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Biking with a bump: Should you ride while pregnant?

Posted by on February 3rd, 2009 at 2:05 pm

Marion Rice and daughter Gleneden

[Publisher's note: This article is by our Family Biking columnist Marion Rice (bio). Marion previously wrote about how to deal with kids who don't want to go by bike. Today, she delves into the topic of biking while pregnant.]



It’s an early fall day in Portland and OB/GYN Alison Edelman is riding 6 miles through the city to get to work at OHSU. With the exception of the big (butt-busting) hill up Terwilliger at the end, her route is not especially challenging (there are bike lanes the whole way). But today, instead of biking up, she opts to take the tram.

Angela Koch -mom to be on her bike-21
BTA staffer Angela Koch — shown
here riding into work last week –
is 20 weeks into her pregnancy.
(Photos © J. Maus)

Who can blame her? She’s 20 weeks pregnant.

Is that crazy? Normal? Is the baby at risk? I decided to delve into this a bit more, starting with Dr. Edelman.

When thinking about whether you should bike while pregnant, Dr. Edelman suggests that it’s really important is to talk to your physician to make an informed decision. “As a physician,” she said, “we normally recommend that pregnant women don’t put themselves in a position where they might be at risk for falling or abdominal (stomach) trauma, like skiing, biking, soccer, etc…”

“Biking is sometimes a hard call because it’s not something you associate with trauma.”
– Dr. Alison Edelman, OB/GYN at OHSU

Dr. Edelmen went on to explain that after about the 12th week of pregnancy (most people consider 40 weeks to be full term), a woman’s boney pelvic structure no longer protects the uterus. But despite the risk of injury if they were to fall, Dr. Edelman says some of her patients still opt to stay active.

So, if you’re pregnant, should you stay off the bike?

“Biking is sometimes a hard call,” she explains, “because it’s not something you associate with trauma. As your body changes, your balance is very different and depending on what type of commute you have and time of year, you may have changing road conditions that increase your chances of having trauma.”

Story continues below

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As more and more women take to the streets of Portland on their bikes, it won’t be that unusual to see expectant moms with really big tummies navigating around. Angela Koch of the Bicycle Transportation Alliance (BTA) is one such mom. She’s 20 weeks into her term and determined to use her bike as her main source of transportation, as long as it makes sense to her and her doctor to do so.

an old shot of Juli 8 months preg.
Juli Maus still rode at 8 months.

For Koch — who also has two daughters ages six and ten — her first trimester was terrible. “I was nauseous, exhausted and my husband had to get the kids to bed and to school. Since we are carfree there were added issues of transportation for my two girls.”

Luckily for Koch, her husband is a bike mechanic so they have several different bike options to choose from. During our recent spate of snowy weather, she was concerned about sliding and losing control of her bike. To make the going easier, Koch said her husband installed some knobby tires on her bike (she also opted to take a bus once or twice).

In Dr. Edelman’s case, she felt comfortable biking until 24 weeks of pregnancy. For her, 24 weeks was a turning point because a fetus is not viable outside the uterus before then. “So if there’s an episode or trauma,” she explained, “that causes premature birth, we can’t really do anything about it.”

To help you make your decision, Dr. Edelman suggests looking at these four things:
  • Discuss how safe biking is for you with your doctor. Forms of moderate exercise usually help improve the health of a pregnancy, but some women may be limited due to issues that may cause them to have a “high” risk pregnancy
  • How safe is your bike commute? -Does your commute allow you to use bike lanes and low traffic volume streets or does it require you to ride close to traffic? Make adjustments in your route to reduce your chances for trauma. Also think about making your bike safer for you – e.g. switch over to regular pedals instead of clipless.
  • What’s the weather and the road conditions?- Are there leaves on the road, gravel on the streets or snow and ice? Could you choose a bike option that is safer in those conditions?
  • How do you feel?- The first trimester can make you seriously tired and/ or nauseous. In the second and third trimester, your balance may be challenged and your back may be sore. You become short of breath more quickly and usually have less capacity for moderate to higher levels of exercise. Be sure to listen to your body and give yourself permission to get a ride or take the bus.

After 24 weeks, Edelman cites statistics showing that less than 25% of children born that early do well. “The thought of having a child for whom my decision impacted their survival and long term health wasn’t justifiable to me.”

Angela Koch.

But everyone has a right to decide on what feels comfortable to them. Dr. Edelman shared the story of a nurse in her office that biked until she was 38 weeks: “She was an experienced biker and felt confident in her choice to continue riding. She also did not have a drivers license so this was her mode of transportation and she did just fine.”

Angela is now in the middle of her second trimester. Her belly is starting to get bigger, and she’s already thinking about switching to a more upright bike. She’s making sure she eats enough calories and protein and listens to her body. For Angela, being carfree is an expression of her ethos and an important part of her life but it doesn’t mean that she is going to bike everywhere all the time.

I’ll check in with Angela again in a couple of months and report on how she’s doing. In the meantime, if you have any words of wisdom, experiences you want to share or words of encouragement for women who are biking while pregnant, please chime in below.

– To contact Marion Rice, and to read her previous articles, click here.

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Comments
  • boriskat February 3, 2009 at 2:19 pm

    Interesting article, thanks for the perspectives!

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  • sarah gilbert February 3, 2009 at 2:45 pm

    in my first two pregnancies, I was a little shocked at the idea of biking while pregnant, but when my second son was 9 months old, we gave up our car. so during my third pregnancy, I re-thought my position on biking, and my ob agreed it was ok; as long as I was as careful as I would be with a child on my bike.

    about seven months into my pregnancy, I began experiencing tailbone pain that was exacerbated by riding the bike; so I stopped riding, but only because it was excruciating.

    now that I have the mamabikeorama (townie + xtracycle + bobike seat), if I get pregnant again I’m sure to ride even longer; the cushy seat and upright stance make it seem safer than walking across the street. safer than driving, actually; I suffered a partial placental abruption during the pregnancy with my second son, and I’m fairly certain that I experienced the trauma because of reaching around from the driver’s seat to the floor of the back seat to pick up something my oldest had dropped.

    after lots of experience with many modes of transportation, I really believe that driving is the least safe of all; I’m frequently dizzy, lightheaded, nauseous, or have sudden pains in my uterus while largely pregnant; all things that make driving very dangerous!

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  • Julian February 3, 2009 at 2:48 pm

    Hey! Pregnant cycling is so hot right now (http://totcycle.com/blog/preggo-velo.html)! Although “Biking with a bump” is a more tasteful title, and your post considerably more informative. Kim’s definitely all done cycling (39 6/7 weeks!), and her biking was limited to more casual jaunts around Ballard on very quiet streets.

    Her burliest pregnant cycling moment was pulling me and our daughter in the rear bin of our Madsen, for all of 10 feet. Before dumping us while stopped. Luckily a grownup in the back can pretty much just stick an arm out to keep from tipping all the way.

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  • Dillon February 3, 2009 at 2:49 pm

    I never thought that Stomach trauma was the issue. But the drugs that you would be receiving if you sustained serious trauma to any part of your body.

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  • mabsf February 3, 2009 at 3:08 pm

    Unfortunately I didn’t ride a lot during my pregnancy due to my job – we lived in SF and I commuted each day to San Ramon.
    But I enjoyed being on my old trek on the weekends. Once the straight bars of my Trek couldn’t accommodate my belly anymore (about 6 month), my husband rode me around on the back of our xtrcycle.

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  • steve February 3, 2009 at 3:20 pm

    This is even better than going carfree-

    http://www.vhemt.org/

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  • April February 3, 2009 at 3:42 pm

    I would think that as long as your balance is okay and you feel comfortable on your bike, you should be fine.

    I saw an image of a brochure from Europe for pregnant women, on how to stay healthy during pregnancy, and it showed a visibly pregnant woman on an upright bicycle!

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  • buglas February 3, 2009 at 3:57 pm

    This is a purely curious question from 1) a male and 2) a nearly empty nester who will never need to make a choice based on this. Any thoughts on recumbant vs upright bikes?

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  • Zaphod February 3, 2009 at 4:10 pm

    I’ll never forget the look my wife got after blazing a pretty steep technical mountain biking downhill when she stopped at the bottom and it was quite clear that she was *very* pregnant. I think she went way faster than the guy on the full suspension bike. :^)

    Our first kid was born in Boulder CO and the doctors there seem to accept an active lifestyle versus being conservative. We were told to not take chances and risk trauma. We avoided long rides that forced her to “go deep” in terms of effort.

    She rode, by her own standards, conservatively and never had even a close call.

    The boy, while brilliant (of course), can be rather whiny at times. Maybe it was the wild ride he went on in the womb that did it.

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  • Marion February 3, 2009 at 4:14 pm

    recumbants are great.. if you have been riding them before you were pregnant or very early on in your pregnancy when balance is not as much of an issue. When you are pregnant why would you want to start anything new where you could dump over and risk any kind of trauma.. but it’s a great thought.

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  • Zaphod February 3, 2009 at 4:14 pm

    steve, your comment is in poor taste.

    Not unexpected, however.

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  • Kristin February 3, 2009 at 4:21 pm

    I’m commuting at 30 weeks and the exercise and good spirits I feel from biking are great for me. I would second the advice on taking it easy, maybe finding ways to alter your route to avoid stressful sections. Biking is surprisingly comfortable, because it takes the stress off my back. I’ll ride into 8 months if I can, just taking it slow.

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  • Biker Mike February 3, 2009 at 5:09 pm

    How is it in “poor taste” to suggest that voluntary cessation of human breeding might actually make the world a better place?

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  • Aaron February 3, 2009 at 5:18 pm

    Marion and Jonathan, thank you so much for bringing up this issue. Pregnancy is one of the many excuses I hear for driving. But it seems to me (someone who will never have the experience) that a pregnancy should be treated like a minor injury and you just take it slow and easy, or ride partway on public transit. Maybe a step through cruiser or a trike would be better.
    I very much applaud those who show such fortitude and commitment.
    And hey, don’t forget the West Side Cougars

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  • KWW February 3, 2009 at 6:26 pm

    Pregnant women on bikes are HOT!
    Wait, that came out wrong….

    Anyway, not that it is comparing apples to apples, but my previous hairstylist would go jogging into her pregnancy into the 7-8th month. She did this with 2 children with no ill effects and it really helped in the postnatal/postpartum term.

    Actually that is a great idea for another article, post-pregnancy biking.

    kww

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  • Marion February 3, 2009 at 6:30 pm

    Thanks KWW.. good idea.. post pregnancy biking is all my other articles :)

    More on Angela later in her pregnancy and postpartum too!

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  • Eileen February 3, 2009 at 8:18 pm

    Wow, I can’t imagine! I mean, good for you. I think if you’re not racing, falls on bikes are rare, but my memory of being pregnant is feeling very wobbly, like all your bones kind of turn to jell-o and feeling not at all in control of my center of gravity. I would think this activity would only be for a pregnant woman who was very used to riding and had been riding through the whole pregnancy.

    Aaron – I’m assuming you’re male. Careful there. Pregnancy dramatically affects EVERY system of your body. There’s a lot more going on than just a “bump”. And it affects every woman differently. There are all kinds of pregnancy symptoms that you never really hear about until you’re actually pregnant and then you say, “you’ve got to be kidding me!” So don’t be too judgmental.

    I would be very interested to see some studies on this as more pregnant women start to ride. Like, will they have easier labors? Will it help the baby to drop the way walking does?

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  • hau February 3, 2009 at 9:31 pm

    Great article! I stopped biking 6 weeks ago when the snowstorm hit. I was around 26 weeks. Biking up Interstate, sometimes with the 3 yr old along for the ride, was becoming uncomfortable. Since this is my third pregnancy and everything feels much looser, I experienced the same tailbone pressure as Sarah. Stability is not an issue with a step through Xtracycle, nor does the belly get in the way. I cannot wait to get back to biking once postpartum. Good for those that can bike for as long as possible and as long as it’s still comfortable.

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  • t27 February 3, 2009 at 9:39 pm

    My sons mom continued to ski until her bump got in the way and continued to bike until the bump was too big to peddle. You try and raise them right but they still grow up to snowboard and ride fixies.

    He doctor told us that any activity that doesn’t involve violent motions is better than no activity. For most moms to be, the risk to mom and child from not enough activity is far greater than the risk of injury from the activity.

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  • Becky February 3, 2009 at 9:51 pm

    I had to stop riding at about 7.5 months, I think, because I have to lean forward on my bike and my knees kept bumping my belly. I tried turning my knees out, but that didn’t work very well either.

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  • Carlsson February 3, 2009 at 10:22 pm

    Steve,

    Thanks for an alternative view. Zaphod, Is it poor taste because you simply disagree or is there something more subversive I’m missing?

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  • wyeast gal February 3, 2009 at 10:33 pm

    I considered biking a more
    “conservative” way to stay active while I was pregnant at 40 for the first time. I kept my heart rate down but still put out the miles. I have always been conservative with downhill speed. Traffic is not so bad as I lived close to Mt Hood and could avoid Hwy 26 mostly.

    My son is now 11 and is starting to leave me on the hills. Keeping him safe on his bike now that he is outside my womb is much more of a concern to me than when he was in it.

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  • Mikael February 4, 2009 at 8:07 am

    Cycling whilst pregnant is recommended by doctors here in Denmark, as well as in Holland. It’s virtually a prescription.

    It’s second nature. Too many doctors elsewhere have succombed to the brainwashing about how cycling is a sport, not a transport option done at relaxing speeds.

    My wife rode to the very end in both pregnancies. It’s easy. It’s natural. It’s effortless.

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  • Jessica Roberts February 4, 2009 at 9:20 am

    Let’s be honest: the biggest risk of the trauma that Dr. Edelman refers to is not from losing balance because of your pregnant belly and falling over. It’s from cars. Once again, here in the US we place the responsibility for traffic safety firmly on the victims of the situation, and let drivers off scot free.

    It’s not the responsibility of drivers to drive attentively and responsibly enough that pregnant women (not to mention children, seniors, and the disabled) can stay safe. No, it’s your responsibility as a pregnant woman to get off the roads.

    The same sad logic leads schools to ban bicycling (because studies show it is more dangerous than being driven), lead us to tell children not to cross the street, and lead to seniors who don’t even have enough time in the walk cycle to cross.

    And it’s not like cars are magically safe either. I’d be willing to bet that one of the major causes of “trauma” to pregnant women is car crashes…yet doctors aren’t telling them to avoid car trips, and no one would blame a woman in that situation for choosing the car in the first place.

    I’m not saying that when it’s YOU making the decision, it’s easy. Having the responsibility for another life is a sobering experience, and it’s not up to me to judge someone who didn’t feel up to bicycling in that situation. I just wish we could all pool our worry and anger and use it to start demanding safer streets, better driver education, and stricter enforcement of laws.

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  • Marion February 4, 2009 at 9:30 am

    Thanks Jessica for that great post. Biking so much with my kids, I usually am never in the individual cyclist category but mostly in the vulnerable roadway user category. I was thinking when I wrote this, wouldn’t it be great if all road users treated each other like we were all 7 months pregnant?

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  • Jessica Roberts February 4, 2009 at 9:40 am

    I couldn’t agree more, Marion.

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  • Val February 4, 2009 at 9:43 am

    For a Danish perspective on this, see: http://tinyurl.com/dlwsqc and http://tinyurl.com/blkmwq Staying active is important, and riding a bike is a much gentler style of excercise than jogging. Unfortunately, our culture features the aberration of considering it dangerous.

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  • BeFit-Mom February 4, 2009 at 10:28 am

    All pregnant women who continue to ride bicycles, either for exercise or for transportation purposes, should be aware that the placenta stops growing at 20 weeks gestation. At this point its’ ability to transport oxygen is capped. As the baby grows and demands more oxygen, pregnant women will need to slowly taper down the intensity of their workouts to stay within a safe aerobic training zone.

    Since resting heart rate(HR) also rises during pregnancy, heart rate reserve diminishes, and the point at which the body transitions from aerobic exercise to anaerobic exercise will occur at a lower HR. Pregnant women should always stay in an aerobic zone that they perceive as “somewhat difficult” and never exercise to the point of panting, or being able to have a normal conversation while exercising.

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  • Angela February 4, 2009 at 10:50 am

    Just to add another two cents, I’m quite frankly way more scared of falling down the stairs each day than I am of anything that might happen while cycling.

    I’m not belittling my responsibility to keep my baby safe from any outside dangers that exist, just pointing out that I prefer to weigh pros and cons realistically rather than be swayed by any real (or perceived) culture of fear.

    I believe in the long run my children – both this new baby and my daughters who observe me and other moms who bike – are far better off because of my choice.

    That being said, this is an entirely personal decision and I wouldn’t advocate for judging any pregnant cyclist who chooses differently during their own pregnancy.

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  • Noelle February 4, 2009 at 11:48 am

    I would think driving a car would be far more dangerous (steering wheel, glass, seat belt) than a bicycle.

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  • E February 4, 2009 at 12:27 pm

    :D

    I personally happen to agree with Steve, but I also think it’s great to have a forum like this where people can discuss such a topic – which is not widely talked about “out there” in the world – and thereby help others facing a similar situation. And of course, kids raised on bikes are better for everyone than kids in SUV’s. Go Moms on Bikes! :)

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  • carless in pdx February 4, 2009 at 1:17 pm

    Zoobomb?

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  • Marni Ratzel February 4, 2009 at 1:54 pm

    During my first pregnancy, I was fortunate enough to live in Boulder, CO where my 3.2 mile commute to work was along the Boulder Creek path, a multi-use path with grade seperated crossings of roadawys. From my home to work I only had to cross one minor roadway. The rest was car-free and care-free. I biked regularly to term and as I lived only a 1/2 mile from the hospital, I also biked there in labor (and had a contraction or two along the way)! The exercise actaully helped me feel better and I choose to turn around and labor at home for several more hours before returning to be admitted. We did drive back to the hospital the second time since it was 11:30 at night and I had progressed. But, I enjoyed the freedom of contining to bike and it I think it helped me bounce back sooner post-partum.

    I switched to an upright bike with a step through frame and I certainly rode slower. I don’t enjoy riding this bike now because it’s slow. But, loved it while pregnant.

    I’m 31 weeks into my second pregnancy now. But, haven’t biked in months becausemy commute is now 12 miles one way (I still live in the Boulder area, but moved to a surrounding town. I also have to drop my son off at daycare 1/2 way into the trip and I’d have to ride a significant portion of the way on-street…in a wide shoulder along arterial roadways. That feels just too risky to me. But, I’m looking forward to the completion of a planned underpass that will allow me to commute between home and the daycare mostly along paths. By then I’ll be trailing two kiddos!

    I recommend comlimenting bike-riding with regular yoga practice. The balancing poses like tree are a good gauge of how you’re center of gravity changes as your belly grows.

    Thanks for writing the article!

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  • Marion February 4, 2009 at 2:40 pm

    Thanks Marni! High Praise… good luck with the birth.. it’s such an exciting time.

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  • West Side Cougar February 5, 2009 at 8:01 am

    #14 Aaron, Thanks for the shout out, I loved riding while pregnant, both times. All over portland, single and tandem bikes, was great way to exercise to be ready for the big day and the big push!!

    #24 Jessica, I was weary of riding with cars, would take less traffic routes when possible and did ride slower for safety for me and baby.

    #32 Zoobomb?-Heck yeah, they don’t mind if you go slow and were great supporters of family biking!
    Big plus, most of the route was not in traffic ;->

    Ride On!
    West Side Cougar Carie

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  • JM Mama February 5, 2009 at 12:22 pm

    I loved riding while pregnant. I never thought that a bike fall could cause “tummy trauma”. But I did tend to be more cautious in choosing routes and speeds. I have to admit too that I did have a freak fall at close to 30 weeks. It was scary initially, but I landed pretty much on my feet, so all good. What are the chances of falling anyway? I’d do it again…albeit it would be harder each time around having to haul more kids :-)

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  • Rob February 5, 2009 at 5:19 pm

    I have to nitpick, sorry.
    You stated:
    “In Dr. Edelman’s case, she felt comfortable biking until 24 weeks of pregnancy. For her, 24 weeks was a turning point because pregnancies are not viable outside the uterus before then.”

    I don’t really understand the point of this statement. If something had happened to require delivery before 24 weeks, the baby would have had a low probability of survival. It seems like if she were concerned with the life of her baby, she wouldn’t have biked *until* reaching 24 weeks.
    BTW (not to start any sort of flame war) the thing you’re referring to being viable isn’t a pregnancy, it’s a baby. A pregnancy is until it isn’t, which happens when the baby is no longer in the uterus. The only type of ex-utero pregnancy would be an ectopic (tubal) pregnancy, and wouldn’t last to 24 weeks.

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  • amanda February 6, 2009 at 8:50 am

    I agree with Rob — I really didn’t understand that point. However, I thought the article was great — gave me some things to think about.

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  • Marion February 6, 2009 at 10:14 am

    O.k. I should have said, the fetus is not viable outside the uterus.. sorry.. I will change that.. good call. Thanks for the catch.

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  • Sean Chaney February 8, 2009 at 5:59 am

    Great article Marion. My wife, who teaches at Sunnyside Environmental School, rode to school from our home on SE 72nd until she was about six months pregnant. That was the point at which her expanding belly made a comfortable reach to the bars impossible (compounded by the fact that all of her bikes were stolen out of our shed in September and she was riding one of mine adjusted for position). Her commute is relatively flat so keeping her heart rate down was fairly easy.

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  • Stefan UK February 8, 2009 at 5:14 pm

    My partner was cycling up to the last day of her pregnancy because it was more comfortable and less exhausting than walking.

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