Exercise in Pregnancy for All Moms: New Research, Health Equity & Practical Support —with DR. RACHEL TINIUS

On today's episode, I sit down with Dr. Rachel Tinius, an Associate Professor at Western Kentucky University in Bowling Green, Kentucky, to discuss her groundbreaking research on the benefits of exercise during pregnancy. 

Dr. Tinius has dedicated her career to studying the impact of physical activity on maternal & infant health outcomes, developing community-based interventions for pregnant/postpartum women, especially those in marginalized communities. 

Her innovative work identified a critical gap in evidence-based exercise interventions for this demographic, leading her to create the mobile app BumptUp®.

The app is designed to provide trustworthy physical activity guidance for women during & after pregnancy, promoting health & wellness at every stage of motherhood.

We talk about:

-reasons for inactivity in pregnancy

-creating BumptUp

-changing guidelines over the years

-reaching underserved communities

-the power of an app

-activity affecting pregnancy outcomes

-pregnancy as a time for new habits

Time Stamps

1:00 Introduction

5:35 inactivity in pregnancy

8:17 creating BumptUp

12:45 what makes BumptUp special

16:45 pilot study

20:20 meeting people where they are

23:54 her experiences with pregnancy

27:35 influences of parents on activity

34:00 empowering moms in pregnancy

38:10 thinking ahead to menopause

42:52 rapid fire questions

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH RACHEL

IG: https://www.instagram.com/bumptuplabs/

Website: bumptupapp.com

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Transcript

SPEAKER_00 0:25

This is the podcast for you. Let's start the show. All right. So our next guest, I had Alyssa reach out and she said, Hey, you've got to check out this app and you've got to check out Rachel Tinneus because she's doing a lot of things to help get good information to women who may not have access normally. I did a quick little PubMed search and a lot of stuff showed up and I said we need to have a conversation. So super excited to have Rachel Tinneus on the show. She's an associate professor at Western Kentucky University in Bowling Green. Welcome, Rachel Tinneus, to the Active Mom Postpartum podcast. Thank you for having me. I'm excited to be here. All right. What do you do? Where are you from? How did you get involved in pregnancy related stuff?

SPEAKER_01 1:12

Yeah. So yeah, I'm an associate professor at Western Kentucky University. And that's one hat that I wear. And then the other hat that I wear is CEO of a company called Bumped Up Labs. And so the how things all got started. Well, for one, I've always been a really strong advocate of exercise and being active. I'm I was a two-sport athlete in college. And then that bled into just being a really avid runner. And so that's just always been something that's been really like at the at the forefront for me. And so I went uh after finishing uh my master's degree, uh, decided to go on for a PhD. Uh, really just wanted to stay in academics and um do something with exercise and and research. And so what ended up happening is I went to Wash U in St. Louis, which is actually where I'm from. Um, and I was there was a movement science PhD program. So it's a very broad program, covers a wide array of topics. It's very um, it's it's the PhD program affiliated with our physical therapy program at Wash U. So um lots of things to do with exercise. And I really went in there like with a totally open mind about like what I wanted to study. I was probably I was a little all over the place. Like, I love biomechanics and I also love bioenergetics, and like, oh, the brain is so cool.

SPEAKER_00 2:17

Like, so like Shirley Sermon will fix that.

SPEAKER_01 2:22

So yeah, yeah, I got to interact with her quite a bit. So um, and so yeah, so we uh I got assigned to a lab with a mentor. Um he was doing at the time obesity research and metabolic research, and I was that I I really did think that was really exciting and cool. So I was like, yeah, that's that sounds like a good fit. Um so what happened is he was um assigned as the he was put as the physical activity person on a huge multi-site project. Um the PI of the study was Sam Klein, who's been on like the weight of the nation on CNN, like he's a big name. Um and so uh my mentor again was assigned to be the physical activity person on this grant. Well, this grant happened to be looking at weight gain in obese, socioeconomically disadvantaged black obese women in St. Louis. Um and so in his job was to do the physical activity assessments and the body composition measurements, which if you're familiar with body composition assessments at the time we were using skin folds, um, which doesn't hurt or anything, but you could argue they're a little bit invasive if you're a woman. Um, and so uh especially a pregnant woman who's maybe not thrilled with her body weight at the time. So he got put in charge of those measurements, and it was literally like the day I walked through the doors the day the study was starting. And so it was sort of like, oh, this is perfect. Like I have a female grad student, like you're gonna basically calibable girl. Yeah. Yeah. And so I was like, cool, like this is perfect. Like, so uh and it was really interesting. I mean, I did it for maybe a couple weeks, and I think I went back to him and was like, this is it, like this is what I want to do forever. Like, I love this population, I love working with pregnant women. Um, as the study went on, we did we got to study them up to two years past the birth of the child, so whole pregnancy plus two years postpartum. So we they were bringing the kids back, you know, at two years. We got to measure them as babies, we got in the the families got involved, you got to know the women. Um, and it was so it was just amazing to me. Like I fell in love with it all then, and I was like, there's zero doubt in my mind that this is like where I want to spend every ounce of my professional energy for the rest of my career, and really fell in love with working uh with pregnancy and postpartum then. And then and I also realized though it was kind of this two-sided thing. It was really fun and really exciting, but also really eye-opening, uh, realizing how um inactive these women were. I mean, crazy inactive, and then also all the misinformation. I mean, they would just say things to me that just made no sense at all. And they and they really just nobody had really stopped and talked to them and educated them about like the benefits of being active during the pregnancy, and really nobody was helping them through that. And so just realizing that there is a real need here for better education information um and support for women to be active during and after the pregnancy, and that's kind of where my whole career kicked off was at that point.

SPEAKER_00 5:04

Yeah, no, and I I think that's such a um, I think we forget, especially, you know, people like myself that we're we're used to working with active populations and this is just the norm. We forget, I forget what the percentages, what percentage of women, period, are not active, and then add pregnancy onto it, where we have all these past myths of, you know, you don't want to exercise too much, you don't want to hurt the baby, kind of all these things. What were some of the threads that or the things that you were told um kind of working through these studies that that kind of lended to that inactivity?

SPEAKER_01 5:42

The reasons why the women weren't into it, you know, I think in that particular population, it was it was somewhat cultural, like that just no, like their parents hadn't, their grandparents hadn't. A lot of them still lived in multi-generation households. Um, and then a lot of them, you know, these were socioeconomically disadvantaged women, like they didn't live in safe neighborhoods, they just didn't have the resources either. I mean, a few of them maybe I could talk into doing something, but they really they did like I don't have a sidewalk in my neighborhood. Right. Well, yeah, that makes it hard to go for a walk, doesn't it? Like, I understand that um or you know, the gym membership, forget it. Um, and they're also they're just trying to navigate like I don't have a stable place to live, I don't have a lot of stability in my life anywhere. And so that just wasn't on the radar for them, really, of something that really important. Um, and you know, and it's it's so interesting because you know, doctors, we talk about maternal morbidity, mortality rates in our country, right? That comes up a lot, especially in underserved populations. Um, and you know, the the threads that get interwoven there in those conversations are things like, you know, all this pre-eclampsy, there's pre-clampsia, there's gestational diabetes, there's you know, being overweight and gaining too much weight, all the implications of that. There's mental health, there's all these inflammatory things going on. And I know I'm biased and I think you're in the same camp as me, but I'm like, I we have a tool that actually kind of helps self-correct all those things, and it's exercise. Yeah, but we're not using it. Doctors aren't prescribing. And again, I think doctors have almost the same mentality as the patient of like, I'm just trying to get them to stop doing drugs. Like, I don't really have time to get into that. Right. But it's like, well, actually, one of the best things to help them detox might be, you know, take a negative behavior and replace it with a positive behavior. Like, that's actually a really well-known way to fix or or um, you know, improve some maybe negative behaviors like doing drugs or smoking. Um, and so you know, again, exercise is this like underutilized tool that I think it just it makes such a big it could make such a big difference on the lives of these women if we can figure out how do we get you know appropriate guidelines and support into their hands.

SPEAKER_00 7:41

Yeah, well, and and you you bring up another point too, is like basic guidelines, period, we just haven't had them. And you know, not only from just like basic stuff up to our elite athletes that don't have guidance, or just wasn't it's a little better now than it was, but like if you don't have anything to refer back to, then you're just kind of making stuff up anyway. And so if if socially not you know, kind of the norm to exercise, then it becomes a really hard conversation anyway. So what inspired you to be like, I'm gonna make the leap in academia to now diving into kind of creating this app and this company?

SPEAKER_01 8:21

Yeah, so it's a great question. So yeah, so piggybacking on what you said, and then I'll definitely answer that question. Um, you know, like even my own mom, like I think about our own parents, right? Like when we were born, yep, 30-ish years ago, plus plus, um, you know, the guidelines were like, don't exercise really, or like be really careful. And so even my own mom, like when I go run, is like, take a basket with you like in case that baby falls out. Like, and you know, this is an educated, like great person. It's just, you know, we're overcoming so much like negative inertia. Um, and so I I actually ran Boston um last year, uh 12 weeks pregnant. Um, and so my mom like thought I was completely bonkers, you know, and so but it was really cool actually, the crowd support. I feel like we're catching we're catching some good momentum, like people are more and more supportive of it, and that's really cool. Yeah. Um, but yeah, so over there's so much to overcome, but it makes sense. Like the guidelines are just it's only been like 30 something years since we really thought complete opposite of what we're saying now. So exactly it's it's fair that we're working through this negative inertia. But um, for me, the the leap to commercialization. So I um was doing a like some local interventions here. I was again trying to answer this question of like, how do we actually get people to do it? Um, or how do we give them resources? So we were giving them education, we developed this educational module and brochure, we were giving them that. Um, we were giving them six different places they could come here in Bowling Green, which is where I am, and they could work out for free. Um, and it kind of worked. Like we published the study, but it, you know, it I still was like, man, it's just there's got to be a better way. Like we're still not reaching a lot of people, you know, they're not gonna drive to 30 minutes to their prenatal appointment, they're not gonna drive 30 minutes to the gym. Like, how do we reach them? And so, you know, of course, an app was like what came to mind or a digital tool that could be accessible everywhere. Um, so we started developing it. We got some grants to do that. We did, we started with focus groups on the ground floor, like asking, we just sat down with pregnant postpartum women and said, Why aren't you active? What could help you? You know, and and every feature in bumped up is a direct byproduct of their of them. They they picked it. Like I didn't come up with the ideas they did. And it's amazing when you get a community together, how amazing the ideas are. They're so much better than I could ever come up with. But so we designed it, piloted it, and then I had people coming to me be like, you got to commercialize this. And like my visceral reaction was like, No, I don't want to. Like, I have no desire to go into that. Like, I am not a business person, I am a researcher. I don't like my my MO here isn't to make money, it's just not what I want to do. And then it finally one day it was like, you know what? I could spend 20, 30 years developing this amazing tool, but if I don't put it out there where it can be purchased or bought by the world, nobody sees it. I mean, it'll stay in this little academic silo, and it then it doesn't really help anybody. Um, and so that was kind of the moment of like, yeah, I have to do this, like kicking and screaming uh against my will, but I I have to do this. Um and I've been way too like protective of it to turn much else, to turn much of that over. Like I, you know, some options are like hire a CEO and then let them do it, you know, let them run the business. Yeah. But no, I I I just it's you know, uh pun intended. It's your other baby. It is, and I and I feel so strongly that I just want it all done a certain way right now, so that we're so careful on how we do everything and it being evidence-based, and you know, we're not um creating and it's not being created based on commercial needs per se. We're trying to create it based on the like clinical needs, you know, and and evidence-based practices. And so um, but yeah, that's kind of how it ended up going from this academic thing that we developed as part of research into a commercial space. Yeah. And I'm definitely still, you know, as I said, I wear two hats and so still navigating that every day of how to make sure that the I maintain the balance of those things.

SPEAKER_00 12:11

So understanding that like the especially I feel like the last couple of years, there's literally no less than 70,000, you know, pregnancy postpartum apps that are out there now. Um, you having this background in academia, having been on the ground, asking the questions, getting the feedback. Um, what were the pieces of your particular program that you felt like what makes it kind of what it is? What makes bumped up? Um I keep kind of trying to call it bump it up, and it's not, there's no I people. It's just bumped up. B-U-M-P-T-U-P. What makes it what it is?

SPEAKER_01 12:54

Yeah, so great question. So uh a few of the things we kind of already hit on, but I'll reiterate. So that it's designed not by me wanting to make money, it's designed by pregnant postpartum women. And actually, we also brought in obstetric providers and sat them down and said, What do you want your patients to have? So everything is everything is designed with the them in mind and with their needs at the forefront. Um, everything in it is also evidence-based. So there's a lot of education in there, there's a lot of tools in there, everything's evidence-based. So we, you know, a lot of what I've seen that's out there, and we've reviewed the other products very carefully. Um, a lot of it's a mom who like had an anecdotal experience. Like she's like really active, awesome super worker outer girl, and she's amazing, don't get me wrong, but she found that there's this gap and was like, I'm gonna fill it, and like made something. Um, and not to say that those things can't be useful, um, but you know, doesn't have the maybe the academic credentials and the background and the team that I have to kind of put together all the tools. So, I mean, I have myself, I'm a certified exercise physiologist. I have two other exercise physiologists that help me with programming. Um, I also have a nurse practitioner who's on board for every single thing that we do. I have a women's health PT who has reviewed every video, every exercise we ever put in there. She has either been present for the recording of it or has been on actually over Zoom because she lives in Michigan, um, on Zoom while we are recording, sitting there in the background going, no, no, no, you're you know, your the form wasn't perfect, fix it. Because we want to make sure we're not prescribing anything that could be harmful in any way to a pregnant or postpartum woman. Um, and so a lot, I mean, a lot of what we're doing are exercises that you've seen before. We're just repackaging them in a way that makes a pregnant and postpartum woman feel really safe doing it and that you they can trust, like this is this is a safe modification for this exercise or this is a safe way to do it. Um, every so all we have tons of videos in there. There's like 250 right now, I think. Um we have programmed workouts. So for the for pregnancy and for postpartum, every other day you get a workout that's programmed for exactly where you are in your pregnancy or postpartum journey. Um, like I said, every exercise has a video that shows you how to do it. Um, everything's very committed to this 150 minutes a week is the goal. So we're very committed to kind of helping you get there with our workouts. But if you don't like the stuff that we've programmed, or maybe you've got a like a knee thing that's bothering you, or you need to modify, we actually have a way you can look at our bank of exercises and you can build your own workouts. So maybe you or maybe you're someone who's like, I want to do upper body one day and I want to do lower body the next day. That's how you like to split your routine, you can do it that way. Um, we also have everything coded by beginner intermediate advanced, so you can also hop on there and be like, uh, these are a little too hard. I'm just gonna start with all this beginner stuff, or maybe these are too easy. I'm gonna click all the advanced ones and see how hard I can make this. Um we also have a collaboration with uh Move Nourish Love. I don't know if you're familiar with them, but um, she's amazing. Lindsay's great. Um, and so we actually have her videos embedded into there as well. So if you're somebody who like just wants to hit play and do a more intense workout, because I would put hers in the more intense category. Um, you can do that through the app. We have prenatal yoga sessions that you can you can watch um during through the app as well that we've we've created here. So uh those are just a few of the options. We also have mommy and me exercises. That's that's something that comes up a lot as well. I have my kid with me. Um, like so okay, I'm gonna take that barrier away. I'm gonna include your kid. Um and so they can they can select from exercises that incorporate the the baby or the toddler with them. Um, but yeah, the in terms of the exercise features, uh that's you know, those are all things that um I haven't seen anywhere else that make us special.

SPEAKER_00 16:36

And you guys have done a pilot study kind of looking at this. What what kind of was the purpose? Tell us a little bit about that pilot study.

SPEAKER_01 16:44

Yeah, yeah. So uh we had a subset of uh of the population. So was we think it was about 40 women use it, or sorry, in the study. Half of them used it, half did not, and we just followed them throughout their pregnancies and postpartum to see if using the app helped with physical activity levels specifically. That was kind of our main focus. Um, and it did. Uh, and they also reported feeling way more confident, their self-confidence went way higher in their ability to exercise, which for me was like that's a really good start, right? Like we can at least get people to start to believe that they can do it and like feel more confident in their ability to get it done. Um, that's a really big plus. And when we did the pilot, actually, the app was nowhere near as what I would say developed as it is now. So I feel like if the pilot was successful, I'm feeling really good about where we are now. Um, we do have a clinical trial going on right now where we're gonna enrolling 200 women to basically repeat that pilot study with a larger group. So we should have some more data here before too long.

SPEAKER_00 17:39

And is important is this kind of that same or a similar population that you had kind of looked at before, where they're not necessarily exercisers and this is something new, or you know, are these more exercisers or or are you even asking that question?

SPEAKER_01 17:54

Yeah, so good question. So this is not the same like kind of underserved group that we were focused on in St. Louis. Um, our criteria is more broad for this one, so they can be more active or not, they can still enroll um for this one. Okay, but we're certainly trying, like I'm working with the doctors here, and we're definitely trying to reach the ones who maybe aren't as excited about an exercise study, right? Like, we don't want just the people signing up that are like sweet, okay, guys. Let me sign up. Yeah, we're trying to get everybody.

SPEAKER_00 18:23

Yeah. Well, that I feel like in and kind of as as I you know was kind of gathering information about you, I was like, how cool would that to be to go full circle and like you create this program and then go back and try and uh bring it back to that community where exercise isn't part of the culture and um safety was a concern or things like that. And and we we talked a little bit about this before we press record, but I I I grew up in an area that that wasn't particularly uh like it was it was quite rural. We had 25 acres of land, 30 minutes to the closest Wegmans, like 70 miles to the closest like major hospital. Um how can you break the barriers of zip code? Um, how can you make sure that regardless of where you live, if you have the privilege of you know broadband internet, can we make sure that you have access to this information? And then how do we bring it to you in a way that um is palatable, is easy, you know, and you get and I'm sure you're running into this like the barriers of tech and you know, how do people learn and beyond just like the exercises you need for pregnancy? Like there's a lot of parts and pieces. Like when you were kind of creating this app, what were some of the considerations there as far as you know how how to find something to bring forward to people to make it accessible and usable?

SPEAKER_01 19:48

Yeah, great, great question. And actually, that some of the questions you just posed are some of like the ones that I don't know that anybody can answer, right? We're trying so hard to answer those.

SPEAKER_02 19:57

Yeah.

SPEAKER_01 19:57

Um, you know, what I found, and I found this in Inner City St. Louis, it was like these women didn't have a car, they didn't have a stable person, hardly a stable person in their life. They were transient in where they were living. But man, they would text me right back. Uh people are glued to their phones. And actually, my mentor at the time was like, I don't know if you want to be giving away your cell phone number, like just that's your he was like, that's your call. Um, but I was like, if to in order to get them to reliably come back and make sure they knew about their appointments and we would send cabs to pick them up and make sure they had all that communication, like that was the only way, but they were so responsive. I mean, to the point that sometimes they would even call me like unrelated and be like, hey, I got a question, and it was like some pregnancy question or whatever. But I loved that, like some people maybe wouldn't have liked that. I loved that. Um, but I do think that we don't always give even our underserved populations enough credit for their technological abilities. Like they're they're pretty good on the phones. Um, you know, if it and they most of them have that. Um, I think it's like 98% of our, you know, women of childbearing age have a smartphone, even when you talk about inner served groups. So that's that's pretty good. Um now the accessibility piece, you know, we're trying really hard to keep it really simple. Um sixth grade reading level for the educational components. Not not, I mean, people are capable of way way more than that, but people just don't want to be like inundated with like heavy jargon. I don't either. When I go work out, nope, keep it simple. Right. Let me read and they actually we did a focus group yesterday with actually a group of diverse women, and like that was one thing they said they loved. They were like, I could I could read the article in one minute and I got the point, and it was just like a quick read, and it was I love it. Like they actually said they loved that. So that was exciting. So things like that and keeping it just from being overwhelming. Um we're also we're we're working on ways to make it available offline. So even if you don't have good Wi Fi or good service, you can still pull up your exercises for the day. Um so working on on on that strategy is something that we're we're doing for sure. um but yeah i mean i think you know i think those are probably some of the main ways and i and i think figuring out ways to just connect to the people the the end user you know so we're doing these focus groups right now we're bringing in the the end users right the people that are using it and sitting down with them and saying what do you think you know what could help you use it more what are the barriers to you actually using it and you know they say they say the best things like yesterday I had a woman who was so amazing she was like you know she's like I love it she's like I love the exercises I love the programming she's like but I'm so I feel like I'm so busy and I you know I'll forget to eat if somebody doesn't remind me to eat and she was like I feel like I need a reminder that I was going to work out today um but she was like but I want to I want to set when my reminder goes off like I don't want to get a reminder at 7 a.m every day because I don't work out at 7 a.m. every day I want a reminder at four o'clock on Monday and you know noon on Wednesday and and 8 a.m on Friday and I was like that's a brilliant suggestion like like have a system in the in the app where they can tell they get to decide when they get the notice we're not bothering them when they don't want to be bothered. And I was like that's a brilliant suggestion. So I think that you know one of the best ways to make it accessible and to reach people is actually to get on the ground floor and talk to those people. Like I don't think we can figure it out without sitting down with them and figuring it out with them. And so I think that that's what we're trying really hard to do and um hopefully doing well.

SPEAKER_00 23:25

Yeah no and I I I want to chat about kind of your experience kind of um through pregnancy and so on. Cause I know I was I was a PT for I think 12 or 13 years before we had our oldest and um there were a lot of things that I thought were very black and white like of course you're gonna switch hips, you know, holding your baby or of course you're gonna do this or that. And then of course you have a kid and that blows it all to hell in the handbasket. But um you get a lot of perspective from the end user so to speak. So for you like um talk us through a little bit kind of um your experience in pregnancy and how did any of that sort of um filter down into your work?

SPEAKER_01 24:01

Yeah great question so I have uh I have four kids. Oh boy I don't think we can are you okay so I have four and actually my oldest is seven so we are you are in it rapid fire yeah we just went rapid fire um but so it's so interesting and I and I'm so thankful to have had four pregnancies because I I learned so much throughout my own experience. Like I because I was doing this work before I had any kids kind of like you said. And then I my first pregnancy so I was doing all this exercise and pregnancy research and then we had some trouble getting pregnant. And when I finally did get pregnant we had we'd had we had one loss and so when we finally did get pregnant I like found myself afraid to exercise and it was so interesting because I'm like professionally I know better. I I publish information with no risk of a loss. But when it's my own body and my own fear like it it like the emotion outweighed the logic totally and so my first pregnancy I took like 13 weeks off of like running which I'm like a runner runner. So like that was like a big deal to not run for that long. Yeah um but that's just what made me feel okay like it I did other things but I just didn't feel like I should be running. Now in hindsight I think it would have been fine with my second uh actually with the next three um we didn't know we were pregnant when we were and I was still like avidly running and so and they all turned out just fine. So like now I'm like it it's fine. I really believe running is so fine during that time period. So much so with my fourth pregnancy, my most recent one, I actually ran the Boston Marathon while pregnant with her. So I I've I you know I've I've I've seen the I've felt the extremes of like yeah be really really careful this is what I need to do to be really careful also to like I'm gonna go run this marathon it's fine. And so I feel like I I now live more on the like I think it's pretty much you can do whatever you were doing before. You've got the data set. Yeah yeah but I also understand now when a when a woman's like I'm nervous to do that or I get it. Like I totally feel that and that those emotions and I get it. And so I I um I totally support those feelings and how do we also get someone to maybe be active but in a way that they feel comfortable with and I think that that's a conversation that every woman has to navigate with herself um about what she you know needs to do for her health but also what she feels comfortable doing. Now at the same time I don't think I think it can be problematic and sometimes people use it as in like an excuse like oh I'm afraid so I'm just not going to do anything. And so I I would would love to steer people away from that you know I like let's let's figure out what you could do maybe yoga or maybe what could you do that like wouldn't cause your mind to to you know spiral you out of control because I think not doing anything is way more harmful than doing something vigorous. That's my my opinion and that's on a normal healthy pregnancy of course right there are scenarios where we we do need to be cautious. But um yeah my own experience has been has been really fun to kind of watch my own journey there and then um you know I I will say I've had all of my pregnancies really easy really good deliveries. I mean I do feel like being active has was helped me personally so much. So I do feel like that's an aspect that I can say like pretty definitively on my own experiences that it helps those it helps recovery and delivery and like I mean I felt so good throughout my pregnancies I really did and I feel like I I attribute that to being active yeah now you mentioned earlier your mom was looking at you crazy because you're trying to do Boston while you're pregnant like this is this is a conversation that's come up a lot for me in the last year where you know we think about the examples that we had um like was your mom particularly active while you were a kid or that you recall? Yeah yeah my parents both are actually really active people um they both actually played tennis a lot when I was growing up like played on teams and we would go watch them play. My mom walks every morning like religiously goes for a walk every morning um and and now I'm I find myself like I run every morning I'm like I'm turning into my mom. They're both really healthy I mean they're both you know into their 70s and like still you know zipping down here to this kind of me and my kids and my mom's on the floor doing all the things with the grandkids and so I think it's you know certainly paying off for them and I I'm thankful to have had that example but I you know to that point I feel so strongly that for like this next generation of kids like what we're doing is what they what they see us doing is so yeah and my kids actually you know like I said they're there's seven is the oldest but seven five and three year old already I mean they they love to go running like they asked to go with me um we put some pretty funny content on our social medias which you know of of people you know of me running and then three kids running behind me and um they love to they love it. My oldest is just started running cross country and she loves so it's it's just fun to see um you know see your kids kind of pick up on that it's yeah to see and I hope I hope we can instill more of this on these pregnant and postpartum women so that those kids kind of grow up seeing it and that they want to be part of it because that's a a golden ticket to a long healthy life I'd say.

SPEAKER_00 29:10

Yeah. No, I I do think so much about kind of the examples that we had. My my parents were both quite active when I was younger they but in a very different way I almost feel like I was brought up that like exercise was almost like a frilly fru fru thing um like to go for a run or something like that because like my parents built our house. We had this huge garden um like I basically live like little house on the prairie when I was a kid. My mom put up all the food, you know, all this stuff. Eventually because they were teachers, we started traveling in the summer and so you're not doing this kind of physical labor anymore. And then when I started doing sports in middle and high school um cross country running, you know, like it's easier to see us on the trail if you go run and see. And so that's where my parents actually started actively exercising. And it just culturally before that again like if I really kind of think back and again I'd have to drive somewhere to go to a place that wasn't like the side of a country road to go safely for a run or or something along those lines. And so it it really kind of hits me when you're talking about these people that like hey I don't necessarily have a place that I can safely walk out the door and run. And I mean clearly you've found some places that you're training and you've got your kids and and whatnot. It it really kind of where we are in our communities and our social histories and that kind of stuff really do kind of shape that perspective and um it can kind of set those examples for our kids too.

SPEAKER_01 30:35

Right.

SPEAKER_00 30:35

Right. So that's really interesting. So where are you guys going from here? You said you've got um a a trial working right now.

SPEAKER_01 30:44

Yeah yeah so clinical trials ongoing so hopefully in the next I mean it's you know a clinical trial with pregnancy and postpartum is is just takes time because it does take time. It's not a quick study. So but that that you know over the next couple years we should have those data coming out to where we can hopefully you know share the hopefully that the app is is successfully helping more uh women be active and improve uh those obstetric outcomes that we we've talked about a little bit yeah um but in the meantime I mean I'm not just waiting for that data I'm still you know we're ready to get it into the hands of women who need it and so it's it's I mean it's available anybody can get on and buy it but my end goal really is to make it to where it's free for the end user. I really don't want from having to pay for it. People always like why don't you snake it free I'm like because then my company fails and I can't actually all these cool ideas that you're giving me I can't integrate them into an app because I can't make any money and I don't know if anybody knows this but app development is so expensive. It's like I'm like can we tweak this little feature they're like yeah that'll be 10 grand I'm like oh yeah it's so hard and so I just you know we've had to monetize it a bit but I would love to figure out strategies and this is where collaborations and partnerships I think could come in really handy here in the near future. You know, can we get insurance companies or employers or or bigger entities to essentially pay for it so that the end users can have it for free. And I know something that comes up a lot too is well why don't you just put ads in there? I'm like have you ever tried to work out and an ad keeps popping up like no like it is the quickest way to quit working out.

SPEAKER_00 32:20

Well and also to navigate the ad space that's not fun as a developer either right I'm trying hard to stay away from ads.

SPEAKER_01 32:28

I just think it's so experience.

SPEAKER_00 32:30

Well I that's such a good point too um kind of having been in this space for a bit too where you're like all right I need to make enough money to to live I need to make enough money so that I can turn around and give people things for free and that's really hard to do. And I'm thinking with you I was like hmm what telehealth companies might be interested in something like this or but again it would have to be somebody that you know could see the bigger picture of like how do we bring this as a pro bono to a community that needs it. How do we so if anybody is listening and you're like hey this sounds really cool I want to partner up well we'll mop Rachel's information on at the end. Because again I think this is this is where we're gonna make change is like we need the researchers to be like hey these are problems. We need to identify the communities that need our help and then we need people to step up and provide solutions but but all of that costs resources and time and money and that kind of stuff. And um we we need to fund people like you that are trying to do the good work. So you don't have to pimp yourself out.

SPEAKER_01 33:35

I appreciate that I appreciate that yeah I'm definitely seeking you know grant funding and stuff but yeah trying just trying to figure out how to get it out there for women so that they can have it. I want that that's what I want.

SPEAKER_00 33:46

So yeah well and and and again I mean I I think at the end of the day if you have somebody who wants to do it if you have somebody that wants to and especially I I don't know a single new mom that's going to go in and be like no I totally want to screw this up like every new mom wants to go in and do things the best that they can. How do we break those barriers down to make it easy and accessible and you know low-hanging fruit so that it's just this becomes something that's just kind of normalized. And we have a lot of way to go. And I do think that we forget that especially in the you know when we have such a dichotomy in our society right now where we have you know we just had the Olympics this summer and the and the Paralympics where we had these amazing pregnant women with amazing performances and and early postpartum. But yet we need to go back and make sure that everybody's coming up um along as well we don't just focus on the the highest of the high we need to to to come back to the roots and the right um the communities and and and who needs who needs things most.

SPEAKER_01 34:48

So yeah well and I think I think we hit the nail on the head there. So for me the way I view this is like such an opportunity because you get or I view pregnancy as an opportunity because you get people who maybe weren't active at all and maybe didn't even go to the doctor. I mean they maybe not have have haven't been the doctor in 10 years but they get pregnant and they're going to the doctor they're and they are hanging on to every word like they they are it's they are suddenly very focused on their health because it doesn't just affect them anymore it affects their health baby and so they're listening for maybe the first time. And so to me that's like that is the opportunity to intervene is like like and then maybe they adopt it for the rest of their life. So I think so many people like why are you wanting to intervene now? Like it doesn't seem like the right time I'm like no it is the perfect time um to try to get someone to listen who maybe wasn't listening before and I think in the same same note you know that I think that's why the marketing this is really hard because sometimes the women who really need it aren't the ones looking for it. Like there are actually women that are looking for resources.

SPEAKER_00 35:50

Right.

SPEAKER_01 35:51

But they're probably fine. Like they're probably going to still running and they're probably fine. They probably don't us um we need to try to find the woman who's not looking like we need to find the woman whose doctor's saying listen you gotta do make a change here for healthy baby and so it's like making those connections because I actually had a really interesting conversation with an OB um this was a few years ago but and it's just really stuck with me is he so so many women right you know are entering their pregnancies obese and overweight and and a lot of them are having trouble getting pregnant. Like a doctor recently I was having a conversation with here she was like yeah I see so many like prenatal or like pre-conception consults and they're like why aren't I getting pregnant she's like well because you're you know obese and like your hormone profiles are crazy. You're not ovulating like you know all those things and what the the doctor said a few years ago also I didn't mean to jump jump around but um he said I I have you know obese women who want to get pregnant and he's like it it feels like try like a pilot trying to fly in a storm. He's like I don't I would rather wait until the storm passes and then fly the plane. And I was like wow like that's just really kind of just insightful that you know again we've we've got so many women entering their pregnancies with these already kind of difficult yeah and again those are the ones um we need to try to connect and reach with and they they may not be the ones looking for it. And so that's how I think we need providers kind of advocating for the resource um and and an insurance maybe or you know like other entities that are helping pay for it support it so that these women who are right maybe know they need to make a change um have something at their fingertips to help them do it.

SPEAKER_00 37:32

Yeah there's a couple of things I'm I'm thinking of as you're talking about that one is that moms are such pillars in communities and help kind of set examples and um our connect points for communities. So if if you're if you're establishing these relationships this trust this example of exercise is good and this is how we can do it in a scenario here that works for you. But then projecting forward um I'm I'm recently basically uh drinking from the the menopause the menopause fire hose. And so thinking ahead to how do we establish these relationships earlier with women so that they understand what an important role exercise is early on. So we're not teaching them brand new things, you know, while they're also trying to navigate you know middle and high school kids and you know other you know their their parents health issues and all that kind of stuff. How do we start these conversations early so that um communities have trusted advisors that they can turn to people that they can ask questions about exercise even get referrals to good authorities for hormones or just like nutrition or anything along those lines it comes back to how do we create these trusted sources of information that will help meet you where you are and provide a guidance point throughout you know a lifetime. I mean that's like big big public health kind of stuff.

SPEAKER_01 39:06

So no pressure or anything but you bring that up because I had this this exact conversation came up yesterday. They were like can we can you turn this into a thing that like basically from the time you know you're like in puberty like there's some support and like talking through all the way to like through the lifespan of of of menopause. Yeah I this has come up a couple times and I've had a couple like can you make like exercises for like menopausal women because that would be amazing and I was like I hadn't I mean that's just like not even a space I'd ever really thought about but yeah we'll get there I promise yeah you're right you're right well and you know and something else you just said that like reminded me of something I think about a lot too is you know we put a lot of pressure on our OBs like they're amazing. I mean all the OPs I know are incredible. Yeah but they don't have exercise training like that's not they're part of their job and and I think we our patients put all this pressure on the provider to like give them this advice and they don't have the training to do it and they don't have time. Like they're not gonna be able to be like okay I want you to do 10 squats and this is how I want you to do them and then I want you to do you know that's not their job. And so again figuring out how do we how do we better get like the when the provider says I want you to be active then connected to the use and the me's so that they they can have that support um people who that is their job like that is my job like let me walk them through that. And so I would like I try to sell the providers on that like like this is something that can really help your patients and like take a burden off of you. I can do that. Like when you say I want to be active give them give them my QR code and let me have them and then I'll I'll take over from there.

SPEAKER_00 40:41

Well even kind of pulling off you know speaking from a physio lens there there's there's a a strong community that says oh you know every every pregnant postpartum woman should have pelvic floor physio which I disagree with um because I just know that that's not feasible because of a lot of different reasons geography, resources, all that kind of stuff. But can we still have resources through the pipeline that provide access for whatever that person needs. So it might be a basic app that's available to that community. But references, hey, if you're having these other issues you might want to take the advice or talk to your OB or talk to a physio or something along those lines like let's let's let's utilize our resources really intentionally but also make sure that we're um we're not setting up barriers. So if if you're saying to me okay I I I don't have insurance I can't go see a physio I barely can go see an OB, but I can do this app um it's like getting you further than where you were before. And so that's where again I I I think you know all public health systems aside in in the United States like how do we make sure that we're meeting the needs and that's what I love about the studies that you have participated in is you're like hey we're going to the community and figuring out what those needs of that particular community are and we're trying to make something to help meet them where they are um and not make assumptions um which I think is super cool.

SPEAKER_01 42:09

So well I appreciate that yeah definitely trying hard to do that. And yeah so true.

SPEAKER_00 42:15

And um yeah all the all the all the questions that I want to help try to have some answers to well that that's the hard part is like now that you're down this rabbit hole, I'm sure you're one of those people that has like seven million other questions you're like and we can make a product for this like it's it's really hard when you're that idea person too and you're just like I need time I need bodies I need money.

SPEAKER_01 42:36

Right. Yeah no I have to clone ideas like all in the hopper right now the things that I think are are like would be really amazing to be able to Yes we need to clone you.

SPEAKER_00 42:46

We need to clone you all right at the end of every episode we ask all of our guests a couple of questions.

SPEAKER_01 42:53

So first one here uh book you're reading or podcast that you're listening to right now oh gosh good question I am probably gonna be the worst guest you've ever had because no you'd be surprised I'm not reading anything other than like I mean I read scientific literature when I have time to read but um I'm really not I'm not deep in a book or anything right now. I'm kind of well because you have four babies in a company and a job so I've got two kids and uh yeah so really I'm fine. That's all good a little Netflix while I'm if I'm on if I end up on the trip. Oh let's take that what's your what's your Netflix binge oh uh well this week I've been watching there's uh I don't know if I should reveal this but um yes documentary on the lacey peterson story I've kind of diving into that I kind of forgot I mean I I remembered the names but I don't really remember the story and they put out a documentary on that so I've been kind of diving into that and okay pretty crazy stuff.

SPEAKER_00 43:50

I remember that when that happened what I don't remember what year it was though. Do you remember like early two thousands I think. Okay. Yeah I just remember it not being it was just super skeevy and creepy and just crazy people are crazy. Yeah. I have to be in a mood to like watch those. Um I'm currently in a um Emily in Paris selling sunset phase where I'm like I just need brainless right now because two kids just starting middle school and back to sports. I'm like I I need no brain cell action. I get that. I get that so I'll I'll get I'll get to Lacey Peterson later. Yeah when you're ready when you're ready. Yeah exactly I get to homicide later. All right favorite activity since becoming a mom?

SPEAKER_01 44:31

Oh there's so many. And I run with the baby all the time and I love it. Like we I've done it with each of my kids and it's always this time we get one-on-one and I get to get my run in but then I also you know we talk about you know which now the baby's not really talking yet but as they grow up you know and I usually keep them in there till they're like three. So you know then we end up talking about school buses and construction workers and oh yeah the dead squirrel on the road and how did that happen and we'll talk about you know we we end up always having these like cute little one-on-one conversations which I really value now that I have four kids. So I think just taking them for for runs is my favorite.

SPEAKER_00 45:15

I love that that was the saddest day we had two Bobs at one point we had the double which is a bus by the way and then we had a single and the single was the last one we got rid of and I just remember being so so sad getting rid of that because like you said we had so many chats yeah and so many meltdowns and so many things.

SPEAKER_01 45:33

Those are the best yeah the yeah we've got a single and a double team and they are the best that would that would be a bad day for sure. So yeah shameless Bob strollers I guess.

SPEAKER_00 45:41

Yeah well later on it'll be conversations and cars. So this morning our conversation because now both kids go to the same school and we're navigating big brother not necessarily watching out for little sister we were asking the question of what would it take for him to defend his sister and I was like if there was a bobcat attack he's like mom bobcat so I was like all right well I'm just trying to come up with something here so there was a fire like right exactly I'm like what if trying somebody was trying to steal your sister he's like who'd want her I was like okay all right next question so that's what's coming well my mom used to always tell me because I had an older brother and she used to always tell me one day he's gonna be your best friend.

SPEAKER_01 46:20

Just wait one day he's gonna be your best friend and I was always like there's no way but sure enough I I am quite fond of my brother these days so you can always throw that into your arsenal of tools.

SPEAKER_00 46:32

I always tell them I said you two are the only two in this universe that know who how absolutely insane your parents are no one else in the universe understands that in the way that you do except for the two of you. So enjoy that piece all right one piece of advice for moms.

SPEAKER_01 46:47

Yes uh I think my best advice would be it is not selfish to take time for yourself. I think mom guilt is so real. Anytime we try to do anything for ourself we feel bad about it. Um and I think that that just needs to stop. So it's if you want to go for a run, if you want to take a piece of your day that's yours um to do something that there's some kind of self-care, of course I'm gonna advocate for exercise but maybe it's getting your nails done. I don't know maybe there's just something that you need to do for you to kind of keep your sanity I think that you should feel zero guilt in doing that. And and and let's let's get rid of some of this mom guilt. It should not all every burden of every kid's activity and everything going on does not have to fall solely on your shoulders at every second of every day. You need to give yourself that chance. Yes and do something for yourself.

SPEAKER_00 47:34

We need to learn that earlier says the mom of four surviving all right this will go back kind of circle around to the initial question.

SPEAKER_01 47:43

Who's somebody in your space right now that we should know about who who should we be uh stalking next oh good question um you know I would do you know Jenny lacrosse oh she's been on the show has she already I've known her as a student I've known Jenny a very long time she's the bomb okay that's so so she's actually the PT that's that's over oh so you got a good one yes she's amazing so yeah she's she's getting ready to start or looking for faculty positions and um gonna I think hit the research ground running here pretty soon um even more so than she already has and so I think she's definitely someone to look out for she love Jenny.

SPEAKER_00 48:26

Yes you know you you need to go back and listen to that episode because it it we um we talked about I think it was her paper on uh that she was on with birth injuries that was a really good one so yeah Jenny's Jenny's rising star we love her well and it's funny like I've had her um I don't want to say in my back pocket because that doesn't sound right but knowing her before pregnancies has been amazing because it's like yeah like the most amazing person to like shoot a quick text yeah she's so so sweet so smart and I what I appreciate about her most is um she kind of functions like Switzerland where she can speak um research and she can speak clinician yeah um and I think that's such a skill set that's needed right now um and help to bring research more applicably into clinical practice but then also bring those clinical questions back um so we're asking better questions in our research and then everybody's happy so she's already been on the show but I will I will throw out one more person okay looking for actually they're two but they kind of go together.

SPEAKER_01 49:36

So her name is Tanya Nagpal so she is at University of Alberta okay doing really cool pregnancy work exercise and pregnancy work. So definitely stay on the lookout for her stuff she's and actually she has a student right now um who is a visiting scholar with who is here with me for the next eight weeks and her name is Jordan Cox and she is uh gonna get her PhD and then go on to medical school and I think wants to stay in this area. So and and she's also a black woman and so I feel like she is gonna she's like the catalyst to change the world right like she's gonna have a PhD and exercise and pregnancy stuff and then she's gonna go into medicine and represent this conversation so well that we've been talking about today. So I feel like those two they're a team right now um and I'm getting to have a little sampling of being on that team and they're both incredible and I think people to look out for in this space because they're gonna do some things.

SPEAKER_00 50:27

It's such a it's such a cool time to be in this space because I think there's so many more uh women researchers um asking good questions and um I that that's why I I love doing these interviews because I'm like anything I can do to amplify.

SPEAKER_01 50:42

Yeah well this is great. I mean it's so anything we yeah I can do to get this conversation out there I think is so important and so exciting.

SPEAKER_00 50:50

Exactly.

SPEAKER_01 50:50

All right last question what does it mean to you to be an active mom I mean it's kind of my identity I don't even know because I feel like it's it's my personal life and it's my professional life. It's it's everything to me like being active I I I mentioned the mom guilt thing. I I go running every day and I'm completely unapologetic about that. Like my kids even know like that's mom's going for a run. So whether you're coming with me or not uh doesn't really matter uh who who's going or how we're making that happen but it's just like the one thing I unapologetically do for myself every day. And you know once I'm home like the second I walk through the door usually somebody hands me a baby unless they were already with me. And the rest of my day I mean I'll come home from a three mile or three hour training run and my husband will literally hand the baby to me and like like you know what I mean like okay that's but um but you know I think that is my health my mental health my physical health my kids see that it spills into their life they're healthy little kids they're thriving and it just I it's it's personally it's such a huge part of my life and then I love that I can take that into now that I'm in my office I take it into my office and that's basically what I get to do all day is try to kind of get this message even further out there and it's just it's it's it's fun isn't it yeah my whole day every day and I and I couldn't same thing here and we'll bring you along later for the menopause roller coasters. I'm not in any hurry there.

SPEAKER_00 52:23

Let's take our time there it's okay but understand it could be starting early 40s so keep a heads up we'll have that conversation later all right if you guys want to know more about Rachel and her uh app you can check her out bumped up labs no I um Rachel Tineus thanks so much for joining me on the show and thanks for all the work that you're doing in your research. Thank you. Did you enjoy the podcast? If so leave us a five star review on iTunes and tell a friend to do the same. Are you a postpartum mom or postpartum pro wanting to know more about getting back to running after babies? Check out all my free videos on carrypexiano.com. This podcast represents the appearance of Dr. Carrie Pacquiano and her cat. The concept of Dr. Medical Science and it's for 10 minutes of week insult your healthcare professional for any medical questions.