AUTO-GENERATED TRANSCRIPT

Brianna Battles 00:01
welcome to the Practice Brief podcast. I am the host, Brianna Battles, founder of Pregnancy and Postpartum Athleticism, and CEO of Everyday Battles. I’m a career strength and conditioning coach, entrepreneur, mom of two wild little boys, and a lifelong athlete. I believe that athleticism does not end when motherhood begins, and this podcast is dedicated to coaching you by providing meaningful conversations, insights, and interview topics related to fitness, mindset, parenting, and of course all the nuances of pregnancy and postpartum, from expert interviews to engaging conversations and reflections. This podcast is your trustworthy, relatable resource for learning how to practice brave through every season in your life. Hey everyone, welcome back to the Practice Brave podcast. I’m very excited to have Christina Prevett here, and we’re going to be talking all about the research during pregnancy and postpartum, and tying it together with what we see in the research, what we see among the practitioner community, the coaching community, and how all of that is being implemented into our female athletes. So, Christina, thank you for being here.

Christina Prevett 01:12
Oh, you’re so welcome. I’m so excited.

Brianna Battles 01:14
No, I feel like it’s been a long time coming with getting us having a conversation on the podcast, and I’m grateful for your time.

Christina Prevett 01:20
Yeah, our schedules and time zones, it’s always,

Brianna Battles 01:22
yeah, all of that. No, it’s finally happening. And before we dive into the into the nuances, give us a little bit of your academic background, a little bit of your career background, and even your athletic background.

Christina Prevett 01:35
Yeah, I would love that. Okay, so I have been a physical therapist for about 1213 years, I am up in Ontario, and about two years into my clinical practice, I was actually looking in the geriatric space and thinking that there was a ton of under dosage happening in that space, and I would have so many frequent flyers of, we would appropriately load them, they would get stronger, their pain would come down, they would discharge from rehab, they would decondition because they didn’t have a fitness professional that kept them up, and then they would come back onto my schedule, and I was a CrossFitter at the time, and I was just seeing all of these Masters athletes in their 40s, 50s, 60s, just crushing it in the gym, and just thought there’s something here, and so I went back and did my part-time PhD for fun. Do not recommend doing it part time or for fun, though I kind of loved it, and started looking at high load strength training in an older adult frail population. When I was doing that, because I was doing it part time, it takes seven or eight years. I flipped from CrossFit to power lifting, and then power lifting to weightlifting, and I was a national level lifter up here in Canada. During that time, my husband and I got married, started thinking about a family, and I got pregnant with my first kiddo during that transition, and so a couple of things started happening. One, I was lifting during pregnancy, and this was, you know, eight years ago. My eldest is seven, and people were telling me on the internet that my baby was going to die, and my fellow pelvic PTs were telling me that my body was going to prolapse, and that they asked me for my biofeedback numbers, etc. That started happening. The second thing was that I had a committee meeting, and Stu Phillips, who’s very much known, Matt Kinproff online, he said, “Cristina, if you think that there is no research in older adulthood, you should look at pregnancy. And the third thing was I had done some work in my PhD about where physical therapists could help to bridge the gap to health and wellness, and pregnancy and postpartum was one area, and so I had started doing some pelvic health, and I had a class called Strong Like Mom, and so kind of all these things happened together, and when that happened, my husband hates the phrase for me, I’m just going to send an email, because I did, I just sent an email to Dr. Margie Davenport, who you’ve had on the podcast, and said, “Hey, like I’m working with barbell strength athletes, you know, I’m seeing some of this go on, you know, they have lots of questions, but there’s a lot of fear, and you know, I’m working with them in a class setting, in a one on one rehab setting, I’m part of that community, I think there’s something here, and so we did a survey that was published in IUJ, looking at those who self-selected to lift over 80% of their one rep max at some point during their pregnancy, and we looked at rates of pelvic floor dysfunction and safety outcomes, because whenever you’re pushing the boundaries on exercise, there’s a safety component that has to be checkmarked first, and it launched into my postdoctoral fellowship. So now I teach for the Institute of Clinical Excellence, and so I teach our pelvic health curriculum and our geriatric curriculum. I am in clinic once a week. I own a company called the Barbell Mamas, and I’m a postdoctoral research fellow at the University of. Alberta, looking at safety and rates of pelvic floor dysfunction for those participating in high intensity exercise during pregnancy. And then I have a small side project looking at exercise and miscarriage based on my personal experiences.

Brianna Battles 05:13
Yeah, and I mean, I would love to talk about some of the research that you’ve done. We’ll start with the like lifting and what we’re looking at, like, I think what was really great about the podcast with Margie is we acknowledge that for the with the research, so much of it has to just kind of validate what our female athletes have been doing anyway, and then connect that to then what the practitioners are prescribing. We’re kind of like creating all these bridges, but we’re having to reverse it by having the research reflect that, so then the medical communities can get on board, and it just creates a little bit more unity in the messaging across the board, not to just for what the athletes want to hear.

Christina Prevett 05:52
Yeah, so when it comes to our medical decision making, I think what’s really important, and I feel so honored to be, you know, we were talking about us being like bridges, kind of, where I kind of have a foot in the research community and a foot in the clinical community. When we don’t know, often the answer is no, especially in pregnancy, that’s such a protected time. And so last year, Margie and I published a systematic review that was looking at resistance training in pregnancy, and we did a very intentional, like, deep dive into the prescription, and when I tell you that some of the prescriptions were using a Theraband, no more than three kilos, like that was the prescription for 15 to 20 weeks in some of these RCTs, and so, like, my

Brianna Battles 06:42
their doctors, you’re saying, when you say prescription,

Christina Prevett 06:44
like, they were in this, the study, and this was the exercise program that they had prescribed from a resistance running perspective, right? And so, most individuals were not exercising before, but still, like, the baby coming out of your vagina is going to be more likely than the weight, the max weight that some of these, these studies were prescribing it made sense, then for me of where this don’t lift more than 20 or 30 pounds came from, because when nothing has evaluated further, then we’re gonna just say that this is the cut off, because we feel safe in this zone, right? That was kind of like number one, number two, I had a meeting with a maternal fetal medicine doc, and I always say we kind of need to lock shields and understand where people are coming from, and he said to me one time, and I didn’t even know that this was an argument I had to make in my research, is that for example the Val Salva maneuver, like people are worried about it in the medical community, and so Margie has done some work acutely, I’ve done some more work retrospectively, but he said to me, if there is anything that gets your blood pressure over 160 and the doctor knows about it and says that it’s okay, they can be held medically liable, and so there was a liability, and he’s like, I’ve been on, I’ve been on boards or on committees that are looking at medical liability for somebody who didn’t catch higher blood pressure, and he goes, like, how would you respond to that? And I said, one, thank you so much for telling me that, that was an argument I had to make, and two, like, when it comes to our pre-post data, yes, transiently your blood pressure will likely exceed 160 if you are lifting heavy, but it goes right down within seconds, and your criteria for elevated blood pressure in pregnancy is two measurements taken at least 20 minutes apart that show elevated levels, but again, that wasn’t an argument that I realized I had a response to it, I just didn’t know that that was the argument I had to make, and so it wasn’t until I was able to sit down with someone and say, tell me your concerns, like why are you worried about this, and how can I ease your mind based on what we know in the evidence and what I am doing as an athlete, it allowed for more shared decision making, and it, he said, like it kind of changed his practice because he didn’t realize, you know, what that physiology truly looked like, and I thought that was a really powerful moment.

Brianna Battles 09:04
Yeah, absolutely. And I’m really glad that you shared that example, because I do think that there’s been this culture of like liability versus like, you know, the doctors, they just don’t understand exercise well. Maybe they don’t, but other times they’re.. it’s.. it’s just more layered and nuanced than they don’t understand exercise. It’s there’s a liability factor, and it is we don’t or didn’t have research that told them otherwise, so we’re going to default to what they did know or what they did personally feel comfortable with.

Christina Prevett 09:31
Absolutely, and we’re starting to see this kind of same trend and trajectory happen in the world of pregnancy-related complication, where as soon as a complication comes on board, we lock down exercise, and now, like the Society for Maternal Fetal Medicine says that when we actually look at activity restriction and how bad it is for mental health, physiology, muscle quality, like weakening inactivity, et cetera, financial implications of not being able to work. All those things based on our outcomes, they don’t recommend it, and they actually have a consult series that says we do not recommend activity restriction of any kind in certain conditions, and so I think we’re seeing that change as well, where our knee-jerk reaction sometimes in medicine is that exercise makes it worse, and it drives me nuts, because literally, my clients with congestive heart failure, with a low ejection fraction, and so much deconditioning, and all this kind of stuff, are getting more exercise prescription and priority of exercise maintenance than, you know, some of our pregnant postpartum athletes,

Brianna Battles 10:35
right? It’s like the risk of not exercising far outweighs the risk of being told, you know, you can’t,

Christina Prevett 10:41
yeah,

Christina Prevett 10:41
yeah, like you have a complication, don’t wonder at max or deadlift, but you can go for a walk, or like get on a bike, you know,

Brianna Battles 10:48
I think where we can, we both have experienced like the all or nothing thought process that exists, I’d say, in the greater community, it’s not just athlete, and it’s not just coach, it’s not just practitioner medical, it’s kind of like an all-encompassing theme, is you know, it’s either full send or it’s no send, and being right here in the middle ground is not a narrative that sells well, but ultimately that’s the way to stay in the game of what I refer to as this lifetime of athleticism, it’s like use basic principles of strength conditioning to adapt what your training looks like at different points in time, knowing that the bottom line is, how do we keep women training through all seasons of their life? And you come at this from the angle of understanding geriatric, and, and what is ahead for hopefully all of us. I mean, these seasons of pregnancy and postpartum are absolutely catalysts.

Christina Prevett 11:40
Yeah, and I, one of the things I never said that I was going to do a postdoc, one working with Margie is like a dream come true, because she is like such a goat when it comes to the research side of things, but also I was seeing this, these women, because my practice, you’re either pregnant and postpartum or you’re over the age of 70, like those are my two buckets, but my seven year old women would start to feel this sense of fragility within their own bodies that started in pregnancy, where they started to not trust how they were feeling within their body, because they were told that what they were feeling was wrong, and that they should just restrict or do less, or, you know, like, there’s just so much that that narrative has spun in women’s health across the lifespan that I think is so important.

Brianna Battles 12:20
Absolutely, and my mom, and she’s 67 and she’s like a badass little CrossFitter, and, but she didn’t start any of that until she was in her mid 50s, and she’s just like, you know, Brianna, like it just wasn’t a thing for us, like it just wasn’t like no one talked about any of this stuff, both from, like, a it’s taboo to say anything about, you know, the pelvic floor, but there wasn’t even like a word for the pelvic floor for them back then, and women lifting wasn’t common, and so she was just like, yeah, like you became a mom, and that was kind of it. We’ve seen this huge cultural shift with Gen X and millennial women. I think that have really changed the trajectory of of what the future looks like for women, not just during these seasons, but again, how that carries over into their lifespan of being a geriatric, geriatric

Christina Prevett 13:06
athlete. Yeah, and I think, too, like Title Nine just increased a lot of female insurgents into sport, and then the reality that your fertility and your pregnancy window, like your fertility and athletic window, kind of directly overlap, and this understanding of you, like you say it all the time, is that motherhood does not mean the end of your athleticism, and so too, like for people who are at the grassroots level who are working with these moms, this seems so commonplace, but like the research takes time to build levels of evidence and get past ethics boards, like when the standard is a green their band, and I’m saying I want them to deadlift 200 pounds. My ethics board is probably like, what you have to build like this safety profile, and these case reports, and these retrospective studies, and then prospective, and we’re getting there. We really are. It just, yeah, it takes time for, you know, different groups to consistently report on some of these outcomes.

Brianna Battles 14:02
Yeah, so like, there is, how is heavy lifting being determined in the research? Because there’s certain parameters that you have to be mindful of, and then how does that translate into what that actually means for what women are really lifting?

Christina Prevett 14:19
Yeah, so there’s kind of two camps that are going on right now, we have like acute studies, which we are looking at like blood flow to mom and baby when women are lifting, like when they are pregnant, and then we have more longitudinal data that I am, I am kind of in the weeds of that is trying to look at long term trends, and then I’m trying to build in the pelvic floor dysfunction piece, because I think one of the things that frustrates clinicians right now, and I totally get it, because I’m there too, is so much has focused on the safety piece, because we needed that check mark first, but now, like, the nuance of what kind of modification do we do, this, can we do that, and what does that mean for postpartum pelvic floor dysfunction. Hasn’t been evaluated yet, so on the acute safety side, Amy Molik, who is a master student in our lab, working with Margie, has done several series that are going heavier, starting at 50% of 10 rep max, then we’re at 80% of a 10 rep max, where they looked at blood pressure parameters, blood flow to mom and baby, and any changes in any of those parameters, pre to post exercise, with a breath out on exertion, and with a val salva maneuver, and so our lab published that in the British Journal of Sports Medicine last year, that showed acutely there was no drop in baby’s heart rate or increase in something that would be worrisome in baby’s heart rate for these moms who are kind of in their late mid second trimester to early third trimester who were lifting in the 130 to 150 for 10 zone, so these are like well seasoned athletes who were very comfortable with these movements.

Brianna Battles 15:57
Yeah, I’m freaking out of breath too doing that. Yeah,

Christina Prevett 16:00
like two two by 10, one with an exhale and one with a Valsalva each rep, like we were stressing the system, which is wonderful, like to we have to stress the system, and so acutely no issue. And then they went on to have very normal labor and delivery stories, and so that’s kind of our acute safety data,

Brianna Battles 16:18
and that’s looking at just for clarity, for anyone listening, that’s looking at maternal and fetal safety, so like blood pressure, blood volume, and all of those things, but not at pelvic floor outcome or whatever on the system.

Christina Prevett 16:33
No, and so what my work looked at was first cross-sectionally of what does this look like if you self-selected to lift heavy? Tell me a little bit about what you did, how you modified, and then what does your postpartum pelvic health look like? And this was where my own data proved me wrong, like I used to say avoid Valsalva, you know, five, six years ago during pregnancy, just because of pressure, et cetera, because it’ll help with pelvic floor dysfunction postpartum, and now I’m like, “Oh, my own data, consistently said that was not true. And so now I say, “You know, here’s all of these breath strategies, you can choose the one that works the best for you. But again, everyone hates nuance, so they always say, like, one way or the other is a hard rule. And if you are going to Valsalva, I just need you to know how to relax with a closed breath in delivery, because levator and I co-contraction during pushing can prolong our pushing phases, and so some of our barbell athletes tend to have a little bit longer, they can have longer pushing stages if they’re working against themselves, and so

Brianna Battles 17:38
you’re gonna need to say more on that, my girl.

Christina Prevett 17:41
Okay, so I

Brianna Battles 17:42
think because we, you and I, have talked separately, and I think I told you, like, so much of my own first birth after being an extremely heavy lifting active athlete 12 years ago, you know, was very much like in line with even what we’re saying now, which is lift heavy, keep doing all the things, but the nuance of the how and us not being taught the how, and that there are multiple ways to Val Salva that all have different outcomes and or different influences, I should say, on that core system, including the pelvic floor, what you just alluded to here. So, I do want you to talk about Val Salva and the Rainey,

Christina Prevett 18:26
okay? So, Val Salva is a breath strategy, not a core strategy, technically. That’s why we call it like Val Salva bracing or Val Salva bear down. When you use the word Valsalva, it means a closed glottis movement, and so when we are lifting and doing a val salva brace that is a coordinated co-contraction of all four levels or four sides of the cord canister, chest wall, ab wall, lumbar erectors, and pelvic floor, and when we do that, we increase spinal stiffness, it increases emg of the spinal erectors, it allows us to lift more weight, and we automatically will at least transiently Val Selva when we’re over 80% So, what we see is in trained and untrained individuals, as soon as you get over 80% inspiratory volume, that big breath you take before you lift increases, and breath ceases automatically. So, we see this cool curve that happens when we are thinking about a Valsalva bear down for birth. We are using our abdominals to help the smooth muscle of our uterus contract on a relaxed pelvic floor in order for baby to come down into the birth canal, and so where our research in birth is is that levator ani co-contraction, so if you’re accidentally, instead of relaxing your pelvic floor muscles, you’re contracting them, can make it harder for baby to descend, and it can make you kind of have to push longer and longer and longer.

Speaker 1 19:56
Yeah,

Christina Prevett 19:56
and so if I am working with a barbell athlete, I say kind of here. Your breath strategy, if you’re going to Val Salva, that’s great, but I want you to practice holding your breath with a relaxation in the way that I often try and facilitate that is putting the pelvic floor in a lengthened position, which is usually in some sort of posterior pelvic tilt, so child’s pose, happy baby, deep supported squat, and I often get them to do a contraction to a relaxation, because sometimes, too, it’s hard, like you don’t really think about that system until you’re pregnant, or you’re peeing yourself, and you don’t want to be, and then all of a sudden there’s all this attention to the pelvic floor, and you have to just gain awareness of that system. Yeah, like that. That’s my like asterisks, where the nuance is, I will have you val salve all the way up until delivery, as long as you can switch strategies when you’re going into birth.

Brianna Battles 20:49
Yep, and that’s so hard, because that’s not intuitive. I think, like, most people have been taught to, we’re breath hold out or we’re going to bear down, and then that’s just like, it’s such a, I mean, it’s so ingrained into their brain, so then to implement a new way of Valsalva ing, or just any breathing strategy during pregnancy, there’s a bit of a learning curve there, and then you add the stress of labor, your brain often wants to default to what it knows, so that’s why you know the work that we do in pregnancy is so important, because it’s not just about this breath strategy or this pelvic floor exercise, it’s more of just like really understanding your body and your predispositions. I don’t know about you, but I find a lot of my cross sitters are just high tension athletes, like they hold tension, pelvic floor, abs, but everything is just tense, so getting them to learn what it feels like to even go into that length and position and then create a contraction again. There’s just a big disconnect in what’s intuitive and ending of this, and now be more forced into it during the season of body awareness.

Christina Prevett 21:50
Yeah, well, and so many people who like fall in love with like really high intense sport are the ones who are a little bit more type A kind of like, you know, that go go go type of mindset. Anyway, so you’re already kind of predis like, honestly, like I am calling myself out here. Yeah, I was so

Brianna Battles 22:06
irritated when I was like, you’re telling me that I have to like think about breathing, that’s so annoying. And like, I was in 2014 like it was just like that doesn’t even make sense. Why? How can I now? Can’t I just like out exercise or hack this with a movement pattern, it’s like, yes, and there’s a little more to it than that. One

Christina Prevett 22:25
of the things that I’ve started layering into my communication and education is also trying to bridge the performance piece, is like, if you learn how to breathe, your metcons are going to be way easier. Well, yeah, like when I was a competitive athlete in CrossFit, I would almost exclusively be focusing on trying to control my breathing for as long as I could before I hit a red line, and it helps performance tremendously to have that variability, and I think it helps to kind of get some of these athletes on board who are a bit more, you know, hesitant to want to switch strategies or relearn, and like another like caveat here is like if you Val Salva, and you’re a person who’s got a lot of nausea in their first trimester, it might make you feel like you have to hurl, like, so it actually could make things worse, and you’re not going to want to Valsalva at all in the first trimester, because you’re like, I’m going to get this barbell off my back and going to go puke in the garbage on the other side of the gym,

Brianna Battles 23:17
why, like, there’s just so many layers, this conversation, it’s never like do this or do that or don’t do this, it’s just like obviously the annoying thing that we’ve both been saying for a long time is it’s just such an individualized need and knowing like what this person needs who’s very high tension and very athlete brain versus maybe our more gen pop who they actually need to learn how to generate tension like it just kind of depends on the person in front of you,

Christina Prevett 23:41
yeah, one of the things I think that kind of bugs me in the social media landscape is that we have turned our thoughts around, hey, this could help in pregnancy into rigid rules, and we actually don’t have any evidence, like I think the one that really grinds my gears the most is this coning conversation, because everyone’s like, if you avoid coning, then you’ll prevent diastasis recti postpartum. I’m like, one, that’s not even true. Two, our evidence on abdominal exercise volume and its link to postpartum diastasis recti is poor. Nicole Beamish, his work is showing that reduced strength of rectus and obliques is actually a risk factor in postpartum diastasis recti, and rectus does not activate strongly in neutral, it has to go through flexion and extension, and like I’ve seen reels where they’re like, you can’t even get up off a reclined seat like this, you have to roll to this side, I was like, do you know how hard that is, and so we’ve turned these rules, and so my work now is looking retrospectively, and as you would expect, my data is not showing that avoiding core exercise for coning is protective against diastasis recti postpartum, and so we have these set of rules that we’ve turned into rigid rules, instead of saying, hey, if you’re doing sit-ups and you have belly button pain. Or you can’t control your core wall very well. Let’s modify away, not because you’re pregnant and this is bad, but your body isn’t ready for this right now, and you’re I want you to have a strong supported core wall, and that’s when we would modify away, right? And so I went viral because I have a client doing butterfly pull-ups, and she started coning in like two weeks postpartum. When I saw her, she had completely re-approximated, and she had maintained all of her strict pull-up strength. And it’s like, you know, this is one person, and I’m not saying everybody is going to be like this, but I think this idea that we’ve created this line of this is safe and this is unsafe when it’s expected that there’s a lengthening of linea alba, is just there’s so many different examples of this, but it’s one.

Brianna Battles 25:46
I have certainly lived the pendulum swing, and it is – it’s maddening, because we went from no one knew a diastasis was in 2013 when I was first pregnant, and then there’s so many variables that influence somebody’s diocese exercise is just like one of the multitude of variables, like I’m five three and I have 10 pound children, like they are just giant rude boys, like that, they had nowhere to go except into tissue, so it’s like for me that was a really significant consideration, for me, for somebody else it’s not going to be a consideration, but you know what, maybe there are ones that are peeing themselves, or they’re having more prolapse symptoms, or more heaviness symptoms, and so to like, I always say, like, diastasis is a gateway drug to understanding your pelvic floor and everything else, because it gets the attention, there’s a lot of fear around the esthetic changes, coding is like visual feedback, so it’s almost easy to like, like, what’s the word, or like, diagnose, or try to, like, pathologize it, I guess, is the word I was looking for, because it’s a visual cue of a changed pregnancy body, but ultimately it’s just a form of feedback, of like, that’s where pressure is going, because, of course, that’s where it’s going, that’s thinned tissue, it’s not muscle really on that part of the body, so it’s like easy to generate attention there and fear there, but on the other side of the pendulum, it’s like, well, there was no information, then there was mass information, and then mass information leads to fear, and it’s just, it becomes really messy in a lot of the messaging and the advice, and again, it’s something that is trendy and gets a lot of attention, but ultimately a lot of confusion around it.

Christina Prevett 27:23
Yeah, so I don’t know when this is going to go live, but I am actually doing a presentation at the end of May. One of the things that I asked in my surveys was about kinesiophobia, or fear of exercise in general, and then what I see is hyper vigilance or fear around the core wall and pelvic floor, and what we saw was that most active women have a very low fear of movement in general, like we’re kind of in this place, especially with people who are previously active, like they’re not really worried, but there’s a lot of hyper vigilance and fear where they believe strongly that statements like what I do for exercise predicts my pelvic floor dysfunction postpartum. They are in the agree or strongly agree category, and that is higher if they get a lot of their advice from exercise professionals and from social media, in particular. And so I think there is this awareness and this understanding that you know there’s so much to the advocacy and awareness, but the way that you talk about this as a pre postnatal coach is incredibly important. Oh yeah, because you can, especially when we don’t have evidence that backs it up, and my work is is showing more that it’s what’s happening during labor and delivery versus any decision you made, if you did sit-ups until week 18 versus week 16, you know, your anthropometrics, your genetics, if you had a grade three tear versus a grade one tear, if you had a vacuum or forceps versus none, like if you had an episiotomy versus, you know, a trial of labor to cesarean versus a plan C-section, like those are way bigger determinants of what your postpartum pelvic floor journey is going to be than scaring moms into saying that these are the only three exercises you can do that are safe versus not, and when I get into people’s comment section, they get so mad, and I was like, they’re like, you’re not being a girl’s girl, and I was like, I am being a girls girl to every woman who is listening to you and thinking that what they’re doing is unsafe, because unfortunately that is the reality when we have this bifurcation of this is okay and this is not okay. Absolutely,

Brianna Battles 29:33
yeah, I again, I’ve seen the pendulum swing so much that it goes full circle, we just can’t keep having to like fight the same fight the same battles, just taking a different angle on it, and it’s become, I think, a really messy landscape to navigate, because there is more interest, there is more information. How that’s delivered, how that’s communicated is so important. We have a whole communication framework in my certification because of that, and like it does, like exercises, like especially pregnancy, it. My, my personal preference is like I don’t care much about what you do during pregnancy. Come to me postpartum and we’re going to deal with what we got here. There’s also a lot we can do in pregnancy, more from like training your brain, similar to the conversation we had earlier, with like here’s different ways that you can be more aware of it, but more so of like some of those neuromuscular strategies versus exercise strategies, but really, what we’re dealing with is what did delivery look like, and what does your game plan look like for an actual progressive overload postpartum, instead of just trying to get back as fast as you can and skipping over this phase progression that kind of helped build these building blocks of performance.

Christina Prevett 30:38
Yeah, it’s so important. So, Margie was the lead author on our 2025 Canadian postpartum guidelines, and I love them, and our FIFA postpartum protocols, and they talk about symptom-based individualized prescription, and I freaking love that, because it talks about these biopsychosocial considerations, and how your baby is colicky, you have no support, like you had a really traumatic birth, your mental health isn’t great, like all of these things are going to be such important considerations, and it means that I hate, like, when we have week by week of like this is what you do week one and this is what you do week two, because for some people that’s going to be too little, for some people it’s going to be too much, and so how do we go to this like frameworks over protocol approach of like, you know, FIFA is like, here’s what you’re like past this phase, you’re able to do this, this, and this, then you go on to this phase, and for some people that’s two weeks postpartum, and for some people that’s six or eight months postpartum, and no one is doing it right versus wrong, because there’s so many considerations, you know, baby three versus baby one, like you know, all the mom lives next door versus mom’s in a different country, like those are you know your mom, like grandma, yeah,

Brianna Battles 31:53
absolutely, I think we have to focus as coaches and like clinicians on themes, these are general themes, and now make that apply to you as specifically as you can. You know, but because again, no information to then people saying, why didn’t anyone tell me? I was one of those people. Why didn’t anyone tell me? Because this wasn’t common knowledge. And then now we do provide some examples, but then that’s not good enough, because it’s too specific. So now we have to go back to let’s create some frameworks, let’s create some parameters, let’s create some themes, because that’s just good coaching anyway. So, again, we see pendulum swings, and the reactions to all of that. I’ve been in this for so freaking long that I feel like I’ve seen every iteration of, like, how do we spin a lot of the same bottom lines?

Christina Prevett 32:39
Yeah, and I think the reality is that it’s cognitively a lot harder, yeah, to do the nuanced approach than it is to give a week by week. It’s easier to say, okay, don’t do this for six weeks versus hey, you actually are okay to do this, but here’s your buoys and here’s what I want you to do, and you know, so that that awareness of, like, there is a higher cognitive load, but I do hope that we’re going to go into this kind of individualized approach with exercise prescription and pregnancy, that you know some people can do pull-ups up until delivery and feel pretty good about it, and other people get belly button pain and they start compensating, and you know it just truly does depend on the person, their face in life, their goals. Yeah, all that

Brianna Battles 33:24
absolutely. It’s been, you know, we talk so much about, like, there’s the fragility culture, which I think the research is trying so hard to, like, knock that door down, because the athletes have been like, yeah, we, we know, right, like, we’ve never identified as fragile, but we still have to knock that out with the research getting that validated for them to eliminate a lot of that messaging that these women are hearing from their doctors or from a provider who’s like, you have prolapse, you can’t lift over whatever pounds or you can’t run again, and then like that creates a whole psychological spiral for our athletes, but then on the other end of this pendulum we see the glorification culture of like, look, how much I was able to keep doing during pregnancy. I’m this bad ass, they’re not saying that, but like, they’re they’re full sending all the way through, and then they’re showing this like fast return to competition, or to performance, or to what their body looks like, or to what they’re doing in the gym, and it seems like these are the two extremes, but I think what you and I can both validate here, really candidly, is majority of female athletes exist in this middle ground of like, hey, we’re being adaptable and resilient, we’re making changes mentally, physically, etc. throughout these seasons, and what we see on social media is very rarely accurate to what their reality is, it’s just what gets the engagement and the content and the opportunities and hooks and all of that stuff.

Christina Prevett 34:47
I know it’s, it’s so tough. I feel like there’s so much, like, of a comparison game of, like, what about me isms around, like, you know, when you see that, it can be very triggering, and you know, a lot of these. People that are going back early, like that, is all they’re focusing on doing, right? Like, you know, in Canada we have 12 to 18 months of maternity leave, and like you can have that support, like you know, like that’s a very different healing environment than somebody who has to go back to work at four weeks, like all of those things around, you know, that that healing piece is just.. it’s it’s hard because that comparison game, when especially when that was your desire, like I have talked to athletes who they thought they were going to have that pregnancy and then a complication came up, or they thought they were going to have that return, and then their symptom burden on a pelvic floor from a pelvic floor perspective is higher, and so I always have to talk, you know, like in even in our research we talk in averages, but averages have variation around the mean, so like there’s plus or minus standard deviations that try to capture 80% of our humans, and then we still have outliers, and so when we are looking at making clinical guidelines, we have to focus on the majority, and then as clinicians we have to apply that to the human that’s in front of us, that’s true evidence-informed care of, we want the research there to back us up, because it allows us to push our profession forward, and then we have to wiggle that evidence to the human that is having a very real postpartum journey in front of us, and so, How do we blend those things? Is where your and my expertise comes in of moving around that that type of experience,

Brianna Battles 36:24
and I say, like, this is where, like, you know, we have so much information, but so much of it comes down to, like, what is good coaching. Well, good coaching is like, you’re kind of, make you make up a lot of shit as you go based on what the person in front of you is. How do they think? How do they move? What’s their athletic history, injury profile? What are all these other things like that’s just basic freaking coaching that has been honestly really dismissed in the greater conversation around pregnant and postpartum athletes. And as a strength conditioning bro myself, and not a researcher and not a practitioner, I’m like, I’m just talking about this from the scope of, like, how would we coach any other human? Well, we kind of look at what is their needs analysis, and then how do we build out parameters and guidelines from there? And if we can get more coaches thinking like coaches instead of like pregnancy and postpartum, it’s going to move the dial forward in outcomes and experiences mentally, physically, and emotionally,

Christina Prevett 37:19
for sure. Like, I just posted something about, like, here’s five things that I would change before I get rid of running in pregnancy, and all of them were coaching Glenn stuff. It’s like, whoa, whoa, whoa, like, let’s not say, okay, I had one bad run, running is out for the rest of my pregnancy. To your point, like, let’s look at how you’re running, like, what are you doing for running? Have you changed your volume? Did you have trash sleep the night before, like, let’s, let’s chat about this before we remove, and then maybe you know, we kind of look at your risks and benefits, and what your desires are for your return postpartum, and we make that call, but the, yeah, in pregnancy and postpartum is interesting, because you’re right, it’s like yes or no, and we, we sometimes don’t put our coach’s lens

Christina Prevett 38:00
on,

Brianna Battles 38:00
have to wear the coach lens, and that is going to be the thing that will always trump the pregnancy and postpartum like lens coaching lens is going to be because we have known and we’re continuing to validate that it’s not a question of safety for the baby and mom, like it’s more of like, how does, how do you feel in your body, and then just like we’re approaching any other injury or symptom, or like, well, if it’s continually aggravating you, maybe there’s another option. Okay, like, we would do that with a knee, we would do that with a back, we would do that with a shoulder, and so it’s like allowing that athlete brain to say, all right, my body’s not happy anymore with this, I’m going to make a proactive decision instead of just pushing through, and that’s, you know, that’s the hard, the harder avatar to work with sometimes, but I also love them.

Christina Prevett 38:51
Well, and that’s where my research is, like it’s trying to validate that experience of, hey, like, there is no hard or fast rules about, like, these different modifications, because, like, if you look at my, my data, like, and we look at when and how people modify, like, it’s literally all over the place, where some people it’s 12 weeks, some people it’s 39 weeks, like, some people it’s 20, and I think that’s really powerful for our researchers and our medical providers to see, because it means that you know what exercise professionals have seen a lot, and what women have experienced is not only is pregnancy individual, but even within yourself, different pregnancies are different, where you may modify at 28 weeks in baby one, but 19 at baby two, and even if you compare within yourself, you’re, you may think, oh, I’m failing because I did it for longer with my first pregnancy, but really, your pelvic floor had permanent change from your first delivery. You have a toddler at home that’s demanding, you can’t just sleep when you get home, like,

Brianna Battles 39:51
you know, it’s like, I think it’s validating that conversation of, like, who you are as an athlete at 33 is going to be. Print, most likely, anyway, than what you were doing at 23 and we’re not like, ‘Dang it, I wish I was still my 23 year old. You’re like, you’re not trying to compare to that, and it’s similar when it comes to pregnancies, and comparing to other people is just because that’s what worked prior doesn’t necessarily mean that what’s going to work now, because circumstances are different, physical circumstances are different, energetic circumstances are different, and we cannot compare to others or even to ourselves. And I think that’s the hardest part with that like athlete brain that just wants to like out athlete everything. Sometimes your body’s like, “Nah, girl, we’re not doing that, and birth, we’re actually not in that much control so often. I think that’s the other hard part for our athletes, is they’re like, well, I worked out, I did all the things, I followed this and that, and then they’re let down by whatever, by how they feel post card number, about how their birth experience went, and they want to like blame something, but most of the time it’s just like, God, that’s just the cards were dealt. Sometimes I

Christina Prevett 41:02
asked a question on social media a couple of weeks ago, of like knowing what you know now about your postpartum recovery, what would you have changed differently? And and there was a lot of like, I probably wouldn’t have modified as much, or I would have, you know, gotten the epidural earlier. Why did I suffer? Like, you know, but there was also a cohort of individuals who had really, really high symptom burden for pelvic floor dysfunction, and they felt like duped or deceived because nobody really talked about that, and that’s been an interesting, like, thought for me, and reflection point around exercise and pregnancy, where we’re talking about pregnancy, but what also happens is that everybody knows their pelvic floor is going to be affected, but they don’t understand the amount, degree, expectation, recovery expectation, and variability in how labor and delivery would go, and we had some people who are like, I would have done an elective C-section, like hands down, if I would have known that I would still have pelvic floor symptoms, you know, six months later, or a year later. And I think that brings in another interesting layer, where we are now also starting to be aware, as women are are challenging their bodies postpartum, that they’re unearthing those changes in their pelvic floor that before, when we weren’t really pushing the intensity as much, you may not have noticed as intensely, or you know where it’s expected that urethral, like your bladder neck mobility, is going to change after having a delivery. Your opening of your vagina is going to get a little bit bigger after having a delivery, right? Like some of those changes are now known physiological changes, and one of the things I’ve changed in my practice is I start talking about that, of like, hey, if you’ve had a vaginal delivery, irrespective of, you know, amount of tearing or whatever, you’re going to feel this part of,

Speaker 2 42:53
yeah,

Christina Prevett 42:54
like, and some of this is going to feel better, and you know, for some people, their symptoms are more pervasive, or they stay around for longer and I think mom’s going into it educated of like this is my expectation, you know, this is, you know, some people may have, like, not pushed for as long and opted for the C-section earlier, maybe if they knew that they would be recovering from abdominal surgery and pelvic floor injury, and so I think there’s a, you made it such an incredible pointer on the education side of it, because as I’ve kind of like been talking to up to moms who are on the high symptom burden perspective and not in the perfect recovery, there’s a lot of feeling of deception

Brianna Battles 43:34
because it comes down to that same question that catapulted me into this 12 years ago, was like, why didn’t anyone frickin tell me? Like, why did I not know? Because I think there was such a, like, you’re fit, you’re active, you are made for this, like, a lot of, like, more dogmatic messaging versus, like, evidence-based at all, and just, like, a lot of assumptions. And even still, with more people talking about this, I think the keyword you said was just like, how do we help women manage expectations within what is within the realm of normal, and if there’s anything we can do during pregnancy. Sure, like, let’s use pre-hab and different strategies to help there, but again, so much comes down to what was that birth experience, and then how do we hold someone’s hand as they return to exercise postpartum, so that we’re like stretching out that capacity and those thresholds, instead of just like kind of basically the age-old story of like, go back early because you want to feel like yourself again, and then you get injured, or then you’re symptomatic, and then you’re depressed, and then it’s just like this vicious cycle of like, my body failed me.

Christina Prevett 44:39
Yeah, I also wonder, too, and this is something that I want to, like, reach out to colleagues about. Is I actually don’t know what OB and midwives education is on pelvic floor, like I know they have this is the criteria for different pelvic floor dysfunctions, but I do wonder about their education. On pelvic floor physiology across pregnancy, because I feel like their lane is so much around maternal and fetal safety, and I don’t want to be misstepping, because I don’t know, maybe they do, but I think there is a subsection of humans who they don’t know about that education either, and so I wonder if this is just like a big need from everybody, kind of in the birth space.

Speaker 1 45:22
Oh yeah,

Christina Prevett 45:23
around like, how do we educate ourselves, and then educate our patients on on these changes, and does that, you know, desensitize or change the trauma response for individuals postpartum? I don’t know the answer to that, but it’s definitely something I’ve been noodling on a little bit more as I’ve kind of gotten myself into these conversations a bit more,

Brianna Battles 45:42
yeah, I love that. And I think, in like a similar note, like there’s such a belief system that a C-section is automatically a worse outcome than a vaginal birth, and I try to like affirm every athlete I work with that it’s like, no, it’s just it’s just an outcome, like there’s no better or worse or right way to have a baby, they just come with unique considerations, but at the same time, a lot of common themes where there is so much more overlap, and it does not mean that you’re going to have a worse or harder recovery. There’s just so many variables. Is it elective? Was it emergency? Were you like eight centimeters dilated? Was it, you know, what, like there’s so much nuance? Did was there any tearing? Was there substantial tearing like that, all of those things are going to play into the outcomes. I just had an athlete I’m working with who had a C-section, is just like, oh my god, what does this mean for my performance? Am I ever going to be a little heavy again? And I’m like, I just hate that, that’s like the fear in her brain at three weeks postpartum is like, oh shit, I had a C-section, that’s bad, you know, like that just creates so much that sets up our female athletes for failure, and I felt like that too.

Christina Prevett 46:46
And honestly, sometimes from a C-section perspective, because the change in anterior posterior movement of the perineum is less,

Speaker 1 46:52
yeah,

Christina Prevett 46:52
some of my athletes after C-section get back to lifting faster, but gymnastics slower, and then my people with vaginal birth go back to gymnastics faster and lifting a little bit slower, so you know it’s interesting because it changes my green and yellow lights around, you know, where I’m like full send for you with this versus okay, let’s slow down our progressions here. Yeah, and you’re right, like that nuance is so important.

Brianna Battles 47:16
I know it’s hard, and I think I think we can just affirm that either way, like there’s still so much help and hope, and a strategic way to get back to what you want to do. That timeline is just going to look different for all people. You might get back to lifting faster than you get back to running, and but that’s across the board with any birth and any person.

Christina Prevett 47:37
Absolutely.

Brianna Battles 47:39
So, let’s shift gears into some of the research that you have done on miscarriage, and what has been exciting for you to hear. We know that a lot of female athletes, they are going through fertility treatments, or they have struggled with conception or loss, and it’s a very layered conversation when we are hearing and seeing and knowing in the research that exercise is safe and does not cause miscarriage, but sometimes feels emotionally counterintuitive, so can you talk a little bit about that?

Christina Prevett 48:10
Yeah, so to kind of like disclose my own personal history, to know where I’m coming from, 2025 was the worst year of my life, like, but hands down I lost my dog. I had two miscarriages. I lost my mom, and she had diagnosed with stage four small cell carcinoma within nine months. She had passed away, and so this all happened in 2025 And so, with my two losses, when we think about miscarriage, there are three different avenues that you can go when you have a confirmed no heartbeat. You can do expectant management, which is kind of a wait and see, where you kind of a lot of times they’ll just say keep taking pregnancy tests until they’re negative, where you kind of just let your body do its thing, flush everything out until HCG is now down to zero. You can do medical management, which is using medication like Mifepristone or Mifepristone, to and again, I’m not an OB, so don’t trust me on the drugs or anything like that, but you put that in and it essentially cervically dilates you and allows the products of conception to be passed, they say that it is cramping, it is not, it is early labor pain to somebody who has done it, and then you have your surgical management, which is a DNC, or we’re seeing some more around MBA, which is like mechanical, like almost like a suction that’s a little bit meant to be a little bit softer, so we have these three areas, and one of the things that is a hypothesis of mine is that we are seeing potentially more people experience miscarriage just because our detection has gotten so much better, and so instead of finding out at five and a half weeks or six weeks that you’re pregnant, people are finding out at three and a half or three weeks post ovulation or post last menstrual period and. So there’s a lot more openness about these conversations, which I think is wonderful, because a lot of times people, you know, you don’t announce your pregnancy until 12 weeks because you’re worried about loss, and and we’re seeing people announce earlier, share their joy earlier, but then also share their sorrow when things go wrong. We have two systematic reviews that have shown that there is no link between dose or exposure to exercise and risk of miscarriage, and when you are a person who exercises five to six times a week, as I am, and you start bleeding, there’s a very high chance that you start bleeding around exercise, right, because it’s something that you have exposure to, and when you go through and have loss, the first thing you want to know is, Could I have done something differently, or how could I prevent this from happening again, and so it’s easy to see how that link occurs, and so, because of my losses, one of the things that I look for is, is there any guidance on return to exercise and intensity after miscarriage? Because, especially with my second, I did medical management, so I had the medications, and I actually had a lot of blood loss. I had two large sub chorionic hematomas, I think there was a retained bit of blood pooled from first to second, and I think that’s why I lost a second. I had a missed miscarriage, so I had like fetal demise that happened at eight weeks. I didn’t find out until almost 13, and so I had a lot of blood loss, and I had a second bout where, like, not to be too TMI, but like literally imagine me being over the toilet, and like literally blood gushing and worrying, like, do I need a blood transfusion type of blood loss, and so, because of that, my return to intensity was really tough, because fatigue was high, I’m trying to use exercise because it’s my emotional crutch to help deal with the stress of life, and I couldn’t exercise intensely. There was a lot of women, and I felt this too. There was the emotional release of, like, when you start exercising intensely, it’s like your body just starts, like, processing, and I would, like, literally be running and crying at the same time, and, like, there was just so much about my experience that I was like, nobody talks about it. It’s like, oh my gosh, and so we just..

Christina Prevett 52:24
it’s still open, so if anyone is listening and has had a loss in the last year, I would love if you would participate. It’s to look at return to exercise after miscarriage, and we kind of explored beliefs as well, where many people strongly disagreed to, so far, of like, you know, our preliminary like scan on our research that their exercise caused their miscarriage, but interestingly, more people agreed with my next pregnancy, I might exercise a little bit differently, right? So I think, you know, it’s a fair concept of, like, I know I didn’t, but I still have this residual, like, should I try something different my next pregnancy, and so it’s this interesting, again, kind of like mismatch of beliefs, of like, I’m not blaming myself, but I might try and exercise a bit less if I get pregnant again, and so what we’re trying to do with this study is, is to one kind of explore return to give some guidance, and then I’m hoping to create it into like a patient resource of, again, here’s your clinical buoys. It’s not, you know, directly the same as postpartum, just because of the pelvic floor injury piece, but there is a blood loss piece, there is the fatigue piece, there is like the mental health recovery piece, which can be leveraged or can create a barrier, depending on, you know, where your brain is and where your head space

Brianna Battles 53:45
is. Absolutely, well, thank you for sharing that, and for the research that you’re doing in that space. My sister also experienced two losses this past year, including an ectopic pregnancy, and it was, it was obviously crushing from like a physical and emotional side, but then when she got pregnant again, so it’s like she experienced like secondary infertility, so it took a long time for her to get pregnant. Then she had these two two losses, I think it created this like distrust in her body, and so then even when she did get pregnant, it was this like she couldn’t find joy in her exercise or in her pregnancy in general, for I mean, honestly, at all. And then she was hospitalized at like 31 weeks, pregnant, and then was in the hospital for a month, had her baby at 37 So it was like this mind, fuck of a, of a pregnancy, right? And feeling this, this overarching distrust. I cannot trust my body to do something that seemingly is so natural for other people, and was natural for me before. What’s happening this time, and that’s really hard for that athlete brain psyche to wrap around, because you’re like, what could I have done differently? I need to be eating this, or taking this supplement, or not take, not consuming this, and then you’re like, you’re almost like manically trying to. Control what you can,

Christina Prevett 55:01
yeah. They talk about, like, the innocence of pregnancy being loss of, like, the there’s always tempered excitement. And so I am, I am pregnant again for the third time, so fifth pregnancy, hopefully third baby. And I was really open with my first loss, and then my second pregnancy led into my second loss, and you know, this pregnancy won because I was grieving my mom, and so, like, there was a lot of emotions there already around my mom not meeting this baby, and whatever, but I definitely, like, I didn’t trust myself that I was pregnant, I was having all of the symptoms, this is my only pregnancy I’ve ever, like, legit was throwing up the entire first trimester. It was like I got my scan, my team was amazing. I got a scan at eight weeks, was which was post my first loss, and had a confirmed heartbeat. I had a scan right at 13 weeks, that was right after my second loss, like they really tried to like help me with my anxiety of it, and yet still now you know I’m approaching 15 weeks when we record this. I don’t know how many weeks goes live, but I, it’s still like it’s like a, I even like, you know, third baby, I’m not feeling kicks, but I’m definitely feeling I’m like, oh, that’s baby movement, like that’s that’s not a gas bubble, like that, that’s starting to feel like a little bit different, and yet still like you’re, you’re, yeah, I worry, you know, like there’s there’s just so much worry, yeah. So it’s different,

Brianna Battles 56:30
yeah. I think you know, well, first of all, congratulations, and thank you for sharing. It’s really exciting, and I know that, like, so many of the things we talked about on this podcast, there’s just so many layers of emotion and of I think like output in general, whether it’s emotional output, physical output, that just really influence the female athletes’ experience during pregnancy and postpartum, and it really is a, honestly, a great way to create this in conclusion, where we need the research and the medical field and our practitioners and our coaches to all link arms to then help improve outcomes and experiences for women, because there’s no straightforward experience, there’s no perfect protocol, there’s just a lot of nuance, and so much of that is influenced by their own, like, like what we’re saying right now, right, is like them, those emotional factors that go into it, their athletic background, their interests on the other side, and really looking at them as a whole person, and not just pregnancy or postpartum or prolapse, or whatever, whatever diagnosis we want to give them.

Christina Prevett 57:36
Yep, yeah, exactly. And I think that’s where I’m hoping that some of our research is to one expand risk tolerance on the side of the medical provider, where we don’t have ourselves in this safe low to moderate intensity bubble, and we refuse to entertain the idea of high intensity, and when we expand that risk tolerance zone, that allows moms to make decisions within their own risk tolerance based on their decision making, and then we can, you know, use that like kind of freedom of movement to then create nuanced conversations with the pregnant athlete or postpartum athlete that we are working with, and then that’s where we truly get evidence-informed care, because it’s supposed to be a triangle of evidence, clinical practice, and the experience of the human and the experience of the mom is supposed to be in the center of that experience, and so I think we’re getting there, you know, as somebody who’s in the research and understands it is so much slower than we would like it to be, right? It’s so much easier to post a social media post when you know we don’t have to do all the ethics and data analysis and stuff, and so we are in a world that acts fast in a research environment that unfortunately is slow, but what is a really big help is if you are listening to this and you are in the pregnant postpartum time of your life, please, please give me your surveys, and please help our data, because the other thing is that we need a certain amount of people in a study before it has the power, the statistical power to make stronger conclusions, and you know, some people will say, well, it has a small sample size, I was like, okay, but until you have tried to recruit postpartum moms less than six months postpartum to come in for multiple time points and multiple evaluations when life is so chaotic, like, please don’t say small sample size, because I will have an aneurysm, like it’s like it’s so difficult, I understand, I agree, but like also we are working with a time of life that is so chaotic and busy that recruitment is is so challenging, and that is not something that I hold against moms at all, but it’s just sometimes so easy to dismiss studies based on some of those things, and in reality it’s like so messy to data collect. If we’re trying to be pragmatic and be real life, you know, it’s a lot easier if I get mice pregnant and like control every piece of their advice. Are meant I can get as many mics as I want, but like when you’re working and you want this human data, it’s just the reality is like to reach a sample size is going

Speaker 1 1:00:09
to be

Christina Prevett 1:00:09
helpful. It just takes time.

Brianna Battles 1:00:11
Yeah, especially with that population there. I like lovingly joke when coaching them, it’s like our, or like, especially our postpartum population, they’re that’s the flakiest version of yourself, right? Because you’re just like, you’re like, I’m not usually a flaky person, but now that I have this whole human that I’m taking care of, and my life has changed, and my brain’s not totally working, like it’s just very easy to be the flakiest version of yourself, and I feel like that translates in a variety of ways, and it’s not personal, it’s just sometimes the survival mode that we are in,

Christina Prevett 1:00:42
I tried to get there 45 minutes in advance, and I’m still 15 minutes late. Yeah,

Brianna Battles 1:00:46
so we’re like, what’s what’s the problem with the sample size whale? They’re in survival mode, that’s the problem with

Christina Prevett 1:00:56
it. Absolutely,

Brianna Battles 1:00:57
I appreciate the work that you’re doing. Definitely appreciate this conversation, and we can link the research in where you’re trying to get people to participate. We can link all of that in the show notes. Where can people follow you?

Christina Prevett 1:01:09
Yeah, so I am predominantly on Instagram at Dr. Dot Christina underscore Prevet. I also have a podcast called The Barbell Mamas. It’s meant to be for pregnant and postpartum moms versus, like, for clinicians, I have a lot of clinicians who listen to it too, but I created this podcast because I wanted, like, here’s my homework for my pregnant, I need you to listen to this, this, and this episode to, like, kind of understand, so I have that as well, and then if you are like a physical therapist looking for Con Ed, our live course for Pelvic Live teaches the internal and standing assessment, and then return to impact, and jumping, and low A, and that kind of thing.

Brianna Battles 1:01:47
Awesome. Well, Christina, thank you so much for sharing your time, and your work, and your heart too. I really appreciate

Christina Prevett 1:01:54
it. No, thank you so much.

Brianna Battles 1:01:59
Thank you so much for listening to this episode of The Practice Brave Podcast. If you enjoy the show, please leave a review and help us spread the work we are doing to improve the overall information and messaging in the fitness industry and beyond. Now, if you are pregnant and you are looking for a trustworthy exercise program to follow, I have you covered. The Pregnant Athlete Training Program is a well-rounded program for pregnancy with workouts for each week that are appropriate for your changing body. It’s 36 weeks of workouts, three to four workouts each week, and tons of guidance on exercise strategy. We also have an at-home version of that program if you are postpartum and you’re looking for an exercise program to follow the eight week postpartum athlete training program would be a really great way to help bridge the gap between rehab and the fitness you actually want to do. From there we have the practice brave fitness program, which is an ongoing strength conditioning program where you get new workouts each week and have a lot of guidance from myself and my co-coach, Heather Osby. This is the only way that I’m really offering ongoing coaching at this point in time. If you have ever considered becoming a certified pregnancy and postpartum athleticism coach, I would love to have you join us. Pregnancy and postpartum athleticism is a self-paced online certification course that will up level your coaching skills and help connect the dots between pelvic health and long-term athletic performance, especially during pregnancy and postpartum. Become who you needed and become who your online and local community needs by becoming a certified pregnancy and postpartum athleticism coach. Thank you again for listening to the Practice Brave podcast. I appreciate you, and please help me continue spreading this messaging, this information, and this work.