Dr. Tinius Runs the 2023 Boston Marathon – 12 Weeks Pregnant

As many of you have read by now, I ran the Boston Marathon on April 17, 2023 at 12 weeks pregnant. I have run it one other time back in 2015 (notorious for terrible weather- freezing cold, pouring rain, and non-stop headwind). As soon as I finished it in 2015, I almost immediately said well, I want to do that again, but hopefully on a nicer day so I can really enjoy the experience.

As much as I wanted it to be, my 2015 experience was not fun at all (and I know, many of you are thinking, how could running 26.2 miles ever be “fun”?).

2023 was a much different experience. The weather was better (only slightly- but it was about 10 degrees warmer and the rain was on and off versus continuous). But my experience was amplified by something much different than the weather- it was amazing due to the accompaniment of a tiny human growing inside of me. I ran the 2023 Boston marathon 12 weeks pregnant with our 4th child. 

The story of this day really starts well before April. In Fall of 2021, a mere 10 months after having our 3rd child, Tess, I ran the Indianapolis Monumental Marathon. During the summer of 2021, I was fortunate enough to be coerced into running with some people much faster than me (Thanks, Brian & Heather). They were training  for Indy and I caught myself getting more and more involved on training runs with them. Around August, I decided to go for it and jump in the race. It was a great training cycle- and I will admit my first “real” cycle where I followed a plan, and the result was a 20minute PR in the marathon with 3:01:48 at 10 months postpartum. This race lit the fire. I was eager to see what I could do over the next few years. I was 34 years old- which is when many female runners peak. Within a month, I signed up for the Chicago Marathon for the following Fall. It is known for being fast and flat. A year of training later, a PR in every single distance except the marathon (I was running significantly faster than I ran when running track in college!), I was ready for Chicago. However, race day did not go as planned. A head cold the week leading up to it and a lack of pre-race electrolytes/overconsumption of water led to a bad day on the course for me. At mile 2, I knew something was not right. By mile 9, I was experiencing intense muscle cramps. I somehow managed to gut out 17 more miles of cramping and finish with a 3:08; however, my dreams of 2:50s were crushed and I will admit I was pretty devastated. After licking my wounds, I signed up for another marathon 4 weeks later- I was going back to Indy. I knew the sub3 fitness was there. However, 3 more weeks of training and continued symptoms of the lingering head cold that I never let myself recover from landed me hospitalized with double pneumonia and pleurisy. I was unable to run at all for nearly a month. My fitness felt like it was taken back to zero. While the illness was a reminder of what is really important, it was a major setback in the running that had been going so well for me and admittingly had become a big part of my life. 

After recovering, I decided to try and get back into training and see how things went. By late January, my 5k race time was nearly what is was before the illness, and I started to regain my confidence. Boston (which I had already signed up for after my BQ in Indy- you have to sign up WAY in advance) was only 5 months away, and I decided I was going to get back on the horse and at least try to run sub3 at Boston. This would be no easy task as the course is notorious for being a tough one. However, I felt determined once again. Training was underway. I was hitting old splits and times and things were all back on track! That is, until February 19th. I was a few days late on my cycle, which, was not unusual at all. The pneumonia had done such a number on my body that things were often out of whack. I knew when I ovulated and also that the chances of conception were slim to none given a number of details I will spare you. However, I decided to take a pregnancy test to be sure. I had a box that were set to expire, so, why not before I throw them away? Sure enough, there they were: two pink lines. I was in shock. Casey and I had talked about a 4th here and there, but I think as time went by, we thought more and more that our family was complete. If you know Tess, she is the quintessential baby of the family. If you want to see what denial looks like, see the photo. 

As the shock wore off, and a million other emotions (including extreme gratitutde!!), I did have to consider what I should/would do with the Boston Marathon. Right around the time we found out about this pregnancy, the Boston Athletic Association announced a deferral policy for pregnant and postpartum women. This was unprecedented. Normally, if you cannot run for any reason, you cannot defer and you must then requalify and start the whole 2 year process over again. This was an easy out for me, most definitely. Defer my entry, run it in 2024 or 2025. However, my visceral reaction to Casey (my husband) and to my friends was pretty simple, “I am still going to run Boston.” This was my story. And I stuck to it. 

However, I made it clear to Casey that I would only run if my doctor was comfortable with it. At my 8 week OB appointment, I brought Casey with me to discuss running Boston with him. I told Casey, if you sense any hesitation from him at all, I won’t do it. Near the end of the appt, after a confirmed healthy pregnancy, here is how the conversation unfolded: 


 Dr. Gass: Do you have any questions for me?’

Me: Yes, I have one. I am supposed to run the Boston Marathon. Do you think it is okay if I still run it?

Dr. Gass: When is it? 

Me: In 3 weeks

Dr. Gass: I don’t see any problem with it. Go for it. 

Me: (Smiling at Casey)

Dr. Gass: I tell you what, my moms who exercise just do so much better. They are my healthiest pregnancies. 

Medical Student in the room: But Dr. Gass, she said a marathon? I get exercise being good, but a marathon?

Dr. Gass: It is fine. You have been training already, right (to me?)

Me: Yes. I am mostly ready for it. Just have to maintain and run easy between now and then. 

Dr. Gass: I guess just realize it won’t be your fastest or best time, but I see no problem with you doing it. 

Another side note: I am so grateful for Dr. Joseph Gass and his care with my last 2 pregnancies. I am also so grateful for his support of me running Boston. I left that appointment sharing the news with my closest friends that we have a confirmed healthy pregnancy and a doctor who fully supports me running Boston! In a similar vein, a big thank you to my husband Casey for supporting me and all of my crazy ideas in more ways than I can count. I am so lucky! 

I had already done three 20-mile training runs- one just the day before I found out I was pregnant. I had two months to try and maintain fitness. I didn’t have to make gains or get better, just maintain. However, this proved to be far more challenging than I thought it would be. With my first three pregnancies, I had very minimal morning sickness. This pregnancy was a whole new ballgame. I felt pretty sick for about 8 weeks. The best way I can describe it is I felt carsick 24/7. Nothing sounded good to eat. Energy was low. Just getting through the day was a struggle, let alone trying to train for a marathon. Morning weekly runs were fine- a normal 5-6 miles. Many of which I would dry heave on my way out the door, but I would get them done. Each weekend, I would fight the internal battle and make myself hit the pavement for the long run. I remember many nights laying in bed feeling pretty bad at 10-11pm, wondering how in the world I was going to run 18-20 miles at 6am. But I would always just tell myself, you just have to start it. See how you feel. And each weekend, I did just that. And each weekend, I somehow managed to get it done. I also found that eating mini chocolate donuts was my best pre-run pregnancy snack. ? (Side note: Such a BIG thank you to all of my running buddies- Heather, Heather, Cassie, Cort, Kevin, Sam, Brian- to name a few. Without them, I would have never bene able to do any of this!!! I have the best community of runners in my life. I am forever thankful to each of them for the impact they have and continue to have on me as a person and an athlete). 

Two months flew by and the weekend of Boston was quickly upon us. I would be lying if I said there was no part of me that had doubts or fears about running it. I know the research, I know it was not going to cause harm to the baby, but the reality is that this is not a well-studied topic. I could find very little empirical work on marathons during pregnancy. However, given my knowledge about exercise during pregnancy, I felt confident.  I also told myself that if anything doesn’t feel right, I will stop. I also went in with a simple goal: to enjoy the experience and to cross the finish line healthy and with a smile. If you know me, you know I take races way too seriously. I don’t enter a race without a goal of winning or running a time I am happy with. I love them, but they are not taken lightly for me! This was the first race EVER that I decided to go into without any expectation and to just enjoy it. And I am so grateful for this baby affording me the opportunity to experience a race in a totally different way. 

April 15th, 2023 Casey and I headed off to Boston. We went to the EXPO upon arrival. Things were getting real and so exciting. The energy of Boston is really unparalleled. 

We enjoyed dinner together and called it a night. A dinner I vividly remember ordering all the food and basically just staring at it when it arrived. I believe I did eat a large piece of chocolate cake that night, but that was about all I could stomach.  The next day, we went to a Red Sox game which was really fun; the players wore yellow and blue in honor of the runners. 

After the game, we had a dinner with the entire group back at our hotel. I was still really struggling with food and nausea. The thought of lobster and/or clam chowder made me sick, so I didn’t get to enjoy much of what Boston has to offer. However, the night before the race, by some miracle, I was really hungry. We ordered wings, pizza, and pasta, and everything tasted SO good for the first time in weeks. This was an amazing start to the race- to be able to eat!! 

The next morning, I woke up around 5am and ate some oatmeal in the room. I packed bag and met Heather, Brian, and Kevin in the hotel lobby to head to the busses at Boston Commons. If you aren’t familiar, Boston is an out and back course. So, you basically catch a bus near the finish line and they bus you 26 miles out, then you run back! It is a neat concept but also a little eerie. The ride takes nearly an hour, and its hard not to let your mind go to “wait, I have to run this all the way back??”  Bus loading for Wave 1 (which I was in due to my 3:01:48 qualifying time) was 6:45am. And yes, you heard that right! The race for me didn’t start until 10am. But the bus and athletes village is all a process (and most certainly a memory). 

Buses were packed and so we all ended up sitting by different people and made friends and had good conversations along the way. I sat by a girl who was running her first Boston and also hoping to get pregnant soon after Boston. She felt inspired to consider running it next year if she was. ? 

We arrived at athlete’s village in time to use restrooms, change shoes, and do all the things to prepare. At this point, a steady rain had settled in and the forecast was not looking great. The temp was hovering between 45-50 degrees and was manageable. This time is a bit a blur and goes by really fast. While we were there, we heard the elite athletes start and knew the time was coming for our wave to begin.

I was in Wave 1 due to my qualification time, however, I had no intentions to run a wave 1 time. Therefore, I made the decision to start as far back in the wave as possible to make sure I didn’t go out too hard or interfere with anyone else’s race. Once you leave the village, you have about a mile walk to get to the actual start line in Hopkinton, MA. This walk is actually a really fun and exciting part of the race. The energy is high. There are tons of volunteers taking trash in one bag and clothes for donation in another. And right before heading to the start line, I ran into Cort. Out of 30,000 people, what are the odds? We talked and walked to the start line together. 

Before I knew it, I was at the start. I took a moment to strip off a few wet layers and the race began. Deep breath, we got this baby! 

 The race was magic from the start. The crowd support of Boston is unbelievable. It is hard to even articulate or capture in a video, but I did my best to try. At the back of wave 1, they actually have a 10ish minute gap before they start wave 2. This is for the adaptive athletes. I had the privilege to run amongst these amazing humans in early miles. I was among many hearing and visually impaired athletes running with guides. It really was such a testament to how amazing humans are. They inspired me from mile 1. Being at the back of wave 1 was also exceptional in that the course was not jam-packed with runners like it is for basically the rest of the race. I felt I got to have a really unique experience starting here! You can see from the photos, I was never really boxed in or in too much of a crowd. 

Early race miles were fun and easy. I think I smiled a whole lot. I was just taking it in. The Boston Marathon experience is just so neat- you go through each little town and each town SHOWS UP. Marathon Monday is a holiday in Boston. Schools are closed (well, because we had to steal all the buses), businesses shut down- everyone shows up to support the runners. And it shows. While the race as a whole had moments of fatigue or doubt here or there, it was hard to ever feel down when the crowds are constantly rooting for you. I wore a shirt that said “Baby’s first Boston”. The crowd’s reaction to my shirt and the realization that I was running pregnant was so encouraging and invigorating. I was so encouraged by the things people said to me throughout the entire 26.2 miles. Early in the race, I had a girl running next to me who realized I was pregnant. She told me I was amazing and supported me. She then shared that this was her 21st consecutive Boston, and she had 2 young children. She had run 6th months pregnant with her first child and then 6 weeks postpartum with her second. AMAZING!!!!!!!!!!!!!!! We laughed together as she shared the experience of pumping in the porta pot on the way to the start line. What incredible company I found myself with for some early miles. 

Early towns of Ashland, Framingham, Natick were great. I paid careful consideration to fueling and making sure I was taking in plenty of fuel and water along the way. I felt great early. No issues at all. I was acutely aware of some downhill and the quads being fired a bit more than usual, but nothing too bad at all. I tried to ignore my pace and not worry much about it, but every time I looked, I was encouraged to see sub-8 miles one after another. I really felt great! I high-fived so many kids and just soaked in the experience at every moment. 

 Around halfway is Wellesley- an all girls college town notorious for the “scream tunnel” and for giving away free kisses to runners. This was a very memorable timepoint! There is also something really exciting about passing that halfway point. Passed halfway, LETS DO THIS!! 

Three miles after Wellesley, signs for Newton start to appear. This is where all the runners know- the Newton Hills have arrived. Miles 16-21 are notoriously hilly, which ends with Heartbreak Hill at Mile 21. I was very mentally prepared for Newton. I was prepared to slow down and relax on the hills. However, I felt great throughout them and was able to maintain my pace pretty well through them. You do see many runners pulling off the side. I encouraged every single one I could. We have all been there. The cramps in Chicago gave me an entire new appreciation for what it feels like when it goes wrong. Crowd support continues to really pull you through here. So many athletes supporting and encouraging each other. Another testament to how amazing humans are. One of the many things I love so much about being a runner.

After Heartbreak, the mantra becomes “its all downhill from here”. While this is technically true, this is also a point where your quads start to scream a bit and things get tough in the marathon. I will say for me, not racing this one, these became some of my favorite miles. I was actually passing a lot of people, crowds were building and building as we approached the big city of Boston. The crowds know this is where we need them and let me say again, THEY SHOW UP! During the last 5 miles or so, I experienced several downpours of rain, but at that point, no one really cares! I just kept plugging along, pacing consistent, feeling awesome. I couldn’t help but to start letting myself really think about this accomplishment. The fact that this unborn baby and I did this together. I pictured this child sharing a “fun fact” about themselves in Kindergarten. “My fun fact is I have run the Boston Marathon”. This was a special bond we were creating together, and in the late miles, I found myself feeling really emotional about this. This was SPECIAL. And I let all of that emotion sink in. I cried several times during the late miles. Not because it was hard or hurting, I felt great. But because I was just so proud of us.  

1 mile to go- The big legendary CITGO sign. The energy from here in was ELECTRIC. I cannot even fully put it into words. The last mile I felt amazing- in fact, it was my fastest mile. My smile was ear to ear and I will admit tears of gratitude for what my body had just done streamed down my face. The last segment of the race, the only turns, “Right on Hereford, Left on Boyleston”.  

You have two small turns as you head toward the finish on Boyleston Street. The street is lined with bleachers and thousands of spectators. There are announcers and the finish line awaits. Crossing that finish line (time: 3:30:16, pace: 7:57 per my Garmin) on April 17th was one of the most fun and memorable moments of my life (and surprised myself with another Boston Qualifying Time even while pregnant)! My face says it all. Baby, we did it. I am so proud of us. And I hope we can inspire new and expectant moms everywhere that pregnancy is not an illness or something that has to limit you. We were meant to do this! Do you have to make adjustments? Yes. Do you have to taper your own expectations? Yes. It is harder? YES! But that doesn’t mean your answer to whether or not you can do it should be NO. 

So what is the takeaway? The Boston Marathon is an INCREDIBLE experience- the crowds, the volunteers- they are second to none. A major thank you to everyone who makes this race so special. To runners out there, I highly recommend running it for fun at least once. I am so thankful for being able to enjoy the experience and really take it all in (hard to do when racing). To the moms reading this, maybe the marathon isn’t something you want to do. But what is your marathon? What is the thing you think “there’s no way I could do that”? 

But what if you can?