m getting and when is that baby due?! All in all I really do still feel great and am keeping on top of my nutrition as well. Robb has been a great source of information for my nutrition and physiology questions. My pregnancy could not possibly be going any better.

LABOR AND DELIVERY

I couldn’t imagine getting through the weekend marathon labor I had without my CrossFit training. The true meaning of the word “labor” really hit me. I had almost no sleep during my 36 hours of contractions, dilated to seven centimeters at home, and pushed my 9-lb 3-oz baby boy out CrossFit style in 20 minutes! I had complete confidence in my body’s strength and ability to do what Mother Nature intended us goddesses to do. Incidentally, this was a natural (drug-free) VBAC (vaginal birth after cesarean) and I felt like I had conquered the world! [Casee had to do quite a bit of work to convince her doc to al¬low a VBAC. Read up on it. Interesting topic.]

RECOVERY

My recovery has been amazing. I went back to CrossFit one month after delivery, and two months after the birth I was back to my pre-baby weight. The workouts are bringing my strength and body shape back in an unbelievably short period of time. The nurses at my OB’s office couldn’t believe how quickly my body recovered, and I actually feel like I am in better shape now than I was before I got pregnant!

A FEW WORDS MORE

I try not to give unsolicited advice, but I would tell anyone who is trying to get pregnant or is pregnant that CrossFit training is the only way to go. The combination of the extraordinary knowledge of Robb, Nicki and Greg and the satisfaction of completing the unique conditioning classes gave me an inner and outer strength that totally complemented my “holistic” as¬pirations for my pregnancy. If you are ready to take control of your body and health, then CrossFit NorCal is where you need to be.