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By Daniella Gray
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During what was classed as a high-risk pregnancy, a Utah mom received advice she never expected.
Just three weeks earlier, Isabelle Fisher had been told to stop working and placed on complete bed rest as doctors closely monitored her unborn daughter's growth and blood flow.
But when her midwife asked about the exercise routine she had followed before pregnancy, the plan changed.
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"I honestly had the best midwife on this planet," Fisher told Newsweek. "I had some heavy bleeding my first trimester and she walked me through every step of that as well, so I had complete faith in her with the decisions she recommended for me."
Before pregnancy, the mom-to-be mostly powerlifted and even considered entering a powerlifting competition.
At 35 weeks, her midwife suggested she return to the gym, focusing primarily on upper-body exercises while avoiding excessive pelvic-floor strain.
The hope, she said, was that movement might improve blood flow through the umbilical cord.
While exercise is not typically prescribed as a treatment for fetal growth restriction, Dr. Jeffrey Chapa, national medical director of maternal-fetal medicine at Obtelecare, said staying active is no longer discouraged in many pregnancies.
"Exercise can help blood flow in certain cases, mainly by improving vascular endothelial function," Chapa told Newsweek. "For high-risk patients, its main benefit is preventing complications by improving the metabolic profile, maintaining blood flow to the uterus, and lowering the risk of conditions like gestational diabetes and preeclampsia."
When Fisher's midwife cleared her to return to weightlifting, the main priority was ensuring she didn't place too much strain on her pelvic floor or risk triggering early labor.
"My midwife’s biggest thing was making sure I listened to my body," Fisher said. "So I did the occasional pelvic floor exercise to help strengthen it but nothing that overly exhausted myself."
Because of her high-risk pregnancy, Fisher was placed on bed rest at 32 weeks.
Her daughter was measuring around four to five weeks behind because of intrauterine growth restriction (IUGR), which she said was linked to a calcified placenta and poor blood flow through the umbilical cord.
She began twice-weekly monitoring, including non-stress tests and ultrasounds to assess blood flow.
While the baby continued to pass the tests, she said concerns over blood flow and nutrient supply persisted.
She was given steroid injections to help prepare the baby's lungs for a possible early delivery, but by 35 weeks there had been no improvement.
When she was put on bed rest, Fisher said her blood flow had "decreased exponentially."
"When I started lifting again, they actually saw a much stronger flow through the cord than they were expecting," she said. "It came down to a race of how quickly my placenta would calcify. Every ultrasound I had, they noted that it was doing better."
Chapa explained that Doppler measurements can vary from one scan to another, and an improvement after resuming exercise does not necessarily mean the exercise itself caused the change.
"One improved measurement after resuming exercise doesn’t show that exercise caused it," he said. "That variability is exactly why high-risk pregnancies need consistent, ongoing monitoring by experienced specialists."
At 36 weeks, however, Fisher's daughter failed a non-stress test for the first time, having passed almost 15 previously.
An ultrasound showed that blood flow through the umbilical cord was the best doctors had seen, but the baby was moving less than usual.
Concerned that the placenta could no longer adequately support her despite the improved blood flow, Fisher's care team recommended delivery. She was admitted to hospital and induction was started using Cervidil, followed by Pitocin.
"I labored for about 20 hours while my midwife checked on [me] regularly," Fisher said. "But I was not dilating well, and my daughter was not handling my contractions well either."
After an emergency C-section, the family spent three weeks in the Neonatal Intensive Care Unit (NICU) with the baby needing oxygen for two months.
At her 6-week check-up, Fisher was told something by her midwife that she would never forget.
She believed that going back to the gym and lifting helped improve the blood flow and gave her baby what she needed in those final weeks.
Although she was born weighing 4lbs, 5oz, Fisher said her daughter is incredibly healthy now.
"You wouldn’t even be able to tell she had a rough time coming into this world with how much she talks and runs around," she said.
Chapa said recommendations around exercise in pregnancy should always be individualized.
Women who regularly exercised before pregnancy can often continue with modifications, he said, but vigorous activity may not be appropriate when blood flow to the baby is already compromised.
Determining what is causing fetal growth restriction, whether placental problems, an underlying condition or simply a constitutionally small baby, requires specialist assessment.
Fisher hopes her story nevertheless challenges assumptions that pregnant women must automatically abandon the activities they enjoyed before pregnancy.
"I think we lost the knowledge that women are capable of incredible things while growing a human," she said.
Contact Newsweek editors on this story: Kara Dolman, Gray R. Thomas
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